Is Speech Frequency Thresholds Associated with STOP-BANG Score of Commercial Drivers?
Background and Objective: Obstructive sleep apnea (OSA) is a common sleep-disordered breathing (SDB) characterized by intermittent hypoxemia (IH). OSA and IH are considered risk factors for increased hearing thresholds as well. Furthermore, thresholds of speech frequency affect personal fitness for driving. Thus, main purpose of this study was to assess the association between speech frequency thresholds and OSA among commercial drivers.
Materials and Methods: This cross-sectional study was conducted on 1000 commercial drivers who were referred to obtain a health license at the Occupational Medicine Clinic of Baharloo Hospital, Tehran, Iran. Blood pressure, neck size, weight, and height were recorded. Validated Persian version of Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaire were completed by the participants. STOP-BANG score ≥ 3 was defined as high risk for OSA. Fast blood sugar (FBS), triglyceride (TG), and total cholesterol (TC) were measured for all drivers. Hearing threshold levels of all subjects were recorded by pure tone audiometry (PTA) in frequencies of 500, 1000, 2000, and 3000 Hz for each ear in decibels (dB).
Results: The mean age of the participants was 43.0 ± 9.9 years. The mean ESS and STOP-BANG scores of the participants were 3.1 ± 2.8 and 1.8 ± 0.8, respectively. 237 (23.7%) drivers were high-risk for OSA. Participants with OSA had significantly higher thresholds of speech frequencies compared to the low-risk ones (P < 0.0001).
Conclusion: OSA may be also considered as a risk factor for increased thresholds of speech frequency among commercial drivers. During drivers’ periodic medical examination, evaluation of OSA as a strong risk factor for increasing hearing thresholds is recommended.
Sadeghniiat-Haghighi K, Mohajeri-Tehrani MR, Khajeh-Mehrizi A, et al. Insulin resistance and leptin levels in patients with obstructive sleep apnea. J Sleep Sci 2017; 2: 7-2.
Qian Y, Xu H, Wang Y, et al. Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: A meta-analysis. Arch Med Sci 2016; 12: 1077-87.
Rajan P, Greenberg H. Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus. Nat Sci Sleep 2015; 7: 113-25.
Sadeghniiat-Haghighi K, Mohajeri-Tehrani MR, Khajeh-Mehrizi A, et al. Obstructive sleep apnea and excessive daytime sleepiness among patients with type 2 diabetes mellitus: A single-center study from Iran. Int J Diabetes Dev Ctries 2015; 35: 189-93.
Uyar M, Davutoglu V. An update on cardiovascular effects of obstructive sleep apnoea syndrome. Postgrad Med J 2016; 92: 540-4.
Khajeh-Mehrizi A, Rahimi-Golkhandan A, Sedaghat M. Obstructive sleep apnea among individuals admitted for myocardial infarction. J Sleep Sci 2016; 1: 23-7.
Xu S, Wan Y, Xu M, et al. The association between obstructive sleep apnea and metabolic syndrome: A systematic review and meta-analysis. BMC Pulm Med 2015; 15: 105.
Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 2015; 7: 1311-22.
Gozal D, Kheirandish-Gozal L. Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more. Am J Respir Crit Care Med 2008; 177: 369-75.
Fanfulla F, Grassi M, Taurino AE, et al. The relationship of daytime hypoxemia and nocturnal hypoxia in obstructive sleep apnea syndrome. Sleep 2008; 31: 249-55.
Chin K, Ohi M, Kita H, et al. Effects of NCPAP therapy on fibrinogen levels in obstructive sleep apnea syndrome. Am J Respir Crit Care Med 1996; 153: 1972-6.
Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Circadian interleukin-6 secretion and quantity and depth of sleep. J Clin Endocrinol Metab 1999; 84: 2603-7.
Muchnik C, Rubel Y, Zohar Y, et al. Auditory brainstem response in obstructive sleep apnea patients. J Basic Clin Physiol Pharmacol 1995; 6: 139-48.
Mohammadi AH, Mehrparvar AH, SoltaniGerdfaramarzi R, et al. Evaluation of the association between obstructive sleep apnea and hearing loss. J Sleep Sci 2016; 1: 94-100.
Matsumura E, Matas CG, Sanches SGG, et al. Severe obstructive sleep apnea is associated with cochlear function impairment. Sleep Breath 2018; 22: 71-7.
Casale M, Vesperini E, Potena M, et al. Is obstructive sleep apnea syndrome a risk factor for auditory pathway? Sleep Breath 2012; 16: 413-7.
Sheu JJ, Wu CS, Lin HC. Association between obstructive sleep apnea and sudden sensorineural hearing loss: a population-based case-control study. Arch Otolaryngol Head Neck Surg 2012; 138: 55-9.
Ballacchino A, Salvago P, Cannizzaro E, et al. Association between sleep-disordered breathing and hearing disorders: Clinical observation in Sicilian patients. Acta Medica Mediterranea 2015; 31: 607-14.
Deniz M, Ciftci Z, Ersozlu T, et al. The evaluation of auditory system in obstructive sleep apnea syndrome (OSAS) patients. Am J Otolaryngol 2016; 37: 299-303.
Martines F, Ballacchino A, Sireci F, et al. Audiologic profile of OSAS and simple snoring patients: The effect of chronic nocturnal intermittent hypoxia on auditory function. Eur Arch Otorhinolaryngol 2016; 273: 1419-24.
Sachdeva K, Azim S. Sensorineural hearing loss and type II diabetes mellitus. Int J Otorhinolaryngol Head Neck Surg 2018; 4: 499-507.
Das A, Sumit AF, Ahsan N, et al. Impairment of extra-high frequency auditory thresholds in subjects with elevated levels of fasting blood glucose. J Otol 2018; 13: 29-35.
Tan HE, Lan NSR, Knuiman MW, et al. Associations between cardiovascular disease and its risk factors with hearing loss-A cross-sectional analysis. Clin Otolaryngol 2018; 43: 172-81.
Aghazadeh-Attari J, Mansorian B, MirzaAghazadeh-Attari M, et al. Association between metabolic syndrome and sensorineural hearing loss: A cross-sectional study of 11,114 participants. Diabetes Metab Syndr Obes 2017; 10: 459-65. 25. Izadi N, Malek M, Aminian O, et al. Medical risk factors of diabetes mellitus among professional drivers. J Diabetes Metab Disord 2013; 12: 23.
Occupational and Environmental Health Center, Deputy of Health, Ministry of Health and Medical Education. Guideline of drivers' medical examination and standards of issuing health license [Online]. [cited 2014]; Available from: URL: http://mboh.umsha.ac.ir/uploads/d_moayenat_pezeshki .pdf. [In Persian].
Karimi A, Nasiri S, Kazerooni FK, et al. Noise induced hearing loss risk assessment in truck drivers. Noise Health 2010; 12: 49-55.
Ciorba A, Bianchini C, Pelucchi S, et al. The impact of hearing loss on the quality of life of elderly adults. Clin Interv Aging 2012; 7: 159-63.
Sadeghniiat HK, Montazeri A, Khajeh MA, et al. The Epworth Sleepiness Scale: Translation and validation study of the Iranian version. Sleep Breath 2013; 17: 419-26.
Sadeghniiat-Haghighi K, Montazeri A, KhajehMehrizi A, et al. The STOP-BANG questionnaire: Reliability and validity of the Persian version in sleep clinic population. Qual Life Res 2015; 24: 2025-30.
Alberti KG, Zimmet P, Shaw J. The metabolic syndrome--a new worldwide definition. Lancet 2005; 366: 1059-62.
Petersen KF, Befroy D, Dufour S, et al. Mitochondrial dysfunction in the elderly: Possible role in insulin resistance. Science 2003; 300: 1140-2.
Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med 1996; 154: 279-89.
Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991; 14: 540-5.