a Department of Psychology , University of Bath , Bath , UK.
b Royal National Throat Nose and Ear Hospital , University College London Hospitals , London , UK.
Int J Audiol. 2019 May;58(5):311-316. doi: 10.1080/14992027.2018.1547927. Epub 2019 Jan 5.
Insomnia frequently occurs alongside distressing tinnitus, and greater tinnitus severity is associated with more sleep disturbance. Insomnia and tinnitus probably share common underlying processes and sleep studies show striking similarities between primary and tinnitus-related insomnia. This is the first study to evaluate outcomes following insomnia-specific Cognitive Behavioural Therapy (CBTi) for tinnitus-related insomnia in a "real world" clinic.
Treatment was six-sessions of group-based CBTi. Measures of insomnia, sleep diaries, tinnitus distress, psychological distress, anxiety and depression were completed pre-intervention, post-intervention and at six-weeks follow up.
Participants were 24 adults with chronic, distressing tinnitus and associated sleep disturbance. Twenty-two completed treatment.
CBTi was associated with significant improvements from pre-intervention to post-intervention maintained at follow up in insomnia, sleep-diary measures, tinnitus distress, psychological distress, anxiety and depression, largely maintained at follow-up. Reliable improvements were reported in insomnia (by 67% of patients), tinnitus distress (by 50% of patients) and psychological distress (by 38% of patients) post-intervention.
The results suggest that CBTi is associated with reduced insomnia and distress for patients reporting chronic and distressing tinnitus with related insomnia. Further research into CBTi for this population, using utilising robust, randomised controlled designs, is warranted.
失眠常与痛苦的耳鸣同时发生，耳鸣越严重，睡眠障碍越严重。失眠和耳鸣可能有共同的潜在机制，睡眠研究显示原发性和耳鸣相关失眠之间存在惊人的相似之处。这是第一项在“真实世界”诊所评估针对耳鸣相关失眠的失眠特异性认知行为疗法（CBTi）治疗结果的研究。
治疗是六次小组基于 CBTi 的治疗。在干预前、干预后和六周随访时，评估失眠、睡眠日记、耳鸣困扰、心理困扰、焦虑和抑郁的测量。
参与者为 24 名患有慢性、痛苦的耳鸣和相关睡眠障碍的成年人。22 名完成了治疗。
CBTi 与干预前到干预后的显著改善相关，在随访时得到维持，在失眠、睡眠日记测量、耳鸣困扰、心理困扰、焦虑和抑郁方面都得到了维持，在干预后，失眠（67%的患者）、耳鸣困扰（50%的患者）和心理困扰（38%的患者）有可靠的改善。
这些结果表明，对于报告有慢性和痛苦的耳鸣伴相关失眠的患者，CBTi 可减少失眠和困扰。需要进一步研究针对该人群的 CBTi，采用可靠的随机对照设计。
