Obstructive sleep apnea (OSA) is characterized by recurrent episodes of upper airway obstruction during sleep, which is manifested by apnea or hypopnea. Decreased blood oxygen saturation, changes in heart rate, fluctuations in brain perfusion, changes in intracranial pressure, snoring and vibration are factors that may potentially affect hearing in patients with OSA. The aim of the present study was to test the hypothesis that hearing is affected in OSA. 43 males aged 34-74 years (mean 48.2) with suspected sleep-disordered breathing without other comorbidity or medication that may affect sleep or hearing were included. Nocturnal polysomnography, pure tone audiometry (PTA),
transient evoked otoacoustic emissions (TEOAE) and brainstem
auditory evoked potentials (BAEP) were evaluated. The severity
of OSA was indicated by the number of apneas and hypopneas per hour of sleep (apnoe/hypopnoe index – AHI). OSA (AHI≥5) was detected in 28 patients by polysomnography. Mild OSA (AHI 5 -15) was confirmed in 11 patients, severe OSA (AHI≥30) in 17 patients. Simple s
noring (AHI<5) was diagnosed in 15 males. In patients suffering from severe OSA, tone audiometry demonstrated higher auditory threshold at frequencies of 4000 and 8000 Hz than in patients with AHI<15
(p<0.005). Auditory threshold values correlated with age in all groups. At a frequency of 8000 Hz, auditory threshold additionally correlated with BMI, AHI, oxygen desaturation index and decreased oxygen saturation. No differences were detected in TEOAE and BAEP between subjects with OSA and snoring. PTA and TEOAE decreased with increasing age. The present results show decreased perception of high frequency sound in severe OSA.
In order to evaluate the influence of the respiratory cycle on the EEG, we compared the power spectral analysis of the EEG performed by fast Fourier transformation during inspirium and exspirium in 10 healthy subjects. The measurement was performed during spontaneous breathing and then during eupnoe (0.25 Hz), bradypnoe (0.1 Hz) and tachypnoe (0.5 Hz) paced by a metronome. In the course of spontaneous breathing and bradypnoe, there was an increase in the delta power and in the total power in the anterior temporal region during inspirium in comparison with exspirium. The eupnoe was characterized by an inspiratory decrease in the delta power in the parietal region and in the total power in the frontal region. The tachypnoe resulted in a decrease of the beta power in the central region and a decrease of the theta power in the posterior temporal and in the occipital region during inspirium. In comparison of the EEG in eupnoe, bradypnoe and tachypnoe, a decrease of spectral power of all spectral bands was found except for delta during faster breathing frequencies and vice versa with a significant difference which wa
s found mostly between bradypnoe and tachypnoe, less frequently between eupnoe and tachypnoe.