From the Guidelines
Yes, stress can cause tinnitus or worsen existing tinnitus symptoms, as it activates the body's fight-or-flight response, increasing muscle tension, blood pressure, and affecting blood flow to the inner ear, which can trigger or intensify tinnitus symptoms 1. Tinnitus is the perception of noise or ringing in the ears when no external sound is present. The effects of stress on tinnitus symptoms can be significant, as stress often leads to anxiety and poor sleep, which can further exacerbate tinnitus perception. Some key points to consider when evaluating tinnitus include:
- Tinnitus can be categorized as pulsatile or nonpulsatile, primary (idiopathic) or secondary to another condition, and subjective or objective 1.
- The primary evaluation of tinnitus begins with a comprehensive otologic examination to determine if a vascular retrotympanic mass is present, audiometric examination, and review of medical history and medications (including over the counter) before imaging 1.
- Managing stress through relaxation techniques like deep breathing, meditation, yoga, or regular exercise may help reduce tinnitus symptoms, and cognitive behavioral therapy (CBT) has also shown effectiveness in helping people cope with both stress and tinnitus 1.
- If you're experiencing tinnitus that's bothersome or persistent, it's advisable to consult with a healthcare provider, as they may recommend specific stress management strategies or investigate other potential causes of your symptoms 1.
- While there's no specific medication that directly treats stress-induced tinnitus, addressing the underlying stress and anxiety can significantly improve symptoms for many people, and healthcare providers may recommend targeted history and clinical examination as the initial evaluation and determination as to whether the tinnitus is bothersome or not, before any imaging 1.
From the Research
Stress and Tinnitus Relationship
- The relationship between stress and tinnitus is complex, with evidence suggesting that stress can contribute to the development of tinnitus 2.
- Chronic stress has been shown to have negative consequences on the development of tinnitus, while short-term stress may have protective effects on the cochlea 2.
- Emotional stress can worsen pre-existing tinnitus and is an important indicator of tinnitus severity 2.
Tinnitus Management and Stress
- Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are effective in managing chronic subjective tinnitus, with CBT being more effective in decreasing tinnitus-related distress 3.
- Mindfulness meditation and CBT have been shown to reduce tinnitus variables in chronic tinnitus sufferers 4.
- The relationship between stress and tinnitus is not fully understood, and further research is needed to study the association between physiological stress responses, tinnitus percept, and psychological treatment approaches 5.
Studies on Stress and Tinnitus
- A scoping review of 50 studies found that tinnitus patients tend to report louder and more bothersome tinnitus when they are stressed, but the correlation between stress and tinnitus levels varied in strength depending on the instrument used 6.
- The review highlighted the need for further research to study the relationship between stress and tinnitus, considering principal issues such as measurement instruments and post-intervention changes in stress and tinnitus levels 6.