You may not have heard of tinnitus (ringing or buzzing in the ears), but according to the U.S. Centers for Disease Control and Prevention, 50 million patients report having tinnitus. That’s 15 percent of the population! Among those patients reporting tinnitus, 20 million have chronic tinnitus and two million report extreme or debilitating tinnitus.
With these numbers, it is apparent that tinnitus is not an uncommon issue. However, treatment for tinnitus is rarely a straightforward matter. Age is the foremost cause of tinnitus, but many other factors can lead to or exacerbate the condition. These causes and factors include head or neck trauma, ototoxicity, acoustic shock, viral and vascular diseases, and noise-induced hearing loss. Many other medical and psychiatric conditions can also contribute to tinnitus.
Because the causes of tinnitus are varied, the condition is a complex issue that often involves both psychological and neurophysiological mechanisms. While hearing aids can be helpful in reducing the effect of tinnitus, treatment is considered incomplete if the patient does not receive a diagnostic assessment of their auditory system and a therapy plan.
As part of a tinnitus patient’s assessment and treatment planning, they should meet with both an ENT physician (otolaryngologist) and a neuropsychiatrist to identify any medical conditions that require treatment, as well as to help manage issues such as anxiety, depression, stress, insomnia, and other neuropsychiatric disorders.
Interestingly, recent research has found a strong connection between tinnitus and insomnia. Symptoms commonly associated with tinnitus can include insomnia, as well as anxiety, stress, personality disorders, PTSD, headaches and pain, and processing speed difficulties. The correlation between tinnitus and insomnia appears to be particularly strong, and the greater the tinnitus severity, the more likely that the patient will also suffer from insomnia or another sleep problem.
One of the difficulties in the connection between tinnitus and insomnia is that they create a cycle, each one exacerbating the other. For example, a tinnitus patient may worry that their tinnitus is worsening as they lie in bed in a quiet room at night, and their concerns prevent them from sleeping. The lack of sleep will then, in turn, reinforce the patient’s idea that the tinnitus has worsened and that the sound will never end. This cycle tends to intensify negative thoughts and existing emotional disorders.
Such negative thoughts create fear of tinnitus and insomnia, and can even trigger autonomic arousal and emotional distress. Fortunately, studies have found that patients with tinnitus and insomnia can often be successfully treated with therapy. In fact, research indicates that Cognitive Behavioral Therapy for Insomnia (CBTI) provides more lasting sleep improvement, with fewer side effects, than pharmacological treatments.
These results, combined with the necessity of therapy for tinnitus treatment, suggest that treatment for tinnitus and insomnia take similar paths in therapy. With proper treatment, the vicious cycle of tinnitus and insomnia can be halted, or at least, patients can learn appropriate management techniques.
If you believe you are suffering from tinnitus, with or without insomnia, we welcome you to contact our audiology practice today. We are dedicated to ensuring that you receive the treatment you need.