Poor sleep quality in young adults was significantly associated with lower auditory performance, reduced sound tolerance (hyperacusis, phonophobia, and misophonia), and higher anxiety levels.
The majority of young adult participants demonstrated poor sleep quality based on PSQI scores.
Poor sleep quality was negatively correlated with auditory performance in daily life as measured by the Speech, Spatial, and Hearing Qualities Scale (SSQ).
Poor sleep quality was significantly associated with increased anxiety levels.
Poor sleep quality was significantly associated with all three dimensions of decreased sound tolerance: hyperacusis, phonophobia, and misophonia.
The study examined multiple auditory and psychological outcomes simultaneously in a large young adult sample using validated self-report instruments.
This research suggests that poor sleep quality among young adults is linked to multiple negative outcomes involving hearing and mental health. In a study of 607 adults aged 18 to 30, nearly two-thirds reported poor sleep quality. Those who slept poorly tended to report worse ability to hear and understand speech in everyday situations, and they also showed greater sensitivity to sounds — including abnormal loudness discomfort (hyperacusis), fear of specific sounds (phonophobia), and strong negative emotional reactions to certain sounds (misophonia). The connection between poor sleep and anxiety was the strongest relationship found in the study. This research suggests that sleep does not only affect how tired a person feels, but also influences how their auditory system and emotional regulation function on a day-to-day basis. The fact that all three types of sound sensitivity were associated with worse sleep points to a broad impact on how the brain processes and tolerates sound. The moderate correlation with anxiety further indicates that sleep problems may be intertwined with heightened psychological distress. These findings highlight that sleep quality in young adults may have wide-ranging effects beyond simply feeling rested. This research suggests that clinicians and researchers working with hearing difficulties, sound sensitivity disorders, or anxiety in young people may benefit from routinely considering sleep quality as a contributing factor. The study's cross-sectional design means it cannot determine whether poor sleep causes these problems or whether the relationship works in the other direction, but the consistent pattern across multiple outcomes points to sleep as an important area of focus.
Esdogan A, Demirtaş Yılmaz B. (2026). The multidimensional effects of sleep quality in young adults: the relationship between auditory performance, sound tolerance, and anxiety.. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. https://doi.org/10.1007/s00405-025-09979-5