# The multidimensional effects of sleep quality in young adults: the relationship between auditory performance, sound tolerance, and anxiety

**Authors:** Aysegul Esdogan, Beyza Demirtaş Yılmaz

PMC · DOI: 10.1007/s00405-025-09979-5 · European Archives of Oto-Rhino-Laryngology · 2026-01-21

## TL;DR

This study shows that poor sleep quality in young adults is linked to worse hearing performance, increased sensitivity to sounds, and higher anxiety levels.

## Contribution

The study reveals new multidimensional effects of sleep quality on auditory performance, sound tolerance, and anxiety in young adults.

## Key findings

- Poor sleep quality is significantly associated with lower auditory performance in daily life.
- Poor sleep quality correlates with increased anxiety and reduced sound tolerance, including hyperacusis and phonophobia.

## Abstract

This study aimed to comprehensively evaluate the effects of sleep quality on auditory performance, sound tolerance, and anxiety levels in young adults and to examine the possible relationships between these variables.

The study included 607 young adults aged 18-30 years (mean 21.48 ± 2.88 years). Participants completed a participant information form created for this study, the Pittsburgh Sleep Quality Index (PSQI), the Decreased Sound Tolerance Scale-Screening (DSTS-S), the Speech, Spatial, and Hearing Qualities Scale (SSQ), and the Beck Anxiety Scale. Data analysis was performed using IBM SPSS Statistics (Version 23.0) software.

The participants’ PSQI mean was 7.62±3.76, and 65.53% of the participants (>5) showed poor sleep quality. PSQI scores showed a negative correlation with SSQ total scores (rₛ=-0.242, p<0.001) and a moderate positive correlation with Beck Anxiety scores (rₛ=0.420, p<0.001). Furthermore, PSQI showed significant positive correlations with hyperacusis (rₛ=0.294, p<0.001), phonophobia (rₛ=0.159, p=0.001), and misophonia (rₛ=0.312, p<0.001).

This study revealed statistically significant relationships between poor sleep quality in young adults and auditory performance in daily life, reduced sound tolerance, and anxiety levels. The findings of the present study indicate that poor sleep quality is significantly associated with lower auditory performance and sound tolerance. Furthermore, poor sleep quality was found to be associated with higher anxiety levels. These findings demonstrate the effects of sleep on various systems and emphasize its physiological necessity for healthy functioning.

## Full-text entities

- **Diseases:** hyperacusis (MESH:D012001), Anxiety (MESH:D001007), misophonia (MESH:C000719531)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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Source: https://tomesphere.com/paper/PMC13002637