The effects of cognitive-behavioral training and muscle relaxation on the degree of tinnitus and the quality of sleep
,
Abstract
Background and Aim: Tinnitus is an annoying distressing phantom phenomenon that can cause major problems, such as insomnia and sleep deprivation. Therefore, the present study was conducted to determine the effects of cognitive-behavioral training (CBT) and muscle relaxation on the level of tinnitus and the quality of sleep in patients with tinnitus in Ahvaz City in 2018−2019.
Methods: This study is a semi-experimental, pretest, post-test, and follow-up with control group. There are two experimental groups and one control group in this plan. Participants in the first experimental group received eight sessions of CBT and participants in the second experimental group received eight sessions of relaxation training. Control group were not subject to any intervention.
Results: The results of this study showed that cognitive-behavioral approach and muscle relaxation have reduced the amount of tinnitus and increased sleep quality using multivariate covariance analysis. The most important results of this study are the effectiveness and usefulness of cognitive-behavioral approach and muscle relaxation on reducing tinnitus and increasing the quality of sleep.
Conclusion: Cognitive-behavioral therapy and muscle relaxation approaches were effective in improving tinnitus and quality of sleep. More attention and emphasize in these approaches will be a good alternative to some invasive (electric stimulation) or with some side-effects (drug therapy) approaches.
1. De Ridder D, Vanneste S, Freeman W. The Bayesian brain: phantom percepts resolve sensory uncertainty. Neurosci Biobehav Rev. 2014;44:4-15. doi: 10.1016/j.neubiorev.2012.04.001
2. Gilles A, Van Hal G, De Ridder D, Wouters K, Van de Heyning P. Epidemiology of noise-induced tinnitus and the attitudes and beliefs towards noise and hearing protection in adolescents. PLoS One. 2013;8(7):e70297. doi: 10.1371/journal.pone.0070297
3. Erlandsson SI, Holgers KM. The impact of perceived tinnitus severity on health-related quality of life with aspects of gender. Noise Health. 2001;3(10):39-51.
4. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016;333:255-65. doi: 10.1016/j.heares.2015.08.014
5. Jastreboff PJ. Tinnitus retraining therapy. In: Moller AR, Langguth B, DeRidder D, Keinjung T, editors, Textbook of tinnitus. New York, NY:. Springer; 2011. p. 575-96.
6. Gans JJ, Cole MA, Greenberg B. Sustained benefit of mindfulness-based tinnitus stress reduction (MBTSR)
in adults with chronic tinnitus: a pilot study. Mindful¬ness;6(5):1232-34. doi: 10.1007/s12671-015-0403-x
7. Folmer RL, Theodoroff SM, Martin WH, Shi Y. Experimental, controversial, and futuristic treatments for chronic tinnitus. J Am Acad Audiol. 2014;25(1):106-25. doi: 10.3766/jaaa.25.1.7
8. Veldova K, Procházka R. Conscious strategies of coping with tinnitus. Ceskoslovenská psychologie;2(2):162-73.
9. Noble W, Tyler R. Physiology and phenomenology of tinnitus: implications for treatment. Int J Audiol. 2007;46(10):569-74. doi: 10.1080/14992020701506296
10. Zöger S, Svedlund J, Holgers KM. Relationship between tinnitus severity and psychiatric disorders. Psychosomatics. 2006;47(4):282-8. doi: 10.1176/appi.psy.47.4.282
11. McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. Front Neurol. 2014;5:196. doi: 10.3389/fneur.2014.00196
12. Hoare DJ, Kowalkowski VL, Kang S, Hall DA. Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Laryngoscope. 2011;121(7):1555-64. doi: 10.1002/lary.21825
13. Martinez-Devesa P, Perera R, Theodoulou M, Waddell A. Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev. 2010;(9):CD005233. doi: 10.1002/14651858.CD005233.pub3
14. Mottaghi R, Kamkar A, Maredpoor A. [Effectiveness of cognitive-behavioral therapy on the quality of sleep in elderly people with insomnia disorders]. Iranian Journal of ageing. 2016;2(11):235-43. Persian. doi: 10.21859/sija-1102234
15. Berger AM, VonEssen S, Kuhn BR, Piper BF, Agrawal S, Lynch JC, et al. Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: results of a feasibility intervention study. Oncol Nurs Forum. 2003;30(3):513-22. doi: 10.1188/03.ONF.513-522
16. Cima RF, Maes IH, Joore MA, Scheyen DJ, El Refaie A, Baguley DM, et al. Specialized treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomized controlled trial. Lancet. 2012;379(9830):1951-9. doi: 10.1016/S0140-6736(12)60469-3
17. Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010;68(6):539-44. doi: 10.1016/j.jpsychores.2009.10.005
18. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 2009;15(5):¬593-600. doi: 10.1089/acm.2008.0495
19. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78(2):169-83. doi: 10.1037/a0018555
20. Wong SY, Chan FW, Wong RL, Chu MC, Kitty Lam YY, Mercer SW, et al. Comparing the effectiveness of mindfulness-based stress reduction and multidisciplinary intervention programs for chronic pain: a randomized comparative trial. Clin J Pain. 2011;27(8):724-34. doi: 10.1097/AJP.0b013e3182183c6e
21. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain. 2008;134(3):310-9. doi: 10.1016/j.pain.2007.04.038
22. Saeedi M, Ashk Trab, T, Shamsi Khani S, Saatchi K. [The effect of progressive muscle relaxation on insom¬nia severity of hemodialysis patients]. Complementary Medicine. 2012;2:159-70. Persian.
23. Kreuzer PM, Poeppl TB, Bulla J, Schlee W, Lehner A, Langguth B, et al. A proof-of-concept study on the combination of repetitive transcranial magnetic stimula¬tion and relaxation techniques in chronic tinnitus. J Neural Transm (Vienna). 2016;123(10):1147-57. doi: 10.1007/s00702-016-1588-4
24. Biesinger E, Kipman U, Schätz S, Langguth B. Qigong for the treatment of tinnitus: a prospective randomized controlled study. J Psychosom Res. 2010;69(3):299-304. doi: 10.1016/j.jpsychores.2010.04.013
25. Newman CW, Jacobson GP, Spitzer JB. Development
of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143-48. doi: 10.1001/archotol.1996.01890140029007
26. Mahmoudian S, Shahmiri E, Rouzbahani M, Jafari Z, Keyhani M, Rahimi F, et al. Persian language version of the "tinnitus handicap inventory": translation, standar¬dization, validity and reliability. Int Tinnitus J. 2011;16(2):93-103.
27. Girschik J, Heyworth J, Fritschi L. Reliability of a sleep quality questionnaire for use in epidemiologic studies. J Epidemiol. 2012;22(3):244-50. doi: 10.2188/jea.JE20110107
28. Mitchell AEP. The effect of a short course in cognitive and behavioural therapy (CBT) on knowledge acquisition in non-specialist CBT practitioners. Adv Psychol Res. 2017;120(1);103-18.
29. Cleator J, Abbott J, Judd P, Wilding JP, Sutton CJ. Correlations between night eating, sleep quality, and excessive daytime sleepiness in a severely obese UK population. Sleep Med. 2013;14(11):1151-6. doi: 10.1016/j.sleep.2013.04.026
30. Allison KC, Spaeth A, Hopkins CM. Sleep and eating disorders. Curr Psychiatry Rep. 2016;18(10):92.
31. Silton NR, Flannelly LT, Flannelly KJ, Galek K. Toward a theory of holistic needs and the brain. Holist Nurs Pract. 2011;25(5):258-65. doi: 10.1097/HNP.0b013e31822a0301
32. Weber C, Arck P, Mazurek B, Klapp BF. Impact of a relaxation training on psychometric and immunologic parameters in tinnitus sufferers. J Psychosom Res. 2002;52(1):29-33. doi: 10.1016/S0022-3999(01)00281-1
2. Gilles A, Van Hal G, De Ridder D, Wouters K, Van de Heyning P. Epidemiology of noise-induced tinnitus and the attitudes and beliefs towards noise and hearing protection in adolescents. PLoS One. 2013;8(7):e70297. doi: 10.1371/journal.pone.0070297
3. Erlandsson SI, Holgers KM. The impact of perceived tinnitus severity on health-related quality of life with aspects of gender. Noise Health. 2001;3(10):39-51.
4. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016;333:255-65. doi: 10.1016/j.heares.2015.08.014
5. Jastreboff PJ. Tinnitus retraining therapy. In: Moller AR, Langguth B, DeRidder D, Keinjung T, editors, Textbook of tinnitus. New York, NY:. Springer; 2011. p. 575-96.
6. Gans JJ, Cole MA, Greenberg B. Sustained benefit of mindfulness-based tinnitus stress reduction (MBTSR)
in adults with chronic tinnitus: a pilot study. Mindful¬ness;6(5):1232-34. doi: 10.1007/s12671-015-0403-x
7. Folmer RL, Theodoroff SM, Martin WH, Shi Y. Experimental, controversial, and futuristic treatments for chronic tinnitus. J Am Acad Audiol. 2014;25(1):106-25. doi: 10.3766/jaaa.25.1.7
8. Veldova K, Procházka R. Conscious strategies of coping with tinnitus. Ceskoslovenská psychologie;2(2):162-73.
9. Noble W, Tyler R. Physiology and phenomenology of tinnitus: implications for treatment. Int J Audiol. 2007;46(10):569-74. doi: 10.1080/14992020701506296
10. Zöger S, Svedlund J, Holgers KM. Relationship between tinnitus severity and psychiatric disorders. Psychosomatics. 2006;47(4):282-8. doi: 10.1176/appi.psy.47.4.282
11. McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. Front Neurol. 2014;5:196. doi: 10.3389/fneur.2014.00196
12. Hoare DJ, Kowalkowski VL, Kang S, Hall DA. Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Laryngoscope. 2011;121(7):1555-64. doi: 10.1002/lary.21825
13. Martinez-Devesa P, Perera R, Theodoulou M, Waddell A. Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev. 2010;(9):CD005233. doi: 10.1002/14651858.CD005233.pub3
14. Mottaghi R, Kamkar A, Maredpoor A. [Effectiveness of cognitive-behavioral therapy on the quality of sleep in elderly people with insomnia disorders]. Iranian Journal of ageing. 2016;2(11):235-43. Persian. doi: 10.21859/sija-1102234
15. Berger AM, VonEssen S, Kuhn BR, Piper BF, Agrawal S, Lynch JC, et al. Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: results of a feasibility intervention study. Oncol Nurs Forum. 2003;30(3):513-22. doi: 10.1188/03.ONF.513-522
16. Cima RF, Maes IH, Joore MA, Scheyen DJ, El Refaie A, Baguley DM, et al. Specialized treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomized controlled trial. Lancet. 2012;379(9830):1951-9. doi: 10.1016/S0140-6736(12)60469-3
17. Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010;68(6):539-44. doi: 10.1016/j.jpsychores.2009.10.005
18. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 2009;15(5):¬593-600. doi: 10.1089/acm.2008.0495
19. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78(2):169-83. doi: 10.1037/a0018555
20. Wong SY, Chan FW, Wong RL, Chu MC, Kitty Lam YY, Mercer SW, et al. Comparing the effectiveness of mindfulness-based stress reduction and multidisciplinary intervention programs for chronic pain: a randomized comparative trial. Clin J Pain. 2011;27(8):724-34. doi: 10.1097/AJP.0b013e3182183c6e
21. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain. 2008;134(3):310-9. doi: 10.1016/j.pain.2007.04.038
22. Saeedi M, Ashk Trab, T, Shamsi Khani S, Saatchi K. [The effect of progressive muscle relaxation on insom¬nia severity of hemodialysis patients]. Complementary Medicine. 2012;2:159-70. Persian.
23. Kreuzer PM, Poeppl TB, Bulla J, Schlee W, Lehner A, Langguth B, et al. A proof-of-concept study on the combination of repetitive transcranial magnetic stimula¬tion and relaxation techniques in chronic tinnitus. J Neural Transm (Vienna). 2016;123(10):1147-57. doi: 10.1007/s00702-016-1588-4
24. Biesinger E, Kipman U, Schätz S, Langguth B. Qigong for the treatment of tinnitus: a prospective randomized controlled study. J Psychosom Res. 2010;69(3):299-304. doi: 10.1016/j.jpsychores.2010.04.013
25. Newman CW, Jacobson GP, Spitzer JB. Development
of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143-48. doi: 10.1001/archotol.1996.01890140029007
26. Mahmoudian S, Shahmiri E, Rouzbahani M, Jafari Z, Keyhani M, Rahimi F, et al. Persian language version of the "tinnitus handicap inventory": translation, standar¬dization, validity and reliability. Int Tinnitus J. 2011;16(2):93-103.
27. Girschik J, Heyworth J, Fritschi L. Reliability of a sleep quality questionnaire for use in epidemiologic studies. J Epidemiol. 2012;22(3):244-50. doi: 10.2188/jea.JE20110107
28. Mitchell AEP. The effect of a short course in cognitive and behavioural therapy (CBT) on knowledge acquisition in non-specialist CBT practitioners. Adv Psychol Res. 2017;120(1);103-18.
29. Cleator J, Abbott J, Judd P, Wilding JP, Sutton CJ. Correlations between night eating, sleep quality, and excessive daytime sleepiness in a severely obese UK population. Sleep Med. 2013;14(11):1151-6. doi: 10.1016/j.sleep.2013.04.026
30. Allison KC, Spaeth A, Hopkins CM. Sleep and eating disorders. Curr Psychiatry Rep. 2016;18(10):92.
31. Silton NR, Flannelly LT, Flannelly KJ, Galek K. Toward a theory of holistic needs and the brain. Holist Nurs Pract. 2011;25(5):258-65. doi: 10.1097/HNP.0b013e31822a0301
32. Weber C, Arck P, Mazurek B, Klapp BF. Impact of a relaxation training on psychometric and immunologic parameters in tinnitus sufferers. J Psychosom Res. 2002;52(1):29-33. doi: 10.1016/S0022-3999(01)00281-1
| Files | ||
| Issue | Vol 28 No 3 (2019) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/avr.v28i3.1229 | |
| Keywords | ||
| Cognitive-behavioral training; muscle relaxation; tinnitus; sleep quality | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Tavakoli M, Marashi SA, Hamid N, Beshlideh K. The effects of cognitive-behavioral training and muscle relaxation on the degree of tinnitus and the quality of sleep. Aud Vestib Res. 2019;28(3):182-189.
