Effects of cognitive behavioural therapy on insomnia in adults with tinnitus: Systematic review and meta-analysis of randomised controlled trials

Ffion Curtis; Despina Laparidou; Chris Bridle; Graham R Law; Simon Durrant; Alina Rodriguez; Robert H Pierzycki; Aloysius N Siriwardena

doi:10.1016/j.smrv.2020.101405

Effects of cognitive behavioural therapy on insomnia in adults with tinnitus: Systematic review and meta-analysis of randomised controlled trials

Sleep Med Rev. 2021 Apr:56:101405. doi: 10.1016/j.smrv.2020.101405. Epub 2020 Dec 1.

Authors

Ffion Curtis¹, Despina Laparidou², Chris Bridle³, Graham R Law², Simon Durrant², Alina Rodriguez⁴, Robert H Pierzycki⁵, Aloysius N Siriwardena²

Affiliations

¹ Lincoln International Institute for Rural Health, University of Lincoln, UK. Electronic address: fcurtis@lincoln.ac.uk.
² Lincoln International Institute for Rural Health, University of Lincoln, UK.
³ School of Psychology, University of Bedfordshire, Luton, UK.
⁴ Lincoln International Institute for Rural Health, University of Lincoln, UK; School of Public Health, Imperial College London, UK.
⁵ NIHR Nottingham Biomedical Research Centre, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.

PMID: 33360841
DOI: 10.1016/j.smrv.2020.101405

Abstract

Insomnia is common in patients with tinnitus and negatively affects tinnitus symptoms and quality of life. This systematic review aimed to synthesise evidence of the effectiveness of cognitive behavioural therapy (CBT) based interventions on insomnia in adults with tinnitus. We conducted a comprehensive database search (MEDLINE, CINAHL, Web of Science, CENTRAL, ClinicalTrials.gov and PROSPERO) for published, unpublished and ongoing randomised controlled trials of CBT in adults with tinnitus. Five trials met the inclusion criteria for the systematic review, with four of these providing data for the meta-analysis. This demonstrated a statistically significant reduction in Insomnia Severity Index (a standard diagnostic questionnaire of insomnia used in clinical settings) following CBT (-3.28, 95% CI -4.51, -2.05, P=<0.001). There was no evidence of statistical heterogeneity (I² = 0%). Risk of bias was considered low in all categories except blinding of participants, personnel, and/or the assessment of outcomes. Here, for the first time, we demonstrate that CBT-based interventions can significantly improve sleep in adults with tinnitus.

Keywords: Cognitive behaviour therapy; Insomnia; Tinnitus.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adult
Cognitive Behavioral Therapy*
Humans
Quality of Life
Randomized Controlled Trials as Topic
Sleep Initiation and Maintenance Disorders* / therapy
Tinnitus* / therapy