Insomnia can have a negative effect on tinnitus patients, worsening the functional and emotional toll of chronic ringing, buzzing, hissing or clicking in the head and ears, according to a study from Henry Ford Hospital in Detroit in the US.
"Tinnitus involves cognitive, emotional, and psycho-physiological processes, which can result in an increase in a patient's distress," says study co-author Kathleen L. Yaremchuk, M.D., Chair, Department of Otolaryngology-Head & Neck Surgery at Henry Ford. "Sleep complaints, including insomnia, in these patients may result in a decrease in their tolerance to tinnitus."
Predictor of sleep disturbance
For the study, the research team conducted a retrospective study of 117 patients treated between 2009 and 2011 at the Henry Ford Hospital.
Information was gathered from patients through telephone and written interviews using the Tinnitus Reaction Questionnaire (or TRQ, which determines the emotional effects tinnitus has had on a person's lifestyle and general well-being) and the Insomnia Severity Index (or, ISI, a brief screening measure of insomnia) scales.
Severity of TRQ was shown to be a good predictor of sleep disturbance and in predicting group association, especially the "emotional" sub-score component (sensitivity 96.9% and specificity 55.3% for identifying tinnitus patients with insomnia).
Problems â€œgetting to sleepâ€
The greater the insomnia disability, the more severe the patient's complaints were regarding the tinnitus, the study finds.
"Treating patients with tinnitus is challenging," notes Dr. Yaremchuk. "A chronic tinnitus patient presents a challenging clinical picture that may include anxiety, depression, annoyance, or self-reported emotional distress. And one of most frequent self-reported complaint of tinnitus patients is 'getting to sleep.'"
The study also offers further proof that evaluation and treatment of insomnia patients with tinnitus may result in a reduction in tinnitus symptom severity.
The study was presented at the Combined Otolaryngological Spring Meetings in San Diego in April 2012.