Evidence for an Association Between Hearing Impairment and Disrupted Sleep: Scoping Review.
Nathan A Clarke, Derek J Hoare, Edward C Killan
PMID 31626556WHAT IT FOUND
Hearing loss is frequently linked to poorer sleep in adults, but tinnitus is a major confound that many studies ignored.
Clinicians should screen for sleep issues in patients with hearing loss while carefully distinguishing whether tinnitus is the primary driver.
Key findings
01Hearing loss is associated with disrupted sleep, including poorer subjective quality, increased daytime sleepiness, and altered sleep structure, though the specific sleep stages affected vary across studies.
02Tinnitus is a significant confounding variable because it is often present alongside hearing loss and independently disrupts sleep, yet nine of the included studies did not assess tinnitus status.
03Hearing rehabilitation, such as hearing aids, was shown to significantly improve sleep scores in patients with sensorineural hearing loss and tinnitus, but not in those with hearing loss alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Tinnitus was not assessed in nine of the 16 studies, making it difficult to isolate the effect of hearing loss alone on sleep. Hearing loss was measured inconsistently, with many studies relying on self-report rather than objective audiometry. The review included only peer-reviewed, English-language studies, which may have introduced selection bias. Study designs and participant demographics (age, severity of hearing loss) were highly heterogeneous, preventing meta-analysis or firm conclusions about specific mechanisms.
Declared interests
Nathan A. Clarke is supported by a Medical Research Council studentship. Derek J. Hoare is funded by the National Institute for Health Research Biomedical Research Centre program.
The easy way to misread this
Do not assume hearing loss alone causes sleep disruption. Tinnitus is a powerful confound that was not measured in many of the included studies, so the observed sleep problems may be driven by tinnitus rather than hearing impairment itself.