Association between obstructive sleep apnea and sudden sensorineural hearing loss: A population-based case-control study

Objective: To examine the putative association between obstructive sleep apnea (OSA) and sudden sensorineural hearing loss (SSNHL) using a nationwide population-based data set. Obstructive sleep apnea has been associated with generalized inflammation and nervousendocrine, cardiovascular, and other systemic biophysiologic phenomena. However, to our knowledge, no investigations have been conducted using large data sets to examine the association between OSA and auditory disorders. Design: Case-control study. Participants:Weidentified 3192 patients diagnosed with SSNHL from the Taiwan Longitudinal Health Insurance Database as the study group and randomly extracted the data of 15 960 subjects matched by sex, age and year of first SSNHL diagnosis as controls. Main Outcome Measures: Cases of OSA were identified by having been diagnosed as OSA prior to the index date of SSNHL diagnosis. Conditional logistic regression matched on age group and sex was used to assess the possible association between SSNHL and OSA among the sampled patients. Results: Of 19 152 patients, 1.2% had OSA diagnoses prior to the index date; OSA was diagnosed in 1.7% of the SSNHL group and 1.2% of the controls. After adjusting for sociodemographic characteristics and comorbid medical disorders, we found that male patients with SSNHL were more likely to have prior OSA than controls (odds ratio, 1.48; 95% CI, 1.02-2.16) (P=.04). No such association was found among female patients. Conclusions: Male patients with SSNHL had a higher proportion of prior OSA than non-SSNHL-diagnosed controls; no such association was found among female patients. Further study will be needed to confirm our findings, explore the underlying pathomechanisms, and investigate the difference between sexes.