Background: Decompensated tinnitus substantially degrades quality of life. Anxiety and poor sleep are comorbidities in decompensated tinnitus.
Objective: This multicenter study was designed to investigate the risk factors of decompensated tinnitus and to analyze the interaction effect of anxiety and poor sleep on decompensated tinnitus by conducting a multicenter study.
Material and methods: We retrospectively analyzed patients with subjective chronic tinnitus who presented to five Chinese hospitals in China from September 2019 to November 2020. Demographic characteristics, pure tone audiometry, tinnitus-related tests, psychometric and sleep questionnaires were applied.
Results: A total of 338 patients were included, and 99 (29.3%) patients were in the decompensated group. Poor sleep and anxiety were possible risk factors of decompensated tinnitus by a forced-entry binary logistic analysis. Sleep disturbances and anxiety had an additive interaction that accounted for 87% of the decompensated tinnitus cases in our study population (RERI = 10.96, S = 18.22, AP = 0.87).
Conclusions and significance: Anxiety and sleep disturbances are possible risk factors of decompensated tinnitus. The combination of poor sleep and anxiety exerts a greater impact on tinnitus severity than either risk factor alone.
Keywords: Decompensated tinnitus; anxiety; interaction effect; risk factor; sleep.