Parental Separation and Parental Mental Health in Childhood and Risk of Insomnia in Adulthood among Patients with Tinnitus

Abstract

Background:

Many patients seeking help for tinnitus also suffer from insomnia. Adverse childhood experiences may affect the likelihood of insomnia in later life for such patients.

Purpose:

To explore whether parental separation and parental mental health during childhood are related to the severity of insomnia among patients with tinnitus and/or hyperacusis seen in an Audiology clinic.

Research Design:

This was a retrospective cross-sectional study.

Study Sample:

One hundred seventy-four consecutive patients who attended a tinnitus/hyperacusis clinic in the United Kingdom were included.

Data Collection:

Data were based on responses to questionnaires for people seeking help for tinnitus.

Results:

Sixteen percent of patients (27/174) reported that during the first 18 years of life, their parents were separated or divorced and 41% (72/174) reported that their parent(s) suffered from a mental illness. The mean score for the insomnia severity index (ISI) was not significantly affected by parental separation or divorce. However, the mean ISI score was significantly worse for patients whose parents had a mental illness. A multinomial logistic regression model, adjusted for the presence of hyperacusis, hearing loss, age, and gender, indicated that for individuals experiencing tinnitus, a history of parental mental illness during their childhood increased the chance of severe insomnia by a factor of 3.4 (95% confidence interval: 1.1 to 10.8, p = 0.04). The risk of having severe insomnia was 3.8 times greater for patients with hyperacusis than for those without.

Conclusions:

Among patients seeking help for tinnitus/hyperacusis, poor parental mental health was associated with severe insomnia.

Key Words

childhood experience - insomnia - mental health - tinnitus

• REFERENCES

• Aazh H, Lammaing K, Moore BCJ. 2017; Factors related to tinnitus and hyperacusis handicap in older people. Int J Audiol 56: 677-684
• Aazh H, Danesh A, Moore BCJ. 2019; Parental mental health in childhood as a risk factor for anxiety and depression among people seeking help for tinnitus and hyperacusis. J Am Acad Audiol 30: 772-780
• Aazh H, Langguth B, Danesh AA. 2018; Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis. Int J Audiol 57: 941-946
• Aazh H, Moore BCJ. 2017; a Factors associated with depression in patients with tinnitus and hyperacusis. Am J Audiol 26: 562-569
• Aazh H, Moore BCJ. 2017; b Factors related to uncomfortable loudness levels for patients seen in a tinnitus and hyperacusis clinic. Int J Audiol 56: 793-800
• Aazh H, Moore BCJ. 2017; c Usefulness of self-report questionnaires for psychological assessment of patients with tinnitus and hyperacusis and patients’ views of the questionnaires. Int J Audiol 56: 489-498
• Aazh H, Moore BCJ. 2019; Tinnitus loudness and the severity of insomnia: a mediation analysis. Int J Audiol 58: 208-212
• Aazh H, Moore BCJ, Lammaing K, Cropley M. 2016; Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: patients’ evaluations of the effectiveness of treatments. Int J Audiol 55: 514-522
• Anda RF, Brown DW, Dube SR, Bremner JD, Felitti VJ, Giles WH. 2008; a Adverse childhood experiences and chronic obstructive pulmonary disease in adults. Am J Prev Med 34: 396-403
• Anda RF, Brown DW, Felitti VJ, Bremner JD, Dube SR, Giles WH. 2007; Adverse childhood experiences and prescribed psychotropic medications in adults. Am J Prev Med 32: 389-394
• Anda RF, Brown DW, Felitti VJ, Dube SR, Giles WH. 2008; b Adverse childhood experiences and prescription drug use in a cohort study of adult HMO patients. BMC Public Health 8: 198
• Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, Giovino GA. 1999; Adverse childhood experiences and smoking during adolescence and adulthood. JAMA 282: 1652-1658
• Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. 2006; The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 256: 174-186
• Anda R, Tietjen G, Schulman E, Felitti V, Croft J. 2010; Adverse childhood experiences and frequent headaches in adults. Headache 50: 1473-1481
• Bader K, Schafer V, Schenkel M, Nissen L, Schwander J. 2007; Adverse childhood experiences associated with sleep in primary insomnia. J Sleep Res 16: 285-296
• Bastien CH, Vallieres A, Morin CM. 2001; Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2: 297-307
• BSA 2011. a Pure-Tone Air-Conduction and Bone-Conduction Threshold Audiometry with and without Masking: Recommended Procedure. Reading, UK: BSA;
• BSA 2011. b Recommended Procedure: Determination of Uncomfortable Loudness Levels. Reading, UK: BSA;
• Chapman DP, Liu Y, Presley-Cantrell LR, Edwards VJ, Wheaton AG, Perry GS, Croft JB. 2013; Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study. BMC Public Health 13: 1-9
• Chapman DP, Wheaton AG, Anda RF, Croft JB, Edwards VJ, Liu Y, Sturgis SL, Perry GS. 2011; Adverse childhood experiences and sleep disturbances in adults. Sleep Med 12: 773-779
• Cronlein T, Langguth B, Geisler P, Hajak G. 2007; Tinnitus and insomnia. Prog Brain Res 166: 227-233
• Cronlein T, Langguth B, Pregler M, Kreuzer PM, Wetter TC, Schecklmann M. 2016; Insomnia in patients with chronic tinnitus: cognitive and emotional distress as moderator variables. J Psychosom Res 83: 65-68
• Dube SR, Williamson DF, Thompson T, Felitti VJ, Anda RF. 2004; Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse Negl 28: 729-737
• Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. 1998; Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 14: 245-258
• Folmer RL, Griest SE. 2000; Tinnitus and insomnia. Am J Otol 21: 287-293
• Iniguez KC, Stankowski RV. 2016; Adverse childhood experiences and health in adulthood in a rural population-based sample. Clin Med Res 14: 126-137
• Kajeepeta S, Gelaye B, Jackson CL, Williams MA. 2015; Adverse childhood experiences are associated with adult sleep disorders: a systematic review. Sleep Med 16: 320-330
• Lim HM, Kang W, Park WJ, Jang KH, Ann JS, Moon JD. 2017; Insomnia and hearing impairment among occupational noise exposed male workers. Ann Occup Environ Med 29: 36
• Meikle MB, Vernon J, Johnson RM. 1984; The perceived severity of tinnitus. Some observations concerning a large population of tinnitus clinic patients. Otolaryngol Head Neck Surg 92: 689-696
• Ramsawh HJ, Ancoli-Israel S, Sullivan SG, Hitchcock CA, Stein MB. 2011; Neuroticism mediates the relationship between childhood adversity and adult sleep quality. Behav Sleep Med 9: 130-143
• Schecklmann M, Pregler M, Kreuzer PM, Poeppl TB, Lehner A, Crönlein T, Wetter TC, Frank E, Landgrebe M, Langguth B. 2015; Psychophysiological associations between chronic tinnitus and sleep: a cross validation of tinnitus and insomnia questionnaires. BioMed Res Int 2015: 461090
• Test T, Canfi A, Eyal A, Shoam-Vardi I, Sheiner EK. 2011; The influence of hearing impairment on sleep quality among workers exposed to harmful noise. Sleep 34: 25-30
• Tyler RS, Baker JL. 1983; Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 48: 150-154
• Tyler RS, Pienkowski M, Rojas Roncancio E, Jun HJ, Brozoski T, Dauman N, Dauman N, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC. 2014; A review of hyperacusis and future directions: part I. Definitions and manifestations. Am J Audiol 23: 402-419
• Xu Y, Yao J, Zhang Z, Wang W. 2016; Association between sleep quality and psychiatric disorders in patients with subjective tinnitus in China. Eur Arch Otorhinolaryngol 273: 3063-3072