Psychophysiological Associations between Chronic Tinnitus and Sleep: A Cross Validation of Tinnitus and Insomnia Questionnaires.

Martin Schecklmann,Timm B Poeppl,Michael Landgrebe,Berthold Langguth,Maximilian Pregler,Tatjana Crönlein,Elmar Frank,Astrid Lehner,Thomas C Wetter,Peter M Kreuzer

doi:10.1155/2015/461090

Martin Schecklmann, Timm B Poeppl + Show 8 more

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https://doi.org/10.1155/2015/461090

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Abstract

Background. The aim of the present study was to assess the prevalence of insomnia in chronic tinnitus and the association of tinnitus distress and sleep disturbance. Methods. We retrospectively analysed data of 182 patients with chronic tinnitus who completed the Tinnitus Questionnaire (TQ) and the Regensburg Insomnia Scale (RIS). Descriptive comparisons with the validation sample of the RIS including exclusively patients with primary/psychophysiological insomnia, correlation analyses of the RIS with TQ scales, and principal component analyses (PCA) in the tinnitus sample were performed. TQ total score was corrected for the TQ sleep items. Results. Prevalence of insomnia was high in tinnitus patients (76%) and tinnitus distress correlated with sleep disturbance (r = 0.558). TQ sleep subscore correlated with the RIS sum score (r = 0.690). PCA with all TQ and RIS items showed one sleep factor consisting of all RIS and the TQ sleep items. PCA with only TQ sleep and RIS items showed sleep- and tinnitus-specific factors. The sleep factors (only RIS items) were sleep depth and fearful focusing. The TQ sleep items represented tinnitus-related sleep problems. Discussion. Chronic tinnitus and primary insomnia are highly related and might share similar psychological and neurophysiological mechanisms leading to impaired sleep quality.

Highlights

Several neural models regarding the generation and maintenance of chronic and bothersome tinnitus postulate that cochlear dysfunction may be associated with adaptive processes involving both auditory pathway and nonauditory areas
We evaluated whether the Tinnitus Questionnaire (TQ [18]) is sufficient for screening of insomnia symptoms in chronic tinnitus
Tinnitus patients showed significant medium to high correlations of the Regensburg Insomnia Scale (RIS) sum score with the total score of the TQ and all subscores (Table 2)

Summary

Introduction

Several neural models regarding the generation and maintenance of chronic and bothersome tinnitus postulate that cochlear dysfunction may be associated with adaptive processes involving both auditory pathway and nonauditory areas (for overview [1]). By mechanisms of conditioned reflexes the tinnitus percept is reinforced by the negative autonomic reaction These interactions between auditory and nonauditory brain regions can explain why tinnitus is perceived as bothersome and might be the reason why habituation to the tinnitus percept is prevented. These mechanisms can lead to comorbid conditions such as concentration problems, depressivity, and sleep disturbances [6]. Insomnia shows an increased prevalence in chronic tinnitus [7, 8] and an impaired sleep quality is correlated with tinnitus distress and sleep quality [9]. Chronic tinnitus and primary insomnia are highly related and might share similar psychological and neurophysiological mechanisms leading to impaired sleep quality

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