Obstructive sleep apnea (OSA) is a breathing disorder that causes hypoxia which, in turn, causes cochlear dysfunction.

To determine whether Positive Airway Pressure (PAP) treatment has a positive or negative effect on hearing during 6-month follow-up of severe OSA.

There were 59 patients with severe OSA in the study group and 31 volunteers in the control group. Audiologic tests were performed on both groups before the start of PAP treatment, at the 3rd and 6th month of the PAP treatment.

The mean ages of the study and control groups were 46.3 ± 7.1 and 43.8 ± 7.7 years, respectively (p = 0.39). The test means for Sleep Efficiency (89.3 ± 4.2), AHI (45.3 ± 16.8), ODI (39.5 ± 20.8), MOS (89.9 ± 3.7), AD (7.6 ± 3.4), LOS (78 ± 8.5), and TDOS (40.7 ± 26) were registered for the study group. High-frequency PTA (HF-PTA) scores were higher in the study group than in the control (p < 0.01); they also decreased in the 3rd month of treatment (p < 0.01) and persisted in the 6th month. There was a correlation between HF-PTA and MOS, AD, and LOS (p < 0.01; 0.05; 0.045, respectively). Also, 8 kHz hearing levels were highly correlated with HF-PTA in the study and control groups (p < 0.01 and ρ = 0.74; p = 0.01 and ρ = 0.58, respectively).

High-frequency hearing threshold levels may show improvement with the use of PAP therapy. Also, the 8 kHz hearing levels may be used to predict high-frequency hearing loss and early cochlear damage.

Data will be available upon request to the corresponding author.

HA: conceptualization; formal analysis; investigation; methodology; project administration; writing – original draft; writing – review & editing. ZÖ: data curation; investigation; software. NGA: data curation; software; visualization. GA: visualization; writing – review & editing. DÖ: data curation; validation; visualization; writing – review & editing. DMM: supervision; validation; writing – review & editing.

Editor-in-Chief: Geraldo Pereira Jotz.

Received: 08 June 2025

Accepted: 28 December 2025

Article published online:
30 April 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Hande Arslan, Zeynep Özer, Nevra Güllü Arslan, Gökhan Akgül, Doğukan Özdemir, Dursun Mehmet Mehel. High-Frequency Hearing Loss and Decrease in High-Frequency Hearing Thresholds after Positive Airway Pressure Treatment in Patients with Severe OSA. Int Arch Otorhinolaryngol 2026; 30: s00461819642.
DOI: 10.1055/s-0046-1819642