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Background and Objectives There exist few studies about relationship between tinnitus and sleep disturbance. Furthermore, the currently available studies have some limitations of confounding factors. This study evaluated correlation between tinnitus and sleep quality, especially by controlling depression and anxiety factors. Subjects and Method The present study was planned as a cross sectional study using questionnaires. Using 46 patients with tinnitus, sleep quality was investigated by Pittsburgh Sleep Quality Index (PSQI) score, anxiety by State-Trait Anxiety Inventory (STAI, axis1 and axis2), depression by Beck Depression Inventory (BDI), and tinnitus induced distress by Tinnitus Handicap Inventory (THI). The final analysis method was multiple regression analysis. THI and PSQI were regarded as dependent and independent variables, respectively. BDI and STAI were regarded as confounding factors. Results Each factor (PSQI, two STAI, and BDI) revealed significant correlation with THI score. Considering four factors together with regression analysis, PSQI score was the most influencing factor on THI score (p=0.002). Conclusion Although depression and anxiety were both influencing factors on tinnitus-induced distress as known previously, sleep quality influenced tinnitus-induced distress came out as the most significant factor in the multivariable analysis.

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