Factors related to insomnia in adult patients with tinnitus and/or hyperacusis: An exploratory analysis

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 5 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] 5 0.44, p, 0.001), tinnitus annoyance measured via the visual analog scale (VAS) (b 5 0.49, p 5 0.001), anxiety measured via the anxiety subscale of the HADS (b 5 0.21, p 5 0.012), and tinnitus handicap measured via the Tinnitus Handicap Inventory (b 5 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.