How people with tinnitus-related insomnia experience group CBT-for-insomnia (CBTi): a thematic analysis

Abstract

Objective: Although insomnia often compounds tinnitus, sleeping problems in people experiencing tinnitus are rarely treated. This study investigates the experiences of participants receiving Cognitive Behavioural Therapy for insomnia (CBTi) as part of a randomised controlled trial for managing tinnitus-related insomnia. The aim of this study is to gain detailed insight into participants’ perceptions and experiences of this treatment.

Design: Semi-structured interviews were conducted via phone or in-person by one of the two clinical psychologists who facilitated the CBTi sessions. Reflexive thematic analysis with semantic inductive approach was used for analysis to keep the research question theoretically flexible.

Study samples: Eight participants (three females, age range 32–69 years) were interviewed six months after CBTi completion.

Results: Three superordinate themes were identified: “Common humanity and transcending individual distress,” “Changing the things I can” and “Accepting the things I cannot change.” The group environment helped participants to normalise their experiences. Reliable tinnitus/sleep information and robust behavioural change techniques helped participants to respond and relate to their condition differently.

Conclusion: Generally, participants reported long-term benefits from CBTi to treat tinnitus-related insomnia, particularly increased confidence, and getting on with life. CBTi is multi-component, so clinicians need to respond to individual preferences and lifestyles.

Keywords:

• Tinnitus
• insomnia
• CBTi
• thematic analysis
• acceptance

Acknowledgements

We thank the patients who took part in the study. The trial was conducted as a collaboration between the Royal National Ear, Nose and Throat and Eastman Dental Hospital, University College London Hospitals, London, UK and the University of Bath, UK.

Ethical approval

Ethical approval was granted for the trial by the London-Camden and Kings Cross NHS Research Ethics Committee and for the reflective study by the University of Bath Research Ethics Committee, 21-052.

Informed consent

Informed written consent to take part in the qualitative study has been obtained by all eight participants prior to the interviews.

Author contributions

EM led and designed the study, collected the data and contributed to analysis and write up. LC supported the study design, transcribed and analysed the data and contributed to write up. FV and LM contributed to data analysis and write up.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request. Clinical Trial registration: NCT03386123.

Additional information

Funding

It was funded by the “British Tinnitus Large Research Project Funding Award.”