Good news from tinnitus cbt book
46
Living Well with Tinnitus
of the night, and achieving restorative sleep. About 70 per cent of patients seeking help for tinnitus report some form of sleep difficulty. But it is not clear whether the degree of sleep difficulty is related to the loudness or quality of the tinnitus of whether it is related to the psychological impact of the tinnitus
In a study conducted in our clinic in collaboration with the Universities of Nottingham and Cambridge, we assessed whether the loudness of tinnitus was related to sleep dis turbances (insomnia), based on data for 417 patients. The analysis showed that the loudness of tinnitus is only indirectly related to the severity of insomnia. In other words, louder tinnitus does not necessarily lead to more sleep disturbances The severity of insomnia depends on the amount of depression and annoyance caused by the tinnitus. The more depressed and annoyed a person becomes due to their tinnitus, the more sleep disturbances they tend to experience. According to the theory behind CBT, emotional disturbances such as feeling irritated or depressed are not directly due to hearing tinnitus but rather are the result of our thoughts about tinnitus and its impact on our behaviours. Therefore, in order to reduce tinnitus-related sleep disturbances, we need to manage our thoughts and behaviours. This is the aim of CBT for tinnitus as described in this book. Listening to music or background noise at night-time is an avoidance behaviour, and it does not address the key cause of the sleep disturbances, namely the tinnitus-related negative thoughts. In the chapters on treat ment, we discuss how to use CBT to sleep difficulties. manage tinnitus-induced