{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:10:35Z","timestamp":1788887435217,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"133","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Noise exposure is an established risk factor for tinnitus, yet its association with tinnitus-related trouble falling asleep remains underexplored at the population level. This study examined associations between occupational and leisure noise exposure and tinnitus-related trouble falling asleep in U.S. adults, adjusting for hearing difficulty.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Cross-sectional analysis of 36,697 adults aged \u226518 years from the 2014 National Health Interview Survey (NHIS), which included a hearing supplement. The primary outcome was tinnitus-related trouble falling asleep among adults with tinnitus (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20094,292). Secondary outcomes included short sleep (&gt;7 hours) in the full sample (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200933,507). Noise exposure was categorized as: no exposure, occupational only, leisure only, or both. Survey-weighted logistic regression with design-based standard errors estimated adjusted odds ratios (aOR) controlling for age, sex, race\/ethnicity, education, smoking, and hearing difficulty.\n                    <jats:bold>Results:<\/jats:bold>\n                    The weighted 12-month tinnitus prevalence was 11.5%. Among those with tinnitus, 41.8% reported trouble falling asleep. Combined occupational and leisure noise exposure was associated with the highest odds of tinnitus-related trouble falling asleep (aOR\u2009=\u20091.69, 95% confidence interval [CI]: 1.30\u20132.19,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001), followed by leisure noise only (aOR\u2009=\u20091.37, 95% CI: 1.03\u20131.84,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.033); occupational noise alone was not independently significant (aOR\u2009=\u20091.13, 95% CI: 0.92\u20131.39,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.23;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    -for-trend &lt; 0.001). Hearing difficulty was a strong independent predictor (aOR\u2009=\u20091.78, 95% CI: 1.47\u20132.15,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Combined noise exposure is associated with elevated odds of tinnitus-related trouble falling asleep after adjustment for hearing difficulty. Hearing difficulty is the strongest correlate, suggesting that hearing status should be routinely assessed in tinnitus patients with sleep complaints.\n                  <\/jats:p>","DOI":"10.4103\/nah.nah_81_26","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:04:11Z","timestamp":1788343451000},"page":"985-992","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Combined Noise Exposure and Hearing Difficulty as Independent Correlates of Tinnitus-Related Trouble Falling Asleep: A Nationally Representative Analysis of U.S. Adults"],"prefix":"10.4103","volume":"28","author":[{"given":"Seyed-Ali","family":"Sadegh-Zadeh","sequence":"first","affiliation":[{"name":"Department of Computing, School of Digital, Technologies and Arts, University of Staffordshire, Stoke-on-Trent ST4 2DE, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Saadat","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham B15 2GW, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza Soleimani","family":"Mamalo","sequence":"additional","affiliation":[{"name":"Student Research Committee, Urmia University of Medical Sciences, Urmia 5714783734, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Atashbar","sequence":"additional","affiliation":[{"name":"Faculty of Information Technology and Computer Engineering, Azarbaijan Shahid Madani University, Tabriz 53714-161, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nooshin Borhani","family":"Rayeni","sequence":"additional","affiliation":[{"name":"Department of Humanities, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Mohammadinezhad","sequence":"additional","affiliation":[{"name":"Department of Humanities, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasaman","family":"Noshirvanbaboli","sequence":"additional","affiliation":[{"name":"Department of Humanities, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghazal","family":"Naghdibak","sequence":"additional","affiliation":[{"name":"Department of Electronics and Communication Engineering, Politecnico di Torino, 10129 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Hajizadeh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia 5714783734, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Pashaei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia 5714783734, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"R1-20260908","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00420-015-1083-5","article-title":"Occupational noise exposure and hearing: A systematic review","volume":"89","author":"Lie","year":"2016","journal-title":"Int Arch Occup Environ Health"},{"key":"R2-20260908","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1002\/ajim.22082","article-title":"Prevalence of hearing loss in the United States by industry","volume":"56","author":"Masterson","year":"2013","journal-title":"Am J Ind Med"},{"key":"R4-20260908","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1002\/ajim.20223","article-title":"The global burden of occupational noise\u2010induced hearing loss","volume":"48","author":"Nelson","year":"2005","journal-title":"Am J Ind Med"},{"key":"R5-20260908","doi-asserted-by":"crossref","first-page":"3879","DOI":"10.1121\/1.5134465","article-title":"Occupational noise exposure: A review of its effects, epidemiology, and impact with recommendations for reducing its burden","volume":"146","author":"Themann","year":"2019","journal-title":"J Acoust Soc Am"},{"key":"R7-20260908","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","volume":"382","author":"Baguley","year":"2013","journal-title":"Tinnitus. 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