The Impact of Hearing Loss on Sleep Quality in Older Adults: Evidence from Vietnam

Poor sleep quality is a critical health burden among older adults, potentially exacerbated by sensory deficits like hearing loss. This study investigates the impact of hearing loss on sleep quality in community-dwelling older adults in Vietnam. A cross-sectional study evaluated 779 adults aged ≥60 (mean age 71.1; 61.9% female) in Hung Yen Province. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI; poor sleep >5) and hearing loss via pure tone audiometry (PTA ≥20 dB). Poor sleep quality was alarmingly prevalent (67.9%; mean global PSQI = 8.0 ± 3.9). Participants with hearing loss exhibited significantly higher PSQI scores than normal-hearing peers (median 8.0 vs. 7.0, P = 0.003), with subjective sleep quality, sleep latency, and sleep disturbances most severely affected. Multivariable logistic regression demonstrated that hearing loss independently increased the odds of poor sleep by 62% (aOR=1.62, 95% CI: 1.15–2.29, P = 0.006). A significant dose-response trend emerged: poor sleep prevalence rose from 58.4% (normal hearing) to 71.1% (mild hearing loss) and 72.4% (moderate+ hearing loss) (P = 0.002). Beyond hearing status, advanced age and hypertension further impaired sleep, whereas higher education and moderate-to-high physical activity were strongly protective (aOR=0.55–0.58). Poor sleep is highly prevalent among older Vietnamese adults and is significantly compounded by hearing loss in a dose-dependent manner. Integrating comprehensive sleep assessments into routine geriatric and audiological care is strongly warranted to improve overall well-being.