Uyku apnesi, tinnitus ve işitme kaybı arasında bir ilişki var mı?

Öz

ÖZ Amaç: Kronik hipoksi, tıkayıcı uyku apnesi (TUA) olan hastalarda işitme sisteminde işlev bozukluğuna yol açabileceği gibi, işitsel işlev bozukluğu da TUA'yı kötüleştirerek bir kısır döngü oluşturabilir. Bu çalışmanın amacı TUA'da tinnitus ve işitme kaybını araştırmaktı. Gereç ve Yöntemler: Çalışmaya toplam 147 hasta dahil edildi. Polisomnografi (PSG) sonrası apne-hipopne indeksi (AHİ) ≥5 olan hastalar TUA grubuna, AHI<5 olanlar ise basit horlama grubuna dahil edildi. TUA hastaları hafif, orta ve şiddetli TUA alt grubu olarak üç alt gruba ayrıldı. Tüm katılımcılara standart saf ses odyometri (SSO) (0,5, 1, 2, 4 kHz), yüksek frekans odyometri (8, 10, 12 kHz) ve Tinnitus Handikap Envanteri (THE) anketi uygulandı. Çalışma grupları arasında odyolojik sonuçlar ve THE skorları karşılaştırıldı. Bulgular: TUA grubu 46 (%36,5) kadın, 80 (%63,5) erkek olmak üzere toplam 126 hastadan oluşmaktaydı. Basit horlama grubuna 13 (%61,9) kadın, 8 (%38,1) erkek olmak üzere toplam 21 hasta dahil edildi. Ortalama vücut kitle indeksi, test edilen tüm frekanslarda işitme eşikleri ve THE skorları TUA grubunda anlamlı olarak yüksekti (sırasıyla, p=0,024, p=0,001, p=0,015, p=0,017, p=0,039, p=0,002 ve p=0,001). THE skoru, AHİ ile istatistiksel olarak anlamlı ve pozitif korelasyon gösterdi (p=0,004; r=0,252). Ortalama THE skoru hafif TUA alt grubunda orta ve şiddetli TUA alt gruplarına göre anlamlı olarak düşüktü (p=0,019). Sonuçlar: TUA, işitme kaybı ve kulak çınlaması ya komorbiditelerdir ya da etiyolojik olarak ilişkilidir. Basit horlayanlara kıyasla TUA hastalarında işitme bozukluğu prevalansının daha yüksek olması, horlama sesinden ziyade aralıklı gece hipoksisinin işitme bozukluğunda daha fazla rol oynadığını düşündürmektedir.

Anahtar Kelimeler

• Tinnitus.
• İşitme kaybı
• Obstrüktif uyku apnesi
• Polisomnografi

Is there a relation between sleep apnea, tinnitus, and hearing Loss?

Öz

Abstract Background Chronic hypoxia may lead to auditory dysfunction in patients with obstructive sleep apnea (OSA), and this dysfunction may worsen OSA, creating a vicious circle. The aim of this study was to investigate tinnitus and hearing loss in OSA patients. Methods A total of 147 patients were included in the study. After polysomnography (PSG), the patients with an apnea-hypopnea index (AHI) ≥ 5 were included in OSA group, and the ones with an AHI<5 were included in the simple snoring group. The OSA patients were divided into three OSA severity subgroups as mild, moderate and severe OSA subgroups. Standard pure-tone audiometry (PTA) (0.5, 1, 2, 4 kHz) and high-frequency audiometry (8, 10, 12 kHz) were performed, and Tinnitus Handicap Inventory (THI) was applied to all participants. Audiological results and THI scores were compared among the study groups. Results The OSA group consisted of 46 (36.5%) female, 80 (63.5%) male, and a total of 126 patients. The simple snoring group included 13 (61.9%) female, 8 (38.1%) male, and a total of 21 patients. The mean body mass index, hearing thresholds in all tested frequencies and THI scores were significantly higher in OSA group (p=0.024, p=0.001, p=0.015, p=0.017, p=0.039, p=0.002 and p=0.001, respectively). THI score showed a statistically significant and positive correlation with the AHI (p=0.004; r=0.252). The mean THI score was significantly lower in mild OSAS subgroup compared to moderate and severe OSA subgroups (p=0.019). Conclusions OSA, hearing impairment and tinnitus are either comorbidities or related etiologically. Higher prevalence of hearing impairment in OSA patients compared to simple snorers suggests that intermittent nocturnal hypoxia, rather than sound of snoring plays a role in hearing impairment.

Anahtar Kelimeler

• Hearing loss
• Obstructive sleep apnea
• Polysomnography
• Tinnitus.
• İşitme kaybı
• Obstrüktif uyku apnesi
• Polisomnografi

Kaynakça

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