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"Mediation analysis"

Original Article
Purpose
This study investigated the mediating effect of sleep discomfort in the relationship between tinnitus distress and depression.
Methods
This cross-sectional study used the Tinnitus Handicap Inventory, the Korean Screening Tool for Depressive Disorders, and the Korean version of the Pittsburgh Sleep Quality Index to examine a convenience sample of 139 individuals with tinnitus who were selected from an online patient community in January 2023. Data were analyzed using the independent t-test, Pearson's correlation coefficients, and the PROCESS macro with 95% bootstrap confidence intervals. All statistical analyses were performed using IBM SPSS/WIN 25.0.
Results
Tinnitus distress exhibited a positive correlation with depression (r=.70, p<.001) and sleep discomfort (r=.33, p<.001), and depression showed a positive correlation with sleep discomfort (r=.52, p<.001). Further, sleep discomfort had a statistically significant partial mediating effect in the relationship between tinnitus distress and depression (β=.11; 95% CI, 0.05~0.18).
Conclusion
The findings of this study indicate that sleep discomfort plays a partial mediatory role in the relationship between tinnitus distress and depression. Intervention programs for improving sleep discomfort among individuals with tinnitus are recommended to reduce depression in this population. In addition, screenings for sleep discomfort and depression should be routinely carried out as part of the treatment strategy for individuals with tinnitus.
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