Risk factors of decompensated tinnitus and the interaction effect of anxiety and poor sleep on decompensated tinnitus: a multicenter study

Abstract

Background

Decompensated tinnitus substantially degrades quality of life. Anxiety and poor sleep are comorbidities in decompensated tinnitus.

Objective

This multicenter study was designed to investigate the risk factors of decompensated tinnitus and to analyze the interaction effect of anxiety and poor sleep on decompensated tinnitus by conducting a multicenter study.

Material and Methods

We retrospectively analyzed patients with subjective chronic tinnitus who presented to five Chinese hospitals in China from September 2019 to November 2020. Demographic characteristics, pure tone audiometry, tinnitus-related tests, psychometric and sleep questionnaires were applied.

Results

A total of 338 patients were included, and 99 (29.3%) patients were in the decompensated group. Poor sleep and anxiety were possible risk factors of decompensated tinnitus by a forced-entry binary logistic analysis. Sleep disturbances and anxiety had an additive interaction that accounted for 87% of the decompensated tinnitus cases in our study population (RERI = 10.96, S = 18.22, AP = 0.87).

Conclusions and Significance

Anxiety and sleep disturbances are possible risk factors of decompensated tinnitus. The combination of poor sleep and anxiety exerts a greater impact on tinnitus severity than either risk factor alone.

Chinese abstract

背景：失代偿性耳鸣会显著降低生活质量。焦虑和睡眠不佳是失代偿性耳鸣的合并症。

目的：本研究通过一项多中心研究, 调查失代偿性耳鸣的危险因素并分析焦虑和睡眠不足对失代偿性耳鸣的交互作用。

材料和方法：我们回顾性分析了 2019 年 9 月至 2020 年 11 月在中国五家医院就诊的主观慢性耳鸣患者。对人口特征、纯音测听、耳鸣相关测试、心理测量和睡眠进行问卷调查并评估。

结果：共纳入 338 例患者, 99 例（29.3%）患者属失代偿组。根据二元逻辑分析, 睡眠不佳和焦虑可能是失代偿性耳鸣的危险因素。睡眠障碍和焦虑有一种附加的相互作用, 它是导致研究人群中 87% 的失代偿性耳鸣病例的原因 （RERI =10.96, S =18.22, AP= 0.87）。

结论和意义：焦虑和睡眠障碍是失代偿性耳鸣的可能危险因素。睡眠不佳和焦虑两者的综合对耳鸣的严重程度产生比任何一个单独的风险因素更大的影响。

Keywords:

• Decompensated tinnitus
• risk factor
• sleep
• anxiety
• interaction effect

Ethical approval

This study was approved by the Medical Ethics Committee of Peking Union Medical College Hospital (JS-2226).

Consent to participate

Written informed consent was obtained from the patients.

Author contributions

Zhiqiang Gao was the chief investigator; he conceived of the study and critically reviewed the manuscript. Huiying Sun, Guodong Feng, Hong Yu, Yongjin Su, Fengying Zhang and Juan Feng conducted the study in 5 different hospitals. Huiying Sun drafted the manuscript. All authors approved the final manuscript for publication.

Disclosure statement

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Funding

This work was funded by the National Natural Science Foundation of China (NNSFC, Grant number 81870729].