AUTHOR=Barry Gemma , Marks Elizabeth TITLE=Cognitive–behavioral factors in tinnitus-related insomnia JOURNAL=Frontiers in Psychology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.983130 DOI=10.3389/fpsyg.2023.983130 ISSN=1664-1078 ABSTRACT=Background

A significant proportion of individuals with distressing tinnitus also report insomnia. Limited, but emerging, evidence suggests that tinnitus-related insomnia cannot be explained only by the presence of tinnitus and that sleep-related cognitive–behavioral processes may play a key role in exacerbating tinnitus-related insomnia.

Objectives

This study aimed to assess whether sleep-related cognitions and behaviors believed to maintain insomnia disorder are present in individuals with tinnitus-related insomnia.

Methods

This between-groups study recruited 180 participants online for four groups: tinnitus-related insomnia (N = 49), insomnia disorder without tinnitus (N = 34), tinnitus sufferers who are good sleepers (N = 38), and controls (N = 59). They completed questionnaires assessing insomnia severity, sleep-related cognitions and behaviors, sleep quality, anxiety, and depression. People with tinnitus completed a measure of tinnitus severity and rated the loudness of their tinnitus on a subjective measure.

Results

Linear regression demonstrated that group significantly predicted sleep related thoughts and behaviors, and sleep quality. Pairwise comparisons showed that the tinnitus-related insomnia group had significantly greater insomnia-related thoughts and behaviors and significantly worse sleep quality than tinnitus-good sleepers. No differences were seen between the tinnitus-related insomnia and the insomnia groups. The tinnitus-related insomnia group had significantly higher depression, anxiety, and tinnitus distress than tinnitus-good sleepers.

Conclusion

Findings suggest that tinnitus-related insomnia may be maintained by cognitive–behavioral processes similar to those found in insomnia disorder. Such processes are more important than tinnitus severity when understanding sleep disturbance. People with tinnitus-related insomnia may benefit from treatments such as cognitive–behavioral therapy for insomnia.