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Binary logistic regression analysis quantified the associations between SPD, noise exposure (at work or off-work) and HL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SPD\n                      <jats:bold>\u2265<\/jats:bold>\n                      8 hours\/night had an OR of 0.71 (95% CI 0.59 to 0.84) for high-frequency HL vs. an SPD of 6\u20138 hours\/night among the Chinese participants but had an OR of 1.28 (95% CI 1.03 to 1.58) among American participants. Noise exposure (both at work and off-work) was associated with poorer low-frequency (OR 1.58, 1.43; p&lt;0.05), speech-frequency (OR 1.63, 1.29; p&lt;0.05) and high-frequency (OR 1.37, 1.23; p&lt;0.05) hearing among the Chinese participants; and it was associated with worse high-frequency hearing (OR 1.43, 1.66; p&lt;0.05) among the American participants. The negative relationship between SPD\n                      <jats:bold>\u2265<\/jats:bold>\n                      8 hours\/night and HL was mainly observed in the Chinese participants with noise exposure (OR &lt;1, p&lt;0.05), and SPD\n                      <jats:bold>\u2265<\/jats:bold>\n                      8 hours\/night associated with poorer HF hearing was only identified in the American participants without noise exposure (OR &gt;1, p&lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Noise exposure was associated with poorer hearing. SPD\n                      <jats:bold>\u2265<\/jats:bold>\n                      8 hours\/night was negatively associated with HL in the Chinese participants especially when exposed to noise. SPD\n                      <jats:bold>\u2265<\/jats:bold>\n                      8 hours\/night was related to poorer high-frequency hearing in the American participants when they had no noise exposure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-062535","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T12:12:30Z","timestamp":1663675950000},"page":"e062535","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Association of sleep duration and noise exposure with hearing loss among Chinese and American adults: two cross-sectional studies"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5454-552X","authenticated-orcid":false,"given":"E","family":"Wu","sequence":"first","affiliation":[{"name":"School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juntao","family":"Ni","sequence":"additional","affiliation":[{"name":"Women\u2019s Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongquan","family":"Xu","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ci","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Tao","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China"},{"name":"Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"2025121515134450000_12.9.e062535.1","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(16)30777-2","article-title":"Hearing loss: an important global health concern","volume":"387","author":"Lancet","year":"2016","journal-title":"Lancet"},{"key":"2025121515134450000_12.9.e062535.2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/MAO.0000000000002429","article-title":"Mortality and cause of death in hearing loss participants: a longitudinal follow-up study using a national sample cohort","volume":"41","author":"Kim","year":"2020","journal-title":"Otol Neurotol"},{"key":"2025121515134450000_12.9.e062535.3","unstructured":"World Health Organization . 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