REM Sleep Impairment May Underlie Sleep-Driven Modulations of Tinnitus in Sleep Intermittent Tinnitus Subjects: A Controlled Study

Abstract

(1) Background: Poor sleep and fragmented sleep are associated with several chronic conditions. Tinnitus is an auditory symptom that often negatively combines with poor sleep and has been associated with sleep impairment and sleep apnea. The relationship between tinnitus psychoacoustic characteristics and sleep is still poorly explored, notably for a particular subgroup of patients, for whom the perceived loudness of their tinnitus is highly modulated by sleep. (2) Methods: For this observational prospective study, 30 subjects with tinnitus were recruited, including 15 “sleep intermittent tinnitus” subjects, who had reported significant modulations of tinnitus loudness related to night sleep and naps, and a control group of 15 subjects displaying constant non-sleep-modulated tinnitus. The control group had matching age, gender, self-reported hearing loss grade and tinnitus impact on quality of life with the study group. All patients underwent a polysomnography (PSG) assessment for one complete night and then were asked to fill in a case report form, as well as a report of tinnitus loudness before and after the PSG. (3) Results: “Sleep Intermittent tinnitus” subjects had less Stage 3 sleep (p < 0.01), less Rapid-Eye Movement (REM) Sleep (p < 0.05) and more Stage 2 sleep (p < 0.05) in proportion and duration than subjects from the control group. In addition, in the “sleep Intermittent tinnitus” sample, a correlation was found between REM sleep duration and tinnitus overnight modulation (p < 0.05), as well as tinnitus impact on quality of life (p < 0.05). These correlations were not present in the control group. (4) Conclusions: This study suggests that among the tinnitus population, patients displaying sleep-modulated tinnitus have deteriorated sleep quality. Furthermore, REM sleep characteristics may play a role in overnight tinnitus modulation. Potential pathophysiological explanations accounting for this observation are hypothesized and discussed.

Inflammatory Markers and Sleep Architecture in Sleep Bruxism—A Case-Control Study

“…The systemic complications involve the development of hypertension and as a result increase overall cardiovascular risk and reduce healthy life expectancy [47,48]. The formidable challenge is aggravated by the fact that symptoms accompanying hypertension such as headaches and tinnitus can equally be the symptoms of SB [49,50].…”

Cortical evoked activity is modulated by the sleep state in a ferret model of tinnitus. A case study

“…Yet, the possibility remains that local and global changes in brain activity across vigilance states [30,36] may, in turn, interfere with tinnitus-related activity. In particular, high-intensity sleep with high levels of cortical slow wave activity, prompted by cellular and network-level drives for recovery sleep [37], such as after a period of extended wakefulness [30,38,39], could potentially mitigate tinnitus temporarily. This leads to the intriguing hypothesis that a dynamic modulation of the phantom sound sensation occurs across the sleep-wake cycle, depending on the relative weighting of circadian and homeostatic drives.…”

Graph-Based Electroencephalography Analysis in Tinnitus Therapy

“…Tinnitus can stem from various underlying causes [10], including exposure to loud noises, age-related hearing loss, ear infections, specific medications, blockage by earwax, head and neck injuries, and other medical conditions [11]. The impact of tinnitus on individuals can range from mild annoyance to significant distress [12,13], affecting their overall quality of life, sleep patterns [14], ability to concentrate, and emotional well-being.…”