{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:28:24Z","timestamp":1787801304911,"version":"build-2784847793"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["75D301-22-R-72142"],"award-info":[{"award-number":["75D301-22-R-72142"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["75D301-22-R-72244"],"award-info":[{"award-number":["75D301-22-R-72244"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>We sought to determine whether risk for obstructive sleep apnea (OSA) and OSA severity are associated with sensorineural hearing loss (HL) among emergency responders.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>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\u20131.58; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and 1.56 (95% CI: 1.30\u20131.88; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), 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\u2009=\u20091.41; 95% CI\u2009=\u20091.21\u20131.65; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). 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; <jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11325-025-03338-8","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T15:33:55Z","timestamp":1746545635000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between obstructive sleep apnea and hearing loss among a cohort of emergency responders"],"prefix":"10.1007","volume":"29","author":[{"given":"David W.","family":"Appel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2682-7543","authenticated-orcid":false,"given":"David G.","family":"Goldfarb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Zeig-Owens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Flamme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Prezant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"3338_CR1","doi-asserted-by":"crossref","unstructured":"Kheirandish-Gozal L, Gozal D (2019) Obstructive sleep apnea and inflammation: proof of concept based on two illustrative cytokines. 20(3):459","DOI":"10.3390\/ijms20030459"},{"issue":"1","key":"3338_CR2","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1053\/smrv.2002.0261","volume":"7","author":"L Lavie","year":"2003","unstructured":"Lavie L (2003) Obstructive sleep Apnoea syndrome\u2013an oxidative stress disorder. Sleep Med Rev 7(1):35\u201351","journal-title":"Sleep Med Rev"},{"issue":"8","key":"3338_CR3","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1161\/01.CIR.0000052627.99976.18","volume":"107","author":"T Yokoe","year":"2003","unstructured":"Yokoe T, Minoguchi K, Matsuo H et al (2003) Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 107(8):1129\u20131134","journal-title":"Circulation"},{"key":"3338_CR4","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.sleep.2019.01.044","volume":"62","author":"JB Kim","year":"2019","unstructured":"Kim JB, Seo BS, Kim JH (2019) Effect of arousal on sympathetic overactivity in patients with obstructive sleep apnea. Sleep Med 62:86\u201391","journal-title":"Sleep Med"},{"issue":"4","key":"3338_CR5","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1172\/JCI118235","volume":"96","author":"VK Somers","year":"1995","unstructured":"Somers VK, Dyken ME, Clary MP, Abboud FM (1995) Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 96(4):1897\u20131904","journal-title":"J Clin Invest"},{"issue":"2","key":"3338_CR6","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1164\/ajrccm.152.2.7633695","volume":"152","author":"MT Naughton","year":"1995","unstructured":"Naughton MT, Benard DC, Liu PP, Rutherford R, Rankin F, Bradley TD (1995) Effects of nasal CPAP on sympathetic activity in patients with heart failure and central sleep apnea. Am J Respir Crit Care Med 152(2):473\u2013479","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"3338_CR7","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1001\/archoto.2011.227","volume":"138","author":"JJ Sheu","year":"2012","unstructured":"Sheu JJ, Wu CS, Lin HC (2012) Association between obstructive sleep apnea and sudden sensorineural hearing loss: a population-based case-control study. Arch Otolaryngol Head Neck Surg 138(1):55\u201359","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"1","key":"3338_CR8","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1177\/0194599810390859","volume":"144","author":"JH Hwang","year":"2011","unstructured":"Hwang JH, Chen JC, Hsu CJ, Liu TC (2011) Association of obstructive sleep apnea and auditory dysfunctions in older subjects. Otolaryngol Head Neck Surg 144(1):114\u2013119","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"3338_CR9","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1177\/01945998221120777","volume":"169","author":"N Kasemsuk","year":"2023","unstructured":"Kasemsuk N, Chayopasakul V, Banhiran W et al (2023) Obstructive sleep apnea and sensorineural hearing loss: A systematic review and Meta-analysis. Otolaryngol Head Neck Surg 169(2):201\u2013209","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"5","key":"3338_CR10","doi-asserted-by":"publisher","first-page":"719","DOI":"10.5664\/jcsm.5804","volume":"12","author":"A Chopra","year":"2016","unstructured":"Chopra A, Jung M, Kaplan RC et al (2016) Sleep apnea is associated with hearing impairment: the Hispanic community health study\/study of Latinos. J Clin Sleep Med 12(5):719\u2013726","journal-title":"J Clin Sleep Med"},{"issue":"7","key":"3338_CR11","doi-asserted-by":"publisher","first-page":"485","DOI":"10.7326\/0003-4819-131-7-199910050-00002","volume":"131","author":"NC Netzer","year":"1999","unstructured":"Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131(7):485\u2013491","journal-title":"Ann Intern Med"},{"key":"3338_CR12","unstructured":"Centers for Disease Control and Prevention World Trade Center Health Program What conditions are covered by the Program? 2022. Located at: https:\/\/www.cdc.gov\/wtc\/pdfs\/coveredConditions\/WTCHP_CoveredConditions_ENG-508.pdf\u200b."},{"key":"3338_CR13","unstructured":"American Academy of Sleep Medicine AASM releases updated version of scoring manual. https:\/\/aasm.org\/aasm-releases-updated-version-scoring-manual\/"},{"issue":"4","key":"3338_CR14","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1044\/jshd.2404.330","volume":"24","author":"R Carhart","year":"1959","unstructured":"Carhart R, Jerger JF (1959) Preferred method for clinical determination of Pure-Tone thresholds. J Speech Hear Disorders 24(4):330\u2013345","journal-title":"J Speech Hear Disorders"},{"issue":"12","key":"3338_CR15","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1097\/JOM.0000000000001717","volume":"61","author":"GA Flamme","year":"2019","unstructured":"Flamme GA, Goldfarb DG, Zeig-Owens R et al (2019) Hearing loss among world trade center firefighters and emergency medical service workers. J Occup Environ Med 61(12):996\u20131003","journal-title":"J Occup Environ Med"},{"issue":"10278","key":"3338_CR16","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/S0140-6736(21)00516-X","volume":"397","author":"GBD 2019 Hearing Loss Collaborators","year":"2021","unstructured":"GBD 2019 Hearing Loss Collaborators (2021) Hearing loss prevalence and years lived with disability, 1990\u20132019: findings from the global burden of disease study 2019. Lancet 397(10278):996\u20131009","journal-title":"Lancet"},{"issue":"16","key":"3338_CR17","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1056\/NEJMcp2306778","volume":"390","author":"FR Lin","year":"2024","unstructured":"Lin FR (2024) Age-Related hearing loss. N Engl J Med 390(16):1505\u20131512","journal-title":"N Engl J Med"},{"key":"3338_CR18","doi-asserted-by":"crossref","unstructured":"Chi JC, Lee SD, Huang RJ et al (2021) CPAP treatment improves pure tone audiometry threshold in sensorineural hearing loss patients with Sleep-Disordered breathing. Int J Environ Res Public Health.;18(13)","DOI":"10.3390\/ijerph18136768"},{"issue":"10","key":"3338_CR19","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.5664\/jcsm.5080","volume":"11","author":"M Nakayama","year":"2015","unstructured":"Nakayama M, Masuda A, Ando KB et al (2015) A pilot study on the efficacy of continuous positive airway pressure on the manifestations of Meniere\u2019s disease in patients with concomitant obstructive sleep apnea syndrome. J Clin Sleep Med 11(10):1101\u20131107","journal-title":"J Clin Sleep Med"},{"issue":"5","key":"3338_CR20","first-page":"295","volume":"58","author":"AB Hill","year":"1965","unstructured":"Hill AB (1965) The environment and disease: association or causation?? Proc R Soc Med 58(5):295\u2013300","journal-title":"Proc R Soc Med"},{"issue":"9","key":"3338_CR21","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1007\/s10654-020-00703-7","volume":"36","author":"M Shimonovich","year":"2021","unstructured":"Shimonovich M, Pearce A, Thomson H, Keyes K, Katikireddi SV (2021) Assessing causality in epidemiology: revisiting Bradford hill to incorporate developments in causal thinking. Eur J Epidemiol 36(9):873\u2013887","journal-title":"Eur J Epidemiol"},{"issue":"19","key":"3338_CR22","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1056\/NEJMoa043104","volume":"353","author":"HK Yaggi","year":"2005","unstructured":"Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034\u20132041","journal-title":"N Engl J Med"},{"issue":"1","key":"3338_CR23","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1164\/ajrccm.163.1.2001008","volume":"163","author":"E Shahar","year":"2001","unstructured":"Shahar E, Whitney CW, Redline S et al (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the sleep heart health study. Am J Respir Crit Care Med 163(1):19\u201325","journal-title":"Am J Respir Crit Care Med"},{"issue":"9464","key":"3338_CR24","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1016\/S0140-6736(05)71141-7","volume":"365","author":"JM Marin","year":"2005","unstructured":"Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046\u20131053","journal-title":"Lancet"},{"issue":"4","key":"3338_CR25","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1001\/jamainternmed.2013.1868","volume":"173","author":"FR Lin","year":"2013","unstructured":"Lin FR, Yaffe K, Xia J et al (2013) Hearing loss and cognitive decline in older adults. JAMA Intern Med 173(4):293\u2013299","journal-title":"JAMA Intern Med"},{"issue":"3","key":"3338_CR26","doi-asserted-by":"publisher","first-page":"261","DOI":"10.5664\/jcsm.27191","volume":"4","author":"G Jean-Louis","year":"2008","unstructured":"Jean-Louis G, Zizi F, Clark LT, Brown CD, McFarlane SI (2008) Obstructive sleep apnea and cardiovascular disease: role of the metabolic syndrome and its components. J Clin Sleep Med 4(3):261\u2013272","journal-title":"J Clin Sleep Med"},{"issue":"4","key":"3338_CR27","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1161\/01.CIR.0000136587.68725.8E","volume":"110","author":"AS Gami","year":"2004","unstructured":"Gami AS, Pressman G, Caples SM et al (2004) Association of atrial fibrillation and obstructive sleep apnea. Circulation 110(4):364\u2013367","journal-title":"Circulation"},{"key":"3338_CR28","doi-asserted-by":"crossref","unstructured":"Bisogno A, Scarpa A, Di Girolamo S et al (2021) Hearing loss and cognitive impairment: epidemiology, common pathophysiological findings, and treatment considerations. Life (Basel).;11(10)","DOI":"10.3390\/life11101102"},{"issue":"8","key":"3338_CR29","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1111\/resp.12140","volume":"18","author":"A Anandam","year":"2013","unstructured":"Anandam A, Patil M, Akinnusi M, Jaoude P, El-Solh AA (2013) Cardiovascular mortality in obstructive sleep Apnoea treated with continuous positive airway pressure or oral appliance: an observational study. Respirology 18(8):1184\u20131190","journal-title":"Respirology"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-025-03338-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-025-03338-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-025-03338-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T13:21:30Z","timestamp":1748006490000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-025-03338-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["3338"],"URL":"https:\/\/doi.org\/10.1007\/s11325-025-03338-8","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"27 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 April 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board of Albert Einstein College of Medicine. As an observational study, analyses were conducted using pre-existing data. All procedures involving human participants adhered to the ethical principles outlined in the 1964 Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants consented to participate.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The sponsor had no role in the design, analysis, interpretation, or publication of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Role of the sponsor"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"177"}}