Association of Music Exposure and Sleep Quality on the Proxy Measures of Hidden Hearing Loss in Young Adults

Abstract

Sleep quality has emerged as a potential factor influencing auditory health, with recent evidence suggesting that sleep disturbances may contribute to subtle auditory deficits even in individuals with normal hearing thresholds. This study investigated the association between sleep quality and proxy measures of hidden hearing loss in young adults aged 18-27 years with normal hearing sensitivity. Fifty participants were divided into two groups based on their Pittsburgh Sleep Quality Index scores: 25 individuals with good sleep quality (≤5) and 25 with poor sleep quality (>10). Comprehensive auditory assessment included extended high-frequency pure tone audiometry (10-14 kHz), amplitude modulation detection thresholds (4000 Hz narrowband noise), distortion product otoacoustic emission input-output functions (input-output function at 4000 Hz), acoustic reflex thresholds, and growth using high-pass noise with 226 Hz and 1000 Hz probe tones, and auditory brainstem responses elicted by high pass clicks. The study also explored whether acoustic exposure (measured with the Noise Exposure Structured Interview (NESI) questionnaire) mediated the relationship between sleep quality and auditory function. Results revealed that most auditory measures showed no significant differences between groups. However, acoustic reflex thresholds measured with a 1000 Hz probe tone were significantly elevated in participants with poor sleep quality. Regression analysis indicated that sleep quality alone predicted 8.1% of the variance in acoustic reflex thresholds, while acoustic exposure showed minimal predictive value. The preservation of cochlear mechanical function alongside elevated reflex thresholds suggests that sleep-related auditory dysfunction primarily affects neural rather than mechanical processes. These findings provide preliminary evidence for an association between sleep quality and subtle auditory dysfunction, highlighting the potential clinical importance of considering sleep-related factors in comprehensive hearing health assessments.