Factors Related to Insomnia in Adult Patients with Tinnitus and/or Hyperacusis: An Exploratory Analysis

J Am Acad Audiol. 2019 Oct;30(9):802-809. doi: 10.3766/jaaa.18020. Epub 2019 Apr 22.

Abstract

Background: People with tinnitus and/or hyperacusis often experience insomnia. However, it is unclear what factors are most strongly associated with insomnia.

Purpose: To explore factors related to insomnia in patients with tinnitus and/or hyperacusis.

Research design: This was a retrospective study using multiple-regression analysis.

Study sample: Data were assessed for 444 consecutive patients who sought help concerning their tinnitus and/or hyperacusis from a specialist audiology center in the UK National Health Service. The average age of the patients was 54 years (standard deviation = 15 years).

Data collection and analysis: The results of audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Multiple-regression analysis was used to assess the relationship between insomnia and other variables.

Results: Sixty-nine percent of patients with tinnitus experienced some form of insomnia as measured via the Insomnia Severity Index (ISI). A multiple-regression model showed that ISI scores were significantly associated with depression scores measured via the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (regression coefficient [b] = 0.44, p < 0.001), tinnitus annoyance measured via the visual analog scale (VAS) (b = 0.49, p = 0.001), anxiety measured via the anxiety subscale of the HADS (b = 0.21, p = 0.012), and tinnitus handicap measured via the Tinnitus Handicap Inventory (b = 0.07, p < 0.001). The model explained 45% of the variance in ISI scores. VAS scores for tinnitus loudness, hyperacusis-related measures, hearing thresholds, age, and gender were not significantly related to insomnia.

Conclusions: The prevalence of insomnia in patients with tinnitus is high. Both tinnitus-related factors and psychological factors are related to the severity of insomnia. Hyperacusis is not significantly associated with insomnia.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hyperacusis / complications*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Self Report
  • Sleep Initiation and Maintenance Disorders / etiology*
  • Tinnitus / complications*