Original article| Volume 34, ISSUE 1-2, P84-90, July 01, 1993

Sleep disturbance associated with chronic tinnitus

      This paper is only available as a PDF. To read, Please Download here.


      Sleep disturbance is a common and frequent complaint reported by tinnitus sufferers. Recent studies have shown that when insomnia and depression are associated with tinnitus there is decreased tolerance and increased discomfort with the tinnitus. The purpose of this study was to assess the reported prevalence and severity of sleep disturbance in chronic tinnitus patients. Patients (n = 80) were military personnel without major psychiatric disturbance and their tinnitus was associated with noise-induced permanent healing loss (NIHL). Mini Sleep Questionnaire (MSQ) scores for sleep disturbance were found to be higher than those of normal controls in 77% of the patients. Highest MSQ scores in tinnitus patients with a sleep complaint were for delayed sleep, morning awakenings, mid-sleep awakenings, morning fatigue, and chronic fatigue. In contrast, a complaint of excessive daytime sleep (EDS) was not common. The self-rated severity of the tinnitus was greater in subjects with higher sleep disturbance scores. Self-rated depressive symptomatology was also highly correlated with sleep disturbance. Retrospective examination of sleep records and polysomnographic data for 10 patients with a complaint of chronic tinnitus revealed a combined effect for the tinnitus condition when associated with another conventional sleep disorder. In spite of the common complaint of sleep disturbance in tinnitus, only a minority seek a sleep examination.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Alster J.
        • Lavie P.
        Spontaneous awakenings within sleep and fragmented sleep.
        in: Sleep. 88. Gustav Fischer Verlag, Stuttgart1989: 193-195
        • Attias J.
        • Shemesh Z.
        • Shoham A.
        • Sohmer H.
        Efficacy of self hypnosis for tinnitus relief.
        Scand Audiol. 1990; 19: 245-249
        • Attias J.
        • Shemesh Z.
        • Sohmer H.
        • Zinger J.
        • Bleich A.
        Psychological profile of help seeking and non-help seeking chronic tinnitus patients.
        in: Aran J.M. Dauman R. Tinnitus 91, Proceedings of the Fourth International Tinnitus Seminar. Kugler Publications, Amsterdam1992
        • Axelsson A.
        • Ringdahl A.
        Tinnitus — A study of its prevalence and characteristics.
        Br J Audiol. 1989; 23: 53-62
        • Barnea G.
        • Attias J.
        • Gold S.
        • Shahar A.
        Tinnitus with normal hearing sensitivity: Extended high-frequency audiometry and auditory-nerve brain-stem evoked responses.
        Audiology. 1990; 29: 36-45
        • Cartwrigth R.
        • Kravitz H.
        • Eastman C.
        • Wood E.
        REM latency and the recovery from depression: Getting over divorce.
        Am J Psychiatry. 1991; 148: 1530-1535
        • Coles R.
        Epidemiology of tinnitus: 1. Prevalance.
        J Lar Otol. 1984; : 7-15
        • Collet L.
        • Moussu M.
        • Disant F.
        • Ahami T.
        • Morgon A.
        Minnesota Multiphasic Personality Inventory in tinnitus disorders.
        Audiology. 1990; 29: 101-106
        • Erlandsson S.
        • Rubinstein B.
        • Carlsson S.
        Tinnitus: Evaluation of biofeedback and stomatognathic treatment.
        Br J Audiol. 1991; 25: 151-161
        • Gerber K.
        • Nehemkis A.
        • Charter R.
        • Jones H.
        Is tinnitus a psychological disorder?.
        Int J Psychiatry Med. 1985; 15: 81-87
        • Hallam R.
        • Jakes S.
        • Hinchcliffe R.
        Cognitive variables in tinnitus annoyance.
        Br J Clin Psycol. 1988; 27: 213-222
        • House J.
        Treatment of severe tinnitus with biofeedback training.
        Laryngoscope. 1978; 88: 406-412
        • House P.
        Personality of the tinnitus patient.
        in: Tinnitus. London: Ciba Foudation Symposium. Pitman Books, 1981: 193-203
        • Hurwitz T.
        • Mahcwald M.
        • Egli E.
        • Smelker E.
        • Woods S.
        Sleep in chronic stress disorders: A preliminary report of clinical and polysomnographic findings in Vietnam combat veterans.
        Sleep Res. 1991; 20A: 272
        • Jakes S.
        • Hallam R.
        • Chambers C.
        • Hinchcliffe R.
        A factor analytical study of tinnitus complaint behavior.
        Audiology. 1985; 24: 195-206
        • Kupfer D.
        • Foster G.
        • Coble P.
        • McPartland R.
        • Ulrich R.
        The application of EEG sleep disorders for the differential diagnosis of affective disorders.
        Am J Psychiatry. 1978; 135: 60-74
        • Lindberg P.
        • Lyttkens L.
        • Melin L.
        • Scott B.
        Tinnitus—Incidence and handicap.
        Scand Audiol. 1984; 13: 287-291
        • Meikle M.
        • Vernon J.
        • Johnson R.
        The perceived severity of tinnitus. Some observations concerning a large population of tinnitus clinic patients.
        Otolaryngol Head Neck Surg. 1984; 92: 689
        • Moller A.
        Pathophysiology of tinnitus.
        Ann Otol Rhinol Laryngol. 1984; 93: 34-39
        • Neher A.
        Tinnitus: The hidden epidemic, A patient's perspective.
        Ann Otol Rhinol Laryngol. 1991; 100: 327-330
      1. Rechtschaffen A. Kales A. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects. U.S. Government Printing Office (Public Heakth Service), Washington, D.C1968
        • Scott B.
        • Lindberg P.
        • Melin L.
        • Lyttkens L.
        Predictors of tinnitus discomfort, adaptation and subjective loudness.
        Br J Audiol. 1990; 24: 51-62
        • Sullivan M.
        • Katon W.
        • Doble R.
        • Sakai C.
        • Russo J.
        • Harrop-Griffiths J.
        Disabling tinnitus—Association with affective disorder.
        Gen Hosp Psychiatry. 1988; 10: 285-291
        • Sullivan M.
        • Sakai C.
        • Dobie R.
        • Katon W.
        Treatment of depressed tinnitus patients with nortriptyline.
        Ann Otol Rhinol Laryngol. 1989; 98: 867-872
        • Sweetow R.
        Cognitive aspects of tinnitus patient management.
        Ear Hearing. 1986; 7: 390-396
        • Tyler R.
        • Baker L.
        Difficulties experienced by tinnitus sufferers.
        J Speech Hearing Disord. 1983; 48: 150-154
        • Zomer J.
        • Peled R.
        • Rubin E.
        • Lavie P.
        Mini Sleep Questionnaire (MSQ) for screening large populations for EDS complaints.
        in: Koella W. Ruther E. Schulz H. Sleep 84, Proceedings of the 7th European Congress of Sleep Research. Gustav Fischer Verlag, Stuttgart1985: 467-470
        • Zung W.W.K.
        A self-rating depression scale.
        Arch Gen Psychiatry. 1967; 12: 63-70