The association of subjective and objective sleep measures with chronic tinnitus

Study Objectives: Poor sleep is a prevalent complaint in the population with chronic tinnitus, but the relationship between the two is not well -characterized. The objective of this study was to understand how subjective and objective measures of sleep compare in patients with or without chronic tinnitus. Methods: This prospective cohort study included consecutive adult patients who presented to a sleep laboratory between January 19, 2017, and January 10, 2020. All patients underwent an in -laboratory nocturnal polysomnogram and filled out questionnaires including the Pittsburgh Sleep Quality Index (PSQI), Tinnitus Screener, and Tinnitus Handicap Inventory, among others. Results: The study included 1,968 participants, out of which 284 (14.4%) reported chronic tinnitus. Patients with chronic tinnitus were younger (51.6 years vs 54.1 years; P < .05) and more likely female (16.4% vs 11.7%; P < .005). They demonstrated worse subjective sleep quality (PSQI: 11.3 vs 9.5; P < .0005) and increased sleepiness (Epworth Sleepiness Scale: 9.8 vs 8.6; P < .005). In the objective sleep parameters only the total sleep time was increased in chronic tinnitus (311.5 vs 294.5 minutes; P < .05) and total arousals were decreased (41.7 vs 47; P < .005). Sleep stage N3 was higher in those with chronic tinnitus (14.9% vs 13.0%; P < .05). In multivariable analyses, as PSQI increases the odds of chronic tinnitus increases. This effect was modified by age: In those younger than 55 years of age, the odds of the presence of chronic tinnitus was 1.10 (95% confidence interval, 1.03, 1.17) times higher as PSQI increased. Conclusions: Chronic tinnitus is associated with significant changes in qualitative sleep (higher PSQI) but no major differences in quantitative sleep measures were observed.