Brazilian Journal of Otorhinolaryngology (Sep 2025)

Association of tinnitus with obstructive sleep apnea and rapid eye movement-related obstructive sleep apnea in similar hearing threshold groups

  • Sun Choi,
  • Seok Hyun Park,
  • Su Yeon Kim,
  • Su Kyoung Park,
  • Sang Chul Park,
  • Jiwon Chang

DOI
https://doi.org/10.1016/j.bjorl.2025.101661
Journal volume & issue
Vol. 91, no. 5
p. 101661

Abstract

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Objectives: Obstructive sleep apnea, a multisystem disease, affects cochlear and vestibular functions due to chronic intermittent hypoxia and recurrent oxygen desaturation. During rapid eye movement sleep, the muscle tone of the upper airway decreases more, and the cardiovascular complication risk is higher than that during non-rapid eye movement sleep. We analyzed whether tinnitus was associated with obstructive sleep apnea and rapid eye movement-related obstructive sleep apnea in patients with similar hearing thresholds. Methods: We evaluated patients with obstructive sleep apnea without (24 patients; group 1) and with (27 patients; group 2) tinnitus. All participants underwent pure-tone audiometry, tinnitus tests, polysomnography, and sleep questionnaires. Results: The sleep efficiency (86.23% ± 10.38% vs. 81.27% ± 8.10%) and Epworth Sleepiness Scale (8.50 ± 4.31 vs. 5.15 ± 2.82) values were higher in group 2 versus group 1. In patients with rapid eye movement-related obstructive sleep apnea, the sleep efficiency value was higher in group 2 (90.55% ± 4.61%) versus group 1 (78.13% ± 11.70%). However, in patients with obstructive sleep apnea and rapid eye movement-related obstructive sleep apnea, medication use that might affect sleep was higher in group 2 (44.4% and 54.4%, respectively) versus group 1 (16.7% and 28.6%, respectively). Conclusions: We evaluated the relationship between tinnitus and obstructive sleep apnea or rapid eye movement-related obstructive sleep apnea in groups with similar hearing thresholds for the first time. The presence of tinnitus in patients with obstructive sleep apnea with similar hearing thresholds was more closely related to subjective parameters than to objective parameters. Patients with tinnitus had poorer sleep quality than those without tinnitus. Level of evidence: 4.

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