Association between obstructive sleep apnea and hearing loss among a cohort of emergency responders

Purpose We sought to determine whether risk for obstructive sleep apnea (OSA) and OSA severity are associated with sensorineural hearing loss (HL) among emergency responders. Methods We evaluated two independent variables: OSA risk, categorized using Berlin Questionnaire criteria, and OSA severity, determined by polysomnogram (PSG) apnea-hypopnea indices (AHI). Logistic regression, adjusted for confounders, was used to assess the association between each OSA exposure and the outcome of HL among a cohort of emergency responders. Results The study cohort included 13,909 participants with audiometric data, 12,834 with Berlin Questionnaire data, and 4,024 participants with PSG data. Those with high and very high OSA risk showed significantly elevated odds of HL at speech frequencies, with adjusted odds ratios (OR) of 1.34 (95% CI: 1.14-1.58; p < 0.01) and 1.56 (95% CI: 1.30-1.88; p < 0.01), respectively, compared to those with no OSA risk. Combining very high and high risk validated category groupings for the Berlin, those individuals had 41% higher odds for HL over speech frequencies compared to those with no risk (OR = 1.41; 95% CI = 1.21-1.65; p < 0.01). Those with PSG-determined severe OSA had higher adjusted odds of HL at speech frequencies than those with no OSA; OR of 1.33 (95% CI: 1.00-1.78; p = 0.04). Conclusions We report a significant association between OSA and HL among emergency responders. Our results underscore a need for an analysis of the longitudinal association between OSA and HL to identify potential causality and for integrated health interventions that target both conditions in this responder population.