[Key factors of the severity of chronic subjective tinnitus: a complex network analysis]

Objective:To investigate the key factors related to the severity of chronic subjective tinnitus through a complex network analysis. Methods:A retrospective study about patients with chronic subjective tinnitus presented to Peking Union Medical College Hospital from December 2019 to October 2020 was conducted. The demographic information, audiometric and tinnitus-related tests, and scores of Tinnitus Handicap Inventory（THI）, Hospital Anxiety and Depression Scale（HADS）, Pittsburgh Sleep Quality Index（PSQI） and Visual Analogue Scale（VAS） of tinnitus loudness and annoyance were set as nodes in a complex network which was conducted and analyzed through the R package. Results:A total of 183 patients were enrolled, including 99（54.1%） males and 84（45.9%） females, with an average age of（41.65±1.05） years. The results of the complex network analysis showed that anxiety and sleep disorder were closely related to THI score, and anxiety was more important than sleep disorder. There was a strong correlation between self-reported anxiety and insomnia. Demographic characteristics, audiologic and tinnitus-associated tests were not significantly related to THI score. Conclusion:Anxiety and sleep disturbance were key factors related to tinnitus severity, and anxiety played a more important role. There was an obvious correlation between sleep disorder and anxiety, and they might have a superimposed effect on tinnitus severity. Future therapies of tinnitus should pay more attention on releasing anxiety and insomnia.