Tinnitus and Sleep Difficulties After Cochlear Implantation

Pierzycki, Robert H.; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J.; Moore, David R.; Kitterick, Pádraig T.

doi:10.1097/aud.0000000000000341

Cited by 16 publications

(28 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Present findings are in general agreement with findings on unilateral electric amplification of sound by CI as reported in retrospective studies (11, 28–30), reviews (3, 4, 31–33), and a growing body of prospective studies [e.g., Ref. (7, 12, 34–39)].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

2017

View full text Add to dashboard Cite

Perceptive and receptive aspects of subjective tinnitus like loudness and tinnitus-related distress are partly independent. The high percentage of hearing loss in individuals with tinnitus suggests causality of hearing impairment particularly for the tinnitus percept, leading to the hypothesis that restoration of auditory input has a larger effect on tinnitus loudness than on tinnitus-related distress. Furthermore, it is assumed that high levels of depression or anxiety prevent reductions of tinnitus loudness and distress following restoration of activity in the cochlea. This prospective study investigated the influence of unilateral cochlear implant (CI) on tinnitus in 19 postlingually deafened adults during 6 months following implantation. All had bimodal provision with the other ear being continuously supported by a hearing aid. On the day before CI implantation (T1, T2), and at about 3 and 6 months postsurgery (T3, T4), participants were questioned about their current tinnitus. Loudness was rated on a Numeric Rating Scale, distress was assessed by the TQ12 Tinnitus Questionnaire, and depression and anxiety were recorded with the Hospital Anxiety and Depression Scale. At T2, 79% experienced tinnitus, one participant developed tinnitus after implantation. Following implantation, tinnitus loudness was reduced significantly by 42%, while reductions in tinnitus-related distress (−24%), depression (−20%), and anxiety (−20%) did not attain statistical significance. Significant correlations existed between tinnitus measures, and between postimplantation tinnitus-related distress and anxiety and depression scores. Moreover, improvement of hearing in the CI ear was significantly correlated with reduction in tinnitus loudness. A new aspect of this study is the particular influence of CI provision on perceptive aspects of preexisting tinnitus (hypothesis 1), with the effect size regarding postimplant reduction of perceived tinnitus loudness (1.40) being much larger than effect sizes on the reduction of tinnitus-related distress (0.38), depression (0.53), and anxiety (0.53). Contrary to expectation both tinnitus measures reduce even in the majority of CI recipients with increased levels of anxiety or depression. This suggests that reduction of the tinnitus signal by restoring activity in the cochlea cannot be entirely compensated for by central tinnitus mechanisms and results in a reduction of perceptive and less so of reactive aspects of subjective tinnitus.

show abstract

Section: Discussionsupporting

confidence: 92%

“…On average, as many as 80% of CI candidates experience tinnitus (3, 4). It was realized early that CIs may reduce tinnitus (5) with several authors reporting on tinnitus reduction (6–11). However, the opposite, namely, exacerbation of a preexisting tinnitus, or development of tinnitus with CI use has also been observed (7, 12).…”

Section: Introductionmentioning

confidence: 99%

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

2017

View full text Add to dashboard Cite

show abstract

“…Practical guidelines for primary care physicians, physician training and pragmatic implementation strategies are likely to enhance guideline adherence for secondary prevention management. Bidirectional referral mechanisms instituted in China in 2015 could facilitate the provision of preventive therapy by primary care institutions22; this programme however is in the early stages of implementation.…”

Section: Discussionmentioning

confidence: 99%

Secondary prevention of cardiovascular disease in China

Zhang

et al. 2020

Heart

View full text Add to dashboard Cite

ObjectiveWe aimed to estimate the current use of secondary prevention drugs and identify its associated individual characteristics among those with established cardiovascular diseases (CVDs) in the communities of China.MethodsWe studied 2 613 035 participants aged 35–75 years from 8577 communities in 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, a government-funded public health programme conducted from 2014 to 2018. Participants self-reported their history of ischaemic heart disease (IHD) or ischaemic stroke (IS) and medication use in an interview. Multivariable mixed models with a logit link function and community-specific random intercepts were fitted to assess the associations of individual characteristics with the reported use of secondary prevention therapies.ResultsAmong 2 613 035 participants, 2.9% (74 830) reported a history of IHD and/or IS, among whom the reported use rate either antiplatelet drugs or statins was 34.2% (31.5% antiplatelet drugs, 11.0% statins and 8.3% both). Among the 1 530 408 population subgroups, which were defined by all possible permutations of 16 individual characteristics, reported use of secondary prevention drugs varied substantially (8.4%–60.6%). In the multivariable analysis, younger people, women, current smokers, current drinkers, people without hypertension or diabetes and those with established CVD for more than 2 years were less likely to report taking antiplatelet drugs or statins.ConclusionsThe current use of secondary prevention drugs in China is suboptimal and varies substantially across population subgroups. Our study identifies target populations for scalable, tailored interventions to improve secondary prevention of CVD.

show abstract

“…A recent systematic review has suggested that CI use has the potential to alleviate the burden imposed by tinnitus (Ramakers, van Zon, Stegeman, & Grolman, 2015). Epidemiological studies have also found tinnitus-related distress to be lower in CI users than in potential candidates to receive a CI and that the effect on distress is associated with tinnitus being perceived less frequently by CI users (Pierzycki et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Effects of Tinnitus on Cochlear Implant Programming

et al. 2019

Self Cite

View full text Add to dashboard Cite

Clinical observations suggest that tinnitus may interfere with programming cochlear implants (CIs), the process of optimizing the transmission of acoustic information to support speech perception with a CI. Despite tinnitus being highly prevalent among CI users, its effects and impact on CI programming are obscure. This study characterized the nature, time-course, and impact of tinnitus effects encountered by audiologists and patients during programming appointments. Semistructured interviews with six CI audiologists were analyzed thematically to identify tinnitus effects on programming and related coping strategies. Cross-sectional surveys with 67 adult CI patients with tinnitus and 20 CI audiologists in the United Kingdom examined the prevalence and time-course of those effects. Programming parameters established at CI activation appointments of 10 patients with tinnitus were compared with those of 10 patients without tinnitus. On average, 80% of audiologists and 45% of patients reported that tinnitus makes measurements of threshold (T) levels more difficult because patients confuse their tinnitus with CI stimulation. Difficulties appeared most common at CI activation appointments, at which T levels were significantly higher in patients with tinnitus. On average, 26% of patients reported being afraid of “loud” CI stimulation worsening tinnitus, affecting measurements of loudest comfortable (C) stimulation levels, and 34% of audiologists reported observing similar effects. Patients and audiologists reported that tinnitus makes programming appointments more difficult and tiresome for patients. The findings suggest that specific programming strategies may be needed during CI programming with tinnitus, but further research is required to assess the potential impact on outcomes including speech perception.

show abstract

Tinnitus and Sleep Difficulties After Cochlear Implantation

Cited by 16 publications

References 38 publications

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

Unilateral Cochlear Implantation Reduces Tinnitus Loudness in Bimodal Hearing: A Prospective Study

Secondary prevention of cardiovascular disease in China

Effects of Tinnitus on Cochlear Implant Programming

Contact Info

Product

Resources

About