Cognitive behavioural therapy for tinnitus-related insomnia: evaluating a new treatment approach

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.