Tinnitus treatment with sound stimulation during sleep

A new strategy for idiopathic subjective tinnitus treatment – sound stimulation during sleep – has been applied. It was based on the knowledgement that the auditory system also works during sleep, processing the incoming information. Eleven patients were stimulated every night during 6 months. The stimulus was a sound that mimetized the tinnitus and was fixed at the same tinnitus intensity, applied through an iPod. All patients decreased their tinnitus intensity in the first month of treatment (statistically significant), most of them in the first week. Tinnitus intensity continued decreasing in the following weeks; three patients presented periods of total silence.

Loquens

It is known that auditory information is continuously processed both during wakefulness and sleep. Consistently, it has been shown that sound stimulation mimicking tinnitus during sleep decreases the intensity of tinnitus and improves the patients’ quality of life. The mechanisms underlying this effect are not known. To begin to address this question, eleven patients suffering from tinnitus were stimulated with sound mimicking tinnitus at different sleep stages; 4 were stimulated in N2, 4 in stage N3 (slow waves sleep) and 3 in REM sleep (stage with Rapid Eyes Movements). Patients’ sleep stage was monitored through polysomnography, for sound stimulation application. Tinnitus level reported by subjects were compared the days before and after stimulation and statistically analyzed (paired Student t test). All patients stimulated at stage N2 reported significantly lower tinnitus intensity the day after stimulation, while none stimulated during stage N3 and only one out of three stimula...

Somnologie, 2005

Question of the study Previous studies showed that disturbed sleep is a common and frequent complaint reported by tinnitus patients. The purpose of this small pilot study was to investigate the impact of tinnitus as a cause of secondary insomnia. Patients and methods We compared polysomnographic records of ten patients with presently untreated chronic tinnitus and a complaint of disturbed sleep with those of 20 patients with primary insomnia and 20 age-and gender-matched healthy controls. Psychometric measurements were also performed using a tinnitus-standard rating scale, PSQI, SF-A, and BDI. Results Concerning subjective sleep quality, both tinnitus and insomnia patients rated their sleep as significantly impaired compared to controls. Differences between patients and healthy controls were also observed with respect to their sleep patterns, with tinnitus patients showing a decreased sleep efficiency (P ¼ 0.049) and total sleep time (P ¼ 0.035) and an increased frequency of awakenings (P ¼ 0.016).

Clinical Medicine Insights: Psychiatry, 2018

Tinnitus is a prevalent medical disorder which frequently becomes chronic and severe. Furthermore, quality of life can become compromised with many experiencing comorbid insomnia. We hypothesize that insomnia is a highly prevalent symptom and diagnostic category accompanying tinnitus. Our article reviews the tinnitus literature examining the prevalence of insomnia, the sleep disturbances found, and any methodological issues. Our literature search included a number of databases such as PubMed, Cochrane, and Embase. We found that 16 prior studies had sufficient data presented that allowed for an assessment of the prevalence rate of insomnia in tinnitus; the prevalence rate ranged from 10% to 80% (most rates were over 40%). The overwhelming majority of these studies inadequately defined insomnia as a diagnosis but described it only as a symptom. They focused predominantly on questionnaires (sent via the mail) asking only 1 to 4 questions on whether tinnitus disturbs sleep. Frequently, ...

Sleep Science, 2014

Based on the knowledge that sensory processing continues during sleep and that a relationship exists between sleep and learning, a new strategy for treatment of idiopathic subjective tinnitus, consisted of customized sound stimulation presented during sleep, was tested. It has been previously shown that this treatment induces a sustained decrease in tinnitus intensity; however, its effect on brain activity has not yet been studied. In this work, we compared the impact of sound stimulation in tinnitus patients in the different sleep stages. Ten patients with idiopathic tinnitus were treated with sound stimulation mimicking tinnitus during sleep. Power spectra and intra-and inter-hemispheric coherence of electroencephalographic waves from frontal and temporal electrodes were measured with and without sound stimulation for each sleep stage (stages N2 with sleep spindles; N3 with slow wave sleep and REM sleep with Rapid Eye Movements). The main results found were that the largest number of changes, considering both the power spectrum and wave's coherence, occurred in stages N2 and N3. The delta and theta bands were the most changed, with important changes also in coherence of spindles during N2. All changes were more frequent in temporal areas. The differences between the two hemispheres do not depend, at least exclusively, on the side where the tinnitus is perceived and, hence, of the stimulated side. These results demonstrate that sound stimulation during sleep in tinnitus patients' influences brain activity and open an avenue for investigating the mechanism underlying tinnitus and its treatment.

International journal of audiology, 2015

Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients' quality of life. Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months. Twelve patients with subjective idiopathic chronic tinnitus were studied. Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the pe...

B-ENT

Effects of subjective tinnitus on sleep quality and mini mental status examination scores. Objectives: We investigated the effects of subjective tinnitus on sleep quality and Mini Mental Status Examination (MMSE) scores of participants. Methods: The study group consisted of 15 patients, including 21 ears with tinnitus (6 bilateral, 9 unilateral). The control group consisted of 8 healthy patients with normal hearing and no tinnitus (16 ears). We assessed sleep quality using the Mini Sleep Questionnaire (MSQ) and mental health using the MMSE. Results: Sleep delay (SD) was significantly higher in tinnitus patients (5.28 ± 2.23) compared to controls (3.25 ± 2.56) (p = 0.018). Subjective tinnitus loudness level (STLL) scores were higher and sleep quality was impaired in females, older patients, and patients with lower MMSE scores. Sleep quality was also worse in patients with longer tinnitus duration. In younger and well educated patients, MMSE scores were higher. Higher STLL scores and shorter tinnitus duration were associated with lower MMSE scores. Patients with newly developed tinnitus reported more disturbances and showed greater effects on mental and cognitive functioning. Conclusion: In subjective tinnitus patients, sleep delay values increased. Long tinnitus duration and high STLL scores may affects patients' cognitive functions as shown by decreased MMSE scores. Furthermore, mental status changes in tinnitus patients were frequently overlooked.

International Journal of Audiology, 2019

Objective: Insomnia frequently occurs alongside distressing tinnitus, and greater tinnitus severity is associated with more sleep disturbance. Insomnia and tinnitus probably share common underlying processes and sleep studies show striking similarities between primary and tinnitus-related insomnia. This is the first study to evaluate outcomes following insomnia-specific Cognitive Behavioural Therapy (CBTi) for tinnitus-related insomnia in a 'real world' clinic. Design: Treatment was six-sessions of group-based CBTi. Measures of insomnia, sleep diaries, tinnitus distress, psychological distress, anxiety and depression were completed preintervention, post-intervention and at six-weeks follow up. Study sample: Participants were 24 adults with chronic, distressing tinnitus and associated sleep disturbance. Twenty-two completed treatment. Results: CBTi was associated with significant improvements from pre-intervention to postintervention maintained at follow up in insomnia, sleep-diary measures, tinnitus distress, psychological distress, anxiety and depression, largely maintained at follow-up. Reliable improvements were reported in insomnia (by 67% of patients), tinnitus distress (by 50% of patients) and psychological distress (by 38% of patients) post-intervention. Conclusions: The results suggest that CBTi is associated with reduced insomnia and distress for patients reporting chronic and distressing tinnitus with related insomnia. Further research into CBTi for this population, using utilizing robust, randomized controlled designs, is warranted.

International Journal of Environmental Research and Public Health, 2023

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of the American Academy of Audiology, 2014

Background: The authors reviewed practicable options of sound therapy for tinnitus, the evidence base for each option, and the implications of each option for the patient and for clinical practice.