Diurnal cortisol levels and subjective ratings of effort and fatigue in adult cochlear implant users: A pilot study

Robert T. Dwyer, René H. Gifford, Fred H. Bess, Michael Dorman, Anthony Spahr, Benjamin W.Y. Hornsby

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Purpose: There is a growing body of literature that suggests a linkage between impaired auditory function, increased listening effort, and fatigue in children and adults with hearing loss. Research suggests this linkage may be associated with hearing loss–related variations in diurnal cortisol levels. Here, we examine variations in cortisol profiles between young adults with and without severe sensorineural hearing loss and examine associations between cortisol and subjective measures of listening effort and fatigue. Method: This study used a repeated-measures, matched-pair design. Two groups (n = 8 per group) of adults enrolled in audiology programs participated, 1 group of adults with hearing loss (AHL) and 1 matched control group without hearing loss. Salivary cortisol samples were collected at 7 time points over a 2-week period and used to quantify physiological stress. Subjective measures of listening effort, stress, and fatigue were also collected to investigate relationships between cortisol levels, perceived stress, and fatigue. Results: Subjective ratings revealed that AHL required significantly more effort and concentration on typical auditory tasks than the control group. Likewise, complaints of listening-related fatigue were more frequent and more of a problem in everyday life for AHL compared to the control group. There was a significant association between subjective ratings of listening effort and listening-related fatigue for our AHL, but not for the control group. In contrast, there was no significant difference in cortisol measures between groups, nor were there significant associations between cortisol and any subjective measure. Conclusions: Young AHL experience more effortful listening than their normal hearing peers. This increased effort is associated with increased reports of listening-related fatigue. However, diurnal cortisol profiles were not significantly different between groups nor were they associated with these perceived differences.

Original languageEnglish (US)
Pages (from-to)686-696
Number of pages11
JournalAmerican journal of audiology
Issue number3
StatePublished - Sep 2019
Externally publishedYes

ASJC Scopus subject areas

  • Speech and Hearing


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