Insomnia is common in patients with tinnitus and negatively affects tinnitus symptoms and quality of life. This systematic review aimed to synthesise evidence of the effectiveness of cognitive behavioural therapy (CBT) based interventions on insomnia in adults with tinnitus. We conducted a comprehensive database search (MEDLINE, CINAHL, Web of Science, CENTRAL, ClinicalTrials.gov and PROSPERO) for published, unpublished and ongoing randomised controlled trials of CBT in adults with tinnitus. Five trials met the inclusion criteria for the systematic review, with four of these providing data for the meta-analysis. This demonstrated a statistically significant reduction in Insomnia Severity Index (a standard diagnostic questionnaire of insomnia used in clinical settings) following CBT (−3.28, 95% CI -4.51, −2.05, P=<0.001). There was no evidence of statistical heterogeneity (I2 = 0%). Risk of bias was considered low in all categories except blinding of participants, personnel, and/or the assessment of outcomes. Here, for the first time, we demonstrate that CBT-based interventions can significantly improve sleep in adults with tinnitus.


University of Lincoln, College of Social Science

Ffion Curtis, University of Lincoln, Lincoln International Institute for Rural Health

Despina Laparidou, University of Lincoln, Lincoln International Institute for Rural Health

Chris Bridle, University of Bedfordshire, School of Psychology

Graham Law, University of Lincoln, Lincoln International Institute for Rural Health

Simon Durrant, Lincoln International Institute for Rural Health

Alina Rodriguez, Lincoln International Institute for Rural Health and Imperial College London, School of Public Health

Robert Pierzycki, NIHR Nottingham Biomedical Research Centre and  University of Nottingham, School of Medicine

Niro Siriwardena, University of Lincoln, Lincoln International Institute for Rural Health