Clonazepam Usage Improves Chronic Tinnitus and Sleep Quality: A Prospective Cohort Study
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Background and Objectives Tinnitus, although being a common chronic disease, can bean intractable disease that causes depression and insomnia. This study aimed to analyze theresults of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), andPittsburgh Sleep Quality Index (PSQI) questionnaire surveys before and after clonazepamtherapy. In addition, we analyzed the association of three pre-treatment questionnaires andevaluated whether pre-treatment factors could predict the post-treatment THI index. Subjects and Method Patients were selected from those who visited a tertiary hospitalfrom 2019 to 2021 for the treatment of chronic tinnitus they had for more than 3 months andwho were over 20 years old. Patients were excluded from the study if they were diagnosed withacute sudden hearing loss, Meniere’s disease, brain/internal auditory canal tumors, or muscular/vascular tinnitus. The questionnaire surveys of THI, BDI, PSQI were conducted beforeand after 3 months of clonazepam therapy (Rivotril [Roche Inc.] 0.25 or 0.5 mg). Questionnairescores were compared using the paired t-test. Multiple regression analysis was used to determinethe relationships among the three questionnaires. Results A total of 76 patients (38 males and 38 females) with the mean age of 57.2±9.01years was analyzed. The average hearing threshold was 30.4±20.67 dB HL on the right and31.7±17.06 dB HL on the left. The pre-treatment THI, BDI, and PSQI scores were 44.3±23.4,7.96±2.36, and 6.85±4.68, respectively. The relationships between the THI and BDI and theTHI and PSQI were significant (p=0.0027 and p<0.0001, respectively). The pre-THI scoreshowed no significant association with age, sex, or hearing threshold (p=0.91, 0.85, and 0.23,respectively). The post-treatment THI score was 33.6±17.1, which was significantly lower thanthe pre-THI scores (p<0.0001). Post-BDI and post-PSQI were 7.38±2.25 and 4.04±3.20, respectively. Post-PSQI also significantly decreased compared with pre-PSQI (p=0.0002), but post-BDI did not significantly decrease (p=0.1231). In the THI survey, Question 7 (sleep disturbance)showed decrease the most, followed by Question 25 (unstable mood). The post-treatment THIcould be predicted by using the formula, 0.7673+0.6947×pre-THI+0.3572×pre-PSQI. Conclusion The appropriate/optional use of clonazepam at low doses (0.25-0.5 mg) cansignificantly improve chronic tinnitus and sleep quality. Tinnitus was significantly associatedwith the scores of THI, BDI, PSQI and the usage of Clonazepam significantly reduced the THIand PSQI scores. However, clonazepam did not affect the BDI score.
Abstract
Background and Objectives Tinnitus, although being a common chronic disease, can bean intractable disease that causes depression and insomnia. This study aimed to analyze theresults of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), andPittsburgh Sleep Quality Index (PSQI) questionnaire surveys before and after clonazepamtherapy. In addition, we analyzed the association of three pre-treatment questionnaires andevaluated whether pre-treatment factors could predict the post-treatment THI index. Subjects and Method Patients were selected from those who visited a tertiary hospitalfrom 2019 to 2021 for the treatment of chronic tinnitus they had for more than 3 months andwho were over 20 years old. Patients were excluded from the study if they were diagnosed withacute sudden hearing loss, Meniere’s disease, brain/internal auditory canal tumors, or muscular/vascular tinnitus. The questionnaire surveys of THI, BDI, PSQI were conducted beforeand after 3 months of clonazepam therapy (Rivotril [Roche Inc.] 0.25 or 0.5 mg). Questionnairescores were compared using the paired t-test. Multiple regression analysis was used to determinethe relationships among the three questionnaires. Results A total of 76 patients (38 males and 38 females) with the mean age of 57.2±9.01years was analyzed. The average hearing threshold was 30.4±20.67 dB HL on the right and31.7±17.06 dB HL on the left. The pre-treatment THI, BDI, and PSQI scores were 44.3±23.4,7.96±2.36, and 6.85±4.68, respectively. The relationships between the THI and BDI and theTHI and PSQI were significant (p=0.0027 and p<0.0001, respectively). The pre-THI scoreshowed no significant association with age, sex, or hearing threshold (p=0.91, 0.85, and 0.23,respectively). The post-treatment THI score was 33.6±17.1, which was significantly lower thanthe pre-THI scores (p<0.0001). Post-BDI and post-PSQI were 7.38±2.25 and 4.04±3.20, respectively. Post-PSQI also significantly decreased compared with pre-PSQI (p=0.0002), but post-BDI did not significantly decrease (p=0.1231). In the THI survey, Question 7 (sleep disturbance)showed decrease the most, followed by Question 25 (unstable mood). The post-treatment THIcould be predicted by using the formula, 0.7673+0.6947×pre-THI+0.3572×pre-PSQI. Conclusion The appropriate/optional use of clonazepam at low doses (0.25-0.5 mg) cansignificantly improve chronic tinnitus and sleep quality. Tinnitus was significantly associatedwith the scores of THI, BDI, PSQI and the usage of Clonazepam significantly reduced the THIand PSQI scores. However, clonazepam did not affect the BDI score.
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