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European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 6, pp 1419–1424 | Cite as

Audiologic profile of OSAS and simple snoring patients: the effect of chronic nocturnal intermittent hypoxia on auditory function

  • Francesco Martines
  • Antonella Ballacchino
  • Federico Sireci
  • Marianna Mucia
  • Eleonora La Mattina
  • Serena Rizzo
  • Pietro SalvagoEmail author
Otology

Abstract

The objective of this work was to study the effect of nocturnal intermittent hypoxia on auditory function of simple snoring patients and subjects affected by OSAS; we compared the audiologic profile with the severity of OSAS to detect early signs of cochlear damage. One hundred-sixty patients underwent overnight polysomnography, micro-otoscopy, multi-frequency audiometry, acufenometry, TEOAE recording and d-ROMs test. All subjects were divided in four groups, based on presence/absence of AHI (simple snoring without OSAS, mild OSAS, moderate OSAS, severe OSAS). Sixty (37.5 %) patients were not affected by OSAS, 58 (36.25 %) presented a mild OSAS, 18 (11.25 %) a moderate OSAS and 24 (15 %) a severe OSAS; the 57.14 % of moderate to severe OSAS suffered from tinnitus with respect to the 31.03 % of mild OSAS (P = 0.024). A higher percentage (41.66 %) of hearing loss was found among individuals with moderate to severe degree of OSAS (P < 0.0001). All groups were characterized by a mean hearing threshold <25 dB HL for 0.25–3 kHz frequencies and a progressive decrease in hearing sensitivity, particularly for 6–16 kHz frequencies (P < 0.05). The analysis of otoacoustic emissions SNR mean values evidenced a significant difference between simple snoring and severe OSAS individuals for 3 and 4 kHz frequencies (P < 0.05). d-ROM levels resulted higher in patients with severe OSAS with respect to simple snoring subjects (P = 0.004). Our data underline the key role of chronic nocturnal intermittent hypoxia in the development of an early cochlear damage and a more marked high-frequency hearing loss in case of severe OSAS (P < 0.05).

Keywords

OSAS Hearing loss Tinnitus Multi-frequency audiometry TEOAE 

Notes

Compliance with the ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Newman AB, Nieto FJ, Guidry U, Lind BK, Redline S, Pickering TG, Quan SF (2001) Relation of sleep-disordered breathing to Cardiovascular Disease Risk. The Sleep Heart Health Study. Am J Epidemiology 154:50–59CrossRefGoogle Scholar
  2. 2.
    Bradley TD, Floras JS (2009) Obstructive sleep apnoea and its cardiovascular consequences. Lancet 373:82–93CrossRefPubMedGoogle Scholar
  3. 3.
    Fletcher EC (1995) The relationship between systemic hypertension and obstructive sleep apnea: facts and theory. Am J Med 98:118–128CrossRefPubMedGoogle Scholar
  4. 4.
    Nazzaro P, Schirosi G, Clemente R, Battista L, Serio G, Boniello E, Carratù PL, Lacedonia D, Federico F, Resta O (2008) Severe obstructive sleep apnoea exacerbates the microvascular impairment in very mild hypertensives. Eur J Clin Invest 38:766–773CrossRefPubMedGoogle Scholar
  5. 5.
    Gozal D, Kheirandish-Gozal L (2008) Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more. Am J Respir Crit Care Med 177:369–375CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Broderick M, Guilleminault C (2008) Neurological aspects of obstructive sleep apnea. Ann NY Acad Sci 1142:44–57CrossRefPubMedGoogle Scholar
  7. 7.
    Dyken ME, Im KB (2009) Obstructive sleep apnea and stroke. Chest 136:1668–1677CrossRefPubMedGoogle Scholar
  8. 8.
    Colrain IM, Campbell KB (2007) The use of evoked potentials in sleep research. Sleep Med Rev 11:277–293CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Gupta PP, Sood S, Atreja A, Agarwal D (2008) Evaluation of brain stem auditory evoked potentials in stable patients with chronic obstructive pulmonary disease. Ann Thor Med 3:128–134CrossRefGoogle Scholar
  10. 10.
    Ni D (1991) Auditory brain-stem response in obstructive sleep apnea syndrome. Zhonghua Er Bi Yan Hou Ke Za Zhi 26:284–286PubMedGoogle Scholar
  11. 11.
    Lazarini PR, Camargo AC (2006) Idiopathic sudden sensorineural hearing loss: etiopathogenic aspects. Braz J Otorhinolaryngol 72:554–561CrossRefPubMedGoogle Scholar
  12. 12.
    Muchnik C, Rubel Y, Zohar Y, Hildesheimer M (1995) Auditory brainstem response in obstructive sleep apnea patients. J Basic Clin Physiol Pharmacol 6:139–148CrossRefPubMedGoogle Scholar
  13. 13.
    Kotterba S, Rasche K (1996) Acoustic evoked potentials (AEP) in obstructive sleep apnea syndrome. Pneumologie 50:924–926PubMedGoogle Scholar
  14. 14.
    Atiş S, Ozge A, Sevim S (2001) The brainstem auditory evoked potential abnormalities in severe chronic obstructive pulmonary disease. Respirology 6:225–229CrossRefPubMedGoogle Scholar
  15. 15.
    Casale M, Vesperini E, Potena M, Pappacena M, Bressi F, Baptista PJ, Salvinelli F (2012) Is obstructive sleep apnea syndrome a risk factor for auditory pathway? Sleep Breath 16:413–417CrossRefPubMedGoogle Scholar
  16. 16.
    American Academy of Sleep Medicine (2005) International classification of sleep disorders. Diagnostic and coding manual, 2nd edn. American Academy of Sleep Medicine, WestchesterGoogle Scholar
  17. 17.
    Martines F, Bentivegna D, Martines E, Sciacca V, Martinciglio G (2010) Assessing audiological, pathophysiological and psychological variables in tinnitus patients with or without hearing loss. Eur Arch Otorhinolaryngol 267:1685–1693CrossRefPubMedGoogle Scholar
  18. 18.
    Martines F, Bentivegna D, Martines E, Sciacca V, Martinciglio G (2010) Characteristics of tinnitus with or without hearing loss: clinical observations in Sicilian tinnitus patients. Auris Nasus Larynx 37:685–693CrossRefPubMedGoogle Scholar
  19. 19.
    Martines F, Bentivegna D, Di Piazza F, Martines E, Sciacca V, Martinciglio G (2010) Investigation of tinnitus patients in Italy: clinical and audiological characteristics. Int J Otolaryngol. doi: 10.1155/2010/265861 PubMedPubMedCentralGoogle Scholar
  20. 20.
    Martines F, Sireci F, Cannizzaro E, Costanzo R, Martines E, Mucia M, Plescia F, Salvago P (2014) Clinical observations and risk factors for tinnitus in a Sicilian cohort. Eur Arch Otorhinolaryngol. doi: 10.1007/s00405-014-3275-0 Google Scholar
  21. 21.
    Simiakakis M, Kapsimalis F, Chaligiannis E, Loukides S, Sitaras N, Alchanatis M (2012) Lack of effect of sleep apnea on oxidative stress in obstructive sleep apnea syndrome (OSAS) patients. PLoS One 7:e39172CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Palmieri B, Sblendorio V (2007) Oxidative stress tests: overview on reliability and use. Part II. Eur Rev Med Pharmacol Sci 11:383–399PubMedGoogle Scholar
  23. 23.
    Broderick M, Guilleminault C (2008) Neurological aspects of obstructive sleep apnea. Ann NY Acad Sci 1142:44–57CrossRefPubMedGoogle Scholar
  24. 24.
    Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112:2660–2667CrossRefPubMedGoogle Scholar
  25. 25.
    Yamauchi M, Kimura H (2008) Oxidative stress in obstructive sleep apnea: putative pathways to the cardiovascular complications. Antioxid Redox Signal 10:755–768CrossRefPubMedGoogle Scholar
  26. 26.
    Sha SH, Taylor R, Forge A, Schacht J (2001) Differential vulnerability of basal and apical hair cells is based on intrinsic susceptibility to free radicals. Hear Res 155:1–8CrossRefPubMedGoogle Scholar
  27. 27.
    Sheu JJ, Wu CS, Lin HC (2012) Association between obstructive sleep apnea and sudden sensorineural hearing loss: a population-based case-control study. Arch Otolaryngol Head Neck Surg 138:55–59CrossRefPubMedGoogle Scholar
  28. 28.
    Nakayama M, Kabaya K (2013) Obstructive sleep apnea syndrome as a novel cause for Ménière’s disease. Curr Opin Otolaryngol Head Neck Surg 21:503–508CrossRefPubMedGoogle Scholar
  29. 29.
    Kilic T, Karatas E, Toplu Y, Koc A, Bulam N, Kaya O (2014) Evaluation of auditory functions in patients with asthma. Eur Rev Med Pharmacol Sci 18:2615–2620PubMedGoogle Scholar
  30. 30.
    She WD, Zhang Q, Chen F, Jiang P, Wang J (2004) Peri-uvulopalatopharyng oplasty otoacoustic emissions in patients with obstructive sleep apnea-hypopnea syndrome. Zhonghua Er Bi Yan Hou Ke Za Zhi 39:48–51PubMedGoogle Scholar
  31. 31.
    Xu Y, He X, Cai Q, Liang X, Zheng Y, Zhang S, Ji s (2008) Influence of childhood obstructive sleep apnea-hypopnea syndrome on hearing. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 22:436–438PubMedGoogle Scholar
  32. 32.
    Yamauchi M, Nakano H, Maekawa J, Okamoto Y, Ohnishi Y, Suzuki T, Kimura H (2005) Oxidative stress in obstructive sleep apnea. Chest 127:1674–1679CrossRefPubMedGoogle Scholar
  33. 33.
    Schulz R, Mahmoudi S, Hattar K, Sibelius U, Olschewski H, Mayer K, Seeger W, Grimminger F (2000) Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 162:566–570CrossRefPubMedGoogle Scholar
  34. 34.
    Svatikova A, Wolk R, Lerman LO, Juncos LA, Greene EL, McConnell JP, Somers VK (2005) Oxidative stress in obstructive sleep apnoea. Eur Heart J 26:2435–2439CrossRefPubMedGoogle Scholar
  35. 35.
    Wali SO, Bahammam AS, Massaeli H, Pierce GN, Iliskovic N, Singal PK, Kryger MH (1998) Susceptibility of LDL to oxidative stress in obstructive sleep apnea. Sleep 21:290–296PubMedGoogle Scholar
  36. 36.
    Patt BT, Jarjoura D, Haddad DN, Sen CK, Roy S, Flavahan S, Khayat RN (2010) Endothelial dysfunction in the microcirculation of patients with obstructive sleep apnea. Am J Respir Crit Care Med 182:1540–1545CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Shi A (2011) Physiopathology of the cochlear microcirculation. Hear Res 282:10–24CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Francesco Martines
    • 1
  • Antonella Ballacchino
    • 2
  • Federico Sireci
    • 1
  • Marianna Mucia
    • 1
    • 2
  • Eleonora La Mattina
    • 2
  • Serena Rizzo
    • 2
  • Pietro Salvago
    • 1
    • 3
    Email author
  1. 1.Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Sezione di OtorinolaringoiatriaUniversità degli Studi di PalermoPalermoItaly
  2. 2.Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Sezione di AudiologiaUniversità degli Studi di PalermoPalermoItaly
  3. 3.PalermoItaly

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