Yang Hui-Wen, Huang Yu-Chieh, Chiang Kuan-Wei, Wen Yuan-Liang, To Sheng-Yin, Kao Senyeong, Kao Li-Ting
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Nat Sci Sleep. 2024 Dec 25;16:2231-2241. doi: 10.2147/NSS.S491544. eCollection 2024.
Benzodiazepine receptor agonists (BZRAs), including benzodiazepines (BZDs) and Z drugs, are widely prescribed for anxiety and sleep. Therefore, issues of tolerance, dependence and adverse effects are of concern. Recent studies suggested a potential link between BZRAs and hearing problems. However, the actual relationship was still unclear. Accordingly, this study aims to investigate the actual association between BZRA use and risk of sudden sensorineural hearing loss (SSNHL) using population data.
This study used the Taiwan Longitudinal Health Insurance Database. 137,277 BZRA users and 1,328,554 nonusers were identified for relevant analyses. We used cohort design with inverse-probability treatment weighting (IPTW) strategy to balance the baseline differences of demographics and comorbidities between two groups. The 5-year incidence of SSNHL was followed. Cox proportional-hazard regression analyses were used to estimate the hazard ratios (HRs).
BZRA users showed an increased 5-year SSNHL risk (adjusted HR: 1.244) after weighting. Subgroup and sensitivity analyses produced consistent results. Notably, SSNHL risk was higher among young BZRA users (adjusted HR: 1.397). BZRA users had the highest SSNHL risk in the first year (adjusted HR: 2.037) after IPTW.
BZRA use elevated the risk of SSNHL, particularly in young adults and in the first year. This emphasises the importance for physicians and policymakers should be aware of the potential hearing difficulties among BZRA users and take necessary examinations.
苯二氮䓬受体激动剂（BZRAs），包括苯二氮䓬类药物（BZDs）和Z类药物，被广泛用于治疗焦虑和睡眠问题。因此，耐受性、依赖性和不良反应等问题备受关注。最近的研究表明BZRAs与听力问题之间可能存在联系。然而，实际关系仍不明确。因此，本研究旨在利用人群数据调查BZRA使用与突发性感音神经性听力损失（SSNHL）风险之间的实际关联。
本研究使用了台湾纵向健康保险数据库。确定了137277名BZRA使用者和1328554名非使用者进行相关分析。我们采用队列设计和逆概率治疗加权（IPTW）策略来平衡两组人群在人口统计学和合并症方面的基线差异。随访了SSNHL的5年发病率。使用Cox比例风险回归分析来估计风险比（HRs）。
加权后，BZRA使用者的5年SSNHL风险增加（调整后HR：1.244）。亚组分析和敏感性分析得出了一致的结果。值得注意的是，年轻BZRA使用者的SSNHL风险更高（调整后HR：1.397）。在IPTW后的第一年，BZRA使用者的SSNHL风险最高（调整后HR：2.037）。
使用BZRA会增加SSNHL的风险，尤其是在年轻人中以及在使用的第一年。这强调了医生和政策制定者应意识到BZRA使用者中潜在的听力问题并进行必要检查的重要性。
