Association between sleep quality and psychiatric disorders in patients with subjective tinnitus in China

Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3063-72. doi: 10.1007/s00405-016-3906-8. Epub 2016 Jan 30.


The study aimed to investigate the relationship between quality of sleep and psychiatric disorders including anxiety and depression in patients with subjective tinnitus. Early intervention is associated with improved therapeutic outcomes. We used Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and tinnitus handicap inventory (THI) in 543 patients [224 male (41.3 %); 319 female (58.7 %)] with subjective tinnitus enrolled in the ENT outpatient clinic from 2013 to 2015. Tinnitus characteristics and hearing status were recorded. A binary step-wise logistic regression analysis was performed. Two hundred cases (36.8 %) including 65 men (32.5 %) and 135 women (67.5 %) were diagnosed with sleep disorders. The PSQI score was the highest in patients with anxiety plus depression. Prolonged sleep latency and daytime dysfunction were positively associated with anxiety and depression. Increased sleep latency score was associated with 1.521- and 1.667-fold increased risk of anxiety and depression. Increase in the daytime dysfunction score was associated with 1.941- and 1.477-fold increases in the risk of anxiety and depression, respectively. Psychiatric and sleep disorders are highly prevalent in patients with subjective tinnitus. The most severe sleep impairment was found in patients with anxiety plus depression, resulting from prolonged sleep latency and severe daytime dysfunction. Acute duration, young people, hearing loss, impaired sleep, and severity of tinnitus were the major risk factors for tinnitus accompanied with anxiety symptoms. Severity of tinnitus and sleep impairment appeared to be the major risk factors of tinnitus accompanied with depression symptoms.

Keywords: Anxiety; Depression; Sleep disorder; Tinnitus.

MeSH terms

  • Acoustic Impedance Tests
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / etiology*
  • Child
  • China
  • Depression / etiology*
  • Evoked Potentials, Auditory, Brain Stem / physiology
  • Female
  • Hearing Loss / complications
  • Hearing Loss, Sensorineural / etiology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sleep / physiology
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / etiology*
  • Surveys and Questionnaires
  • Tinnitus / physiopathology
  • Tinnitus / psychology*