Fatigue and Quality of Life in Children with Hearing Loss or Obstructive Sleep Apnea

Amy L. Zhang, Rebecca Z. Lin, Emma K. Landes, Amy E. Ensing, Henok Getahun, Judith E.C. Lieu

Research output: Contribution to journalArticlepeer-review


Objective: To investigate the fatigue levels of children with hearing loss (HL) and obstructive sleep apnea (OSA), hypothesizing that the fatigue experienced by children with HL is under-recognized. Study Design: Cross-sectional survey. Methods: We identified children aged 2–18 with HL, OSA, sleep-disordered breathing (SDB), and controls from a pediatric otolaryngology clinic and sleep center. Children and/or parents completed the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS), Hearing Environments And Reflection on Quality of Life (HEAR-QL), and OSA-18. Results: Responses of 50 children with HL, 79 with OSA, and 18 with SDB were compared with those of 49 recruited controls (RC) and literature controls (LC). Children with HL or OSA had higher fatigue than controls in the PedsQL MFS self-reported (HL 65.4, OSA 54.7, RC 71.8, LC 80.5, p < 0.001) and parent-reported (HL 64.6, OSA 59.3, RC 75.2, LC 89.6, p < 0.001). Children with HL had Cognitive Fatigue similar to that of children with OSA (self 60.4 vs. 49.5, p = 0.170; parent 56.0 vs. 56.7, p = 0.998), though with decreased Sleep/Rest Fatigue (self 67.8 vs. 56.3, p = 0.033; parent 69.8 vs. 57.5, p = 0.001). Children with HL or OSA had lower disease-related quality of life (QOL) than controls in the HEAR-QL and OSA-18, respectively. Stratification with disease severity revealed no differences in fatigue. Conclusion: Children with HL or OSA experience higher fatigue and lower QOL than controls. Similar Cognitive Fatigue in both groups suggests under-recognized fatigue in children with HL. Level of Evidence: 3 Laryngoscope, 134:443–451, 2024.

Original languageEnglish
Pages (from-to)443-451
Number of pages9
Issue number1
StatePublished - Jan 2024


  • children
  • fatigue
  • hearing loss
  • obstructive sleep apnea
  • quality of life


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