In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such measures. The aim of the current study was to investigate the effect of hearing acuity on physiological responses and subjective measures acquired during different levels of listening demand, and to investigate the relationship between these measures. A total of 125 participants (37 males and 88 females, age range 37–72 years, pure-tone average hearing thresholds at the best ear between -5.0 to 68.8 dB HL and asymmetry between ears between 0.0 and 87.5 dB) completed a listening task. A speech reception threshold (SRT) test was used with target sentences spoken by a female voice masked by male speech. Listening demand was manipulated using three levels of intelligibility: 20 % correct speech recognition, 50 %, and 80 % (IL20 %/IL50 %/IL80 %, respectively). During the task, peak pupil dilation (PPD), heart rate (HR), pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), and skin conductance level (SCL) were measured. For each condition, subjective ratings of effort, performance, difficulty, and tendency to give up were also collected. Linear mixed effects models tested the effect of intelligibility level, hearing acuity, hearing asymmetry, and tinnitus complaints on the physiological reactivity (compared to baseline) and subjective measures. PPD and PEP reactivity showed a non-monotonic relationship with intelligibility level, but no such effects were found for HR, RSA, or SCL reactivity. Participants with worse hearing acuity had lower PPD at all intelligibility levels and showed lower PEP baseline levels. Additionally, PPD and SCL reactivity were lower for participants who reported suffering from tinnitus complaints. For IL80 %, but not IL50 % or IL20 %, participants with worse hearing acuity rated their listening effort to be relatively high compared to participants with better hearing. The reactivity of the different physiological measures were not or only weakly correlated with each other. Together, the results suggest that hearing acuity may be associated with altered sympathetic nervous system (re)activity. Research using psychophysiological measures as markers of listening effort to study the effect of hearing acuity on such measures are best served by the use of the PPD and PEP.

Previous research has demonstrated that hearing impairment is associated with heightened subjective experiences of listening effort, fatigue, and stress, impacting daily functioning. This study aimed to evaluate whether hearing impairment alters physiological stress systems and whether different aspects of hearing impairment could vary in predicting dysregulation in these systems. Hallmark measures of parasympathetic and sympathetic nervous system activity were derived from electrocardiography, impedance cardiography, and electrodermal activity recordings taken from 133 individuals, aged 37 to 73, over two 24-hr periods, including sleep. Using ecological momentary assessment (EMA), participants reported mood, listening effort, and fatigue seven times daily. Hearing impairment was quantified through pure tone thresholds, speech perception in noise testing, and the Amsterdam Inventory for Auditory Disability questionnaire (Amsterdam Inventory). Using mixed models, we compared average daytime and sleep values of physiological measures across the 2 days, and their daytime-to-sleep contrast, based on each hearing impairment assessment. Results indicated that all three hearing impairment assessments were strong predictors of EMA outcomes of listening effort and fatigue. Contrary to expectations, hearing impairment did not have a significant impact on parasympathetic activity in daily life or on skin sympathetic activity. However, individuals with higher impairment exhibited a larger change in a cardiac sympathetic measure, the pre-ejection period, during wakefulness compared to sleep. Overall, hearing impairment had a small impact on autonomic nervous system functioning in daily life, but the effects were potentially attenuated by reduced exposure to listening demand in those with hearing impairment.

Objectives: 
This study investigated the relationship between physical activity—measured both objectively and subjectively—and hearing acuity.
Design: 
Subjective physical activity data were collected through a questionnaire reflecting participants’ general activity levels. Objective physical activity was measured through accelerometer measurements recorded during daily life over two days in 6-sec epochs during awake hours. In total, 131 Dutch adults with varying levels of hearing acuity, ranging from normal hearing to severe impairment, were included. A trained algorithm classified the accelerometer data into various physical activities—such as walking, cycling, fast walking/running, and stair climbing—as well as postures, including lying down, sitting, and standing. In addition, the movement intensity of dynamic activities was quantified using the vector magnitude of the classified epochs. For each participant, the time spent on each activity or posture was expressed as a percentage of total awake time. Linear regression models were used to compare total awake time spent on each activity with participants’ self-reported activity levels. Furthermore, linear mixed-effects models analyzed the effect of hearing acuity and hearing asymmetry on the time spent engaging in activities and postures, as well as on the movement intensity when being active. Given the compositional nature and homogeneous distribution of objectively measured time in each activity level, both standard and Compositional Data Analysis (CoDA) approaches were applied to assess the effect of hearing acuity measures.
Results: 
The subjective and objective physical activity measures showed a modest relationship using both CoDA and standard approaches. This indicated that the two types of measures captured overlapping aspects of physical activity, supporting our assumption that both are partially valid representations of this underlying construct. A weak association was found between poorer pure-tone average in the better ear and a lower frequency of dynamic activities during the recorded period. This relationship persisted when applying the CoDA method, which also revealed a weak association between lower relative time spent walking and higher (poorer) pure-tone average in the better ear. In contrast, no significant associations were found between hearing acuity and the frequency of specific activities or postures, the intensity of dynamic activities, or subjective activity levels using the standard approach.
Conclusions: 
These findings suggest that individuals with worse hearing acuity may engage less in dynamic activities but are not necessarily characterized by low overall physical activity levels. Future research should consider the cultural context of the study population, the duration of the participant’s hearing loss, and extend accelerometer monitoring periods to provide more comprehensive insights.