Cluster Analysis of Clinical Characteristics, Sleep Quality, Depression and Melatonin Levels in Patients with Idiopathic Subjective Tinnitus

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BACKGROUND: Since the relationship between tinnitus and quality of sleep is still a subject of research, serum melatonin levels may have a role. The aim was to reveal the structural similarities or dissimilarities regarding clinical features, tinnitus-related quality of life (QoL) effects, serum melatonin levels, and sleep quality in patients who have unilateral idiopathic subjective tinnitus. METHODS: A total of 83 cases (46 males, 55.4%; 37 females, 44.6%), with a median age of 51 (range: 18-73) years, were included in the study. Cluster analysis was used to analyze demographic, laboratory, clinical, and sleep-related features of the whole sample in a multivariate manner. RESULTS: Two separate sets of clusters were organized. In Cluster-2, age was older, serum melatonin levels were lower, tinnitus pitch and loudness were higher, and duration was longer; air-conduction pure tone averages were higher, Visual Analog Scale, Tinnitus Handicap Inventory, Beck Depression Inventory, and Pittsburgh Sleep Quality Index scores were also significantly higher than Cluster-1. A stronger correlation was observed between poor sleep quality and depression in Cluster-2. However, in Cluster-1 with younger cases, the negative correlation between tinnitus loudness and serum melatonin values was found to be higher. CONCLUSION: The older-aged patients with lower serum melatonin levels have more severe tinnitus, worse QoL, and sleep problems compared to the younger patients. Among younger individuals, the more pronounced correlations between hearing levels, tinnitus loudness, sleep quality, and serum melatonin levels indicate that this group may particularly benefit from melatonin as a potential therapeutic option for tinnitus as well.

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