ABSTRACT

Insomnia is a significant difficulty and is reported by large proportion of people with tinnitus. Although cognitive behavioural therapy for insomnia (CBTi) might be an effective treatment, no controlled studies had been conducted to date. This randomised controlled trial evaluated the benefits of CBTi on a sample of 102 people with tinnitus-related insomnia. Participants were randomised to 1) CBTi, 2) Audiology-Based Care (ABC) or 3) Sleep Support Group (SSG). Primary outcomes included insomnia, sleep efficiency and total sleep time. Secondary outcomes measured sleep onset latency, sleep quality, tinnitus distress, psychological distress, functioning and quality of life. CBTi was superior at reducing insomnia and increasing sleep efficiency compared to ABC post-intervention and at 6-month follow-up. ABC was superior at reducing insomnia and increasing sleep efficiency compared to SSG. Both CBTi and ABC reported increased total sleep time compared to SSG at 6-month follow. More than 80% of participants in the CBTi group reported clinically meaningful improvements compared to 47% in ABC and 20% for those receiving social support. CBTi was more effective in reducing tinnitus distress and improving sleep quality, functioning and some aspects of mental health. CBTi and ABC offer effective treatments for tinnitus-related sleep disorder but CBTi offers a sizeable benefit.

摘要

失眠是一个很大的困难，大部分耳鸣患者都报告失眠。尽管失眠的认知行为疗法 (CBTi) 可能是一种有效的治疗方法，但迄今为止尚未进行对照研究。这项随机对照试验评估了 CBTi 对 102 名耳鸣相关失眠症患者样本的益处。参与者被随机分配到 1) CBTi，2) 基于听力学的护理 (ABC) 或 3) 睡眠支持小组 (SSG)。主要结果包括失眠、睡眠效率和总睡眠时间。次要结果测量入睡潜伏期、睡眠质量、耳鸣困扰、心理困扰、功能和生活质量。与 ABC 干预后和 6 个月的随访相比，CBTi 在减少失眠和提高睡眠效率方面具有优势。与 SSG 相比，ABC 在减少失眠和提高睡眠效率方面更胜一筹。与 SSG 相比，CBTi 和 ABC 在 6 个月的随访中都报告了总睡眠时间增加。CBTi 组中超过 80% 的参与者报告了临床上有意义的改善，而 ABC 组中这一比例为 47%，接受社会支持的参与者中这一比例为 20%。CBTi 在减少耳鸣困扰和改善睡眠质量、功能和心理健康的某些方面方面更有效。CBTi 和 ABC 为耳鸣相关的睡眠障碍提供了有效的治疗方法，但 CBTi 提供了相当大的好处。CBTi 组中超过 80% 的参与者报告了临床上有意义的改善，而 ABC 组中这一比例为 47%，接受社会支持的参与者中这一比例为 20%。CBTi 在减少耳鸣困扰和改善睡眠质量、功能和心理健康的某些方面方面更有效。CBTi 和 ABC 为耳鸣相关的睡眠障碍提供了有效的治疗方法，但 CBTi 提供了相当大的好处。CBTi 组中超过 80% 的参与者报告了临床上有意义的改善，而 ABC 组中这一比例为 47%，接受社会支持的参与者中这一比例为 20%。CBTi 在减少耳鸣困扰和改善睡眠质量、功能和心理健康的某些方面方面更有效。CBTi 和 ABC 为耳鸣相关的睡眠障碍提供了有效的治疗方法，但 CBTi 提供了相当大的好处。