# Exploring a Possible Link Between Tinnitus and the Risk of Obstructive Sleep Apnea—A National Population-Based Cohort Study Using Propensity Score Matching Analysis

## TL;DR

This study explores the link between tinnitus and obstructive sleep apnea (OSA), finding that tinnitus is more common in high OSA risk groups but is likely caused by hearing loss rather than OSA itself.

## Contribution

The study uses propensity score matching to show that tinnitus severity is linked to hearing loss rather than OSA directly.

## Key findings

- High-risk OSA groups had higher tinnitus incidence, persistence, and severity.
- High-frequency hearing loss in the worse ear and smoking were key factors for tinnitus experience and severity.
- After controlling for tinnitus-affective factors, no significant differences were found between OSA risk groups.

## Abstract

Objectives: The association between tinnitus and obstructive sleep apnea (OSA) has received attention; however, the mechanisms linking both conditions with diverse outcomes are still unclear. This study aimed to evaluate the association between OSA risk and tinnitus, including the OSA-related characteristics affecting tinnitus. Methods: We included participants aged 40–65 years with auditory examinations and STOP-BANG questionnaire between 2019 and 2021 from the Korean National Health and Nutrition Examination Survey data. Possible causative factors for tinnitus were identified using logistic regression analysis. Participants in the low- and high-risk groups for OSA were 1:1 matched using propensity score matching to compare the possible causative factors. Results: The high-risk group exhibited a higher incidence of tinnitus, persistence, and severity. However, when the causative factors of tinnitus were matched, no significant differences were observed. The most likely contributing factors were high-frequency hearing level in the worse ear for the experience and persistence of tinnitus and smoking for the severity of tinnitus. The high-risk group experienced tinnitus more often than the low-risk group, with no differences between the groups when tinnitus-affective factors were controlled. Conclusions: These findings suggest that tinnitus is unaffected by OSA itself but by the hearing loss that accompanies OSA.