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Abstract：
BACKGROUND: Tinnitus affects approximately 740 million adults globally, involving hearing, emotion, and sleep systems. However, studies using polysomnography and pure-tone audiometry (PTA) are limited. We aimed to assess the correlation between tinnitus and hearing, sleep quality, characteristics, and depression using polysomnography and PTA.
METHODS: In this cross-sectional study, we divided participants into tinnitus and non-tinnitus groups. We included 100 outpatients (65 with tinnitus, 35 without) from a medical center in Taiwan, who underwent polysomnography and completed rating scales including the Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM). We analyzed correlations, conducted group comparisons, assessed factors related to THI-CM scores, constructed ROC curves to predict depression in the tinnitus group, and performed multinomial and logistic regression to explore associations.
RESULTS: Descriptive statistics identified a cohort with mean age 53.9 ± 12.80 years, 63% exhibited PHQ-9 scores ≥ 10, and 66% had Apnea-Hypopnea Index (AHI) > 5. The ratio of rapid eye movement and deep sleep to stage 1 + 2 sleep was relatively low and non-significant. Likewise, leg movements was higher in the tinnitus group but not statistically significant. In the tinnitus group, 63.08% had depression, and 81.54% had AHI > 5. Univariate logistic regression linked tinnitus to AHI > 5 (Odds ratio (OR) 2.67, p = 0.026) and male sex (OR 2.49, p = 0.034). A moderate positive correlation was found between the THI-CM score and PHQ-9 score (rs = 0.50, p < 0.001). Further adjustment for obstructive sleep apnea showed associations between PHQ-9 (total score) or depression and THI-CM Grade 3-5 (OR = 1.28; OR = 8.68). Single- and multifactor regression analyses highlighted significant associations of PSQI scores > 13 (OR 7.06, p = 0.018) and THI-CM scores > 47 (OR 7.43, p = 0.002) with depression.
CONCLUSIONS: Our study recruited tinnitus participants with slight or mild hearing loss and mild tinnitus handicap. Depression was identified as a predominant factor in tinnitus-related handicap. The mild tinnitus handicap in tinnitus participants may explain the lack of significant differences in depression, sleep quality, and polysomnographic sleep characteristics between tinnitus and non-tinnitus groups. Further extensive and prospective studies are needed to elucidate the complex links among depression, sleep, and tinnitus.
METHODS: In this cross-sectional study, we divided participants into tinnitus and non-tinnitus groups. We included 100 outpatients (65 with tinnitus, 35 without) from a medical center in Taiwan, who underwent polysomnography and completed rating scales including the Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM). We analyzed correlations, conducted group comparisons, assessed factors related to THI-CM scores, constructed ROC curves to predict depression in the tinnitus group, and performed multinomial and logistic regression to explore associations.
RESULTS: Descriptive statistics identified a cohort with mean age 53.9 ± 12.80 years, 63% exhibited PHQ-9 scores ≥ 10, and 66% had Apnea-Hypopnea Index (AHI) > 5. The ratio of rapid eye movement and deep sleep to stage 1 + 2 sleep was relatively low and non-significant. Likewise, leg movements was higher in the tinnitus group but not statistically significant. In the tinnitus group, 63.08% had depression, and 81.54% had AHI > 5. Univariate logistic regression linked tinnitus to AHI > 5 (Odds ratio (OR) 2.67, p = 0.026) and male sex (OR 2.49, p = 0.034). A moderate positive correlation was found between the THI-CM score and PHQ-9 score (rs = 0.50, p < 0.001). Further adjustment for obstructive sleep apnea showed associations between PHQ-9 (total score) or depression and THI-CM Grade 3-5 (OR = 1.28; OR = 8.68). Single- and multifactor regression analyses highlighted significant associations of PSQI scores > 13 (OR 7.06, p = 0.018) and THI-CM scores > 47 (OR 7.43, p = 0.002) with depression.
CONCLUSIONS: Our study recruited tinnitus participants with slight or mild hearing loss and mild tinnitus handicap. Depression was identified as a predominant factor in tinnitus-related handicap. The mild tinnitus handicap in tinnitus participants may explain the lack of significant differences in depression, sleep quality, and polysomnographic sleep characteristics between tinnitus and non-tinnitus groups. Further extensive and prospective studies are needed to elucidate the complex links among depression, sleep, and tinnitus.
摘要：
背景：耳鸣影响全球约7.4亿成年人，涉及听力，情感，和睡眠系统。然而,使用多导睡眠图和纯音测听（PTA）的研究有限。我们的目的是评估耳鸣和听力之间的相关性，睡眠质量,特点,和抑郁症使用多导睡眠图和PTA。
方法：在这项横断面研究中，我们将参与者分为耳鸣和非耳鸣组。我们纳入了100名门诊患者(65名耳鸣患者，35没有）来自台湾的医疗中心，接受多导睡眠监测并完成包括患者健康问卷-9（PHQ-9）在内的评定量表，匹兹堡睡眠质量指数（PSQI）中文版和中文版耳鸣障碍量表(THI-CM)。我们分析了相关性，进行了分组比较，与THI-CM得分相关的评估因素，构建ROC曲线来预测耳鸣组的抑郁，并进行多项和逻辑回归以探索关联。
结果：描述性统计确定了一个平均年龄为53.9±12.80岁的队列，63%的患者PHQ-9评分≥10，66%的患者呼吸暂停低通气指数(AHI)>5。快速眼动和深度睡眠与1+2阶段睡眠的比率相对较低且不显着。同样，耳鸣组的腿部运动较高,但无统计学意义.在耳鸣组中，63.08%有抑郁症,81.54%的AHI>5。单因素logistic回归分析将耳鸣与AHI>5（赔率比（OR）2.67，p=0.026）和男性（OR2.49，p=0.034）相关联。THI-CM评分与PHQ-9评分呈中度正相关(rs=0.50,p<0.001)。对阻塞性睡眠呼吸暂停的进一步调整显示PHQ-9（总分）或抑郁症与THI-CM3-5级之间存在关联（OR=1.28；OR=8.68）。单因素和多因素回归分析强调了PSQI评分>13(OR7.06,p=0.018)和THI-CM评分>47(OR7.43,p=0.002)与抑郁的显著关联。
结论：我们的研究招募了有轻微或轻度听力损失和轻度耳鸣障碍的耳鸣参与者。抑郁症被认为是耳鸣相关障碍的主要因素。耳鸣参与者的轻度耳鸣障碍可以解释抑郁症缺乏显着差异，睡眠质量,耳鸣和非耳鸣组之间的多导睡眠图睡眠特征。需要进一步广泛和前瞻性的研究来阐明抑郁症之间的复杂联系，睡眠,还有耳鸣.
方法：在这项横断面研究中，我们将参与者分为耳鸣和非耳鸣组。我们纳入了100名门诊患者(65名耳鸣患者，35没有）来自台湾的医疗中心，接受多导睡眠监测并完成包括患者健康问卷-9（PHQ-9）在内的评定量表，匹兹堡睡眠质量指数（PSQI）中文版和中文版耳鸣障碍量表(THI-CM)。我们分析了相关性，进行了分组比较，与THI-CM得分相关的评估因素，构建ROC曲线来预测耳鸣组的抑郁，并进行多项和逻辑回归以探索关联。
结果：描述性统计确定了一个平均年龄为53.9±12.80岁的队列，63%的患者PHQ-9评分≥10，66%的患者呼吸暂停低通气指数(AHI)>5。快速眼动和深度睡眠与1+2阶段睡眠的比率相对较低且不显着。同样，耳鸣组的腿部运动较高,但无统计学意义.在耳鸣组中，63.08%有抑郁症,81.54%的AHI>5。单因素logistic回归分析将耳鸣与AHI>5（赔率比（OR）2.67，p=0.026）和男性（OR2.49，p=0.034）相关联。THI-CM评分与PHQ-9评分呈中度正相关(rs=0.50,p<0.001)。对阻塞性睡眠呼吸暂停的进一步调整显示PHQ-9（总分）或抑郁症与THI-CM3-5级之间存在关联（OR=1.28；OR=8.68）。单因素和多因素回归分析强调了PSQI评分>13(OR7.06,p=0.018)和THI-CM评分>47(OR7.43,p=0.002)与抑郁的显著关联。
结论：我们的研究招募了有轻微或轻度听力损失和轻度耳鸣障碍的耳鸣参与者。抑郁症被认为是耳鸣相关障碍的主要因素。耳鸣参与者的轻度耳鸣障碍可以解释抑郁症缺乏显着差异，睡眠质量,耳鸣和非耳鸣组之间的多导睡眠图睡眠特征。需要进一步广泛和前瞻性的研究来阐明抑郁症之间的复杂联系，睡眠,还有耳鸣.
