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‘Ringing in the ears’ is common among U.S. adults, but few get appropriate treatment, study finds

Tinnitus is significantly more likely to occur among people who have been regularly exposed to a noisy environment, either on the job or during leisure pursuits.

Nearly one in 10 adults in the U.S. report experiencing at least one episode of tinnitus — a persistent ringing, roaring or buzzing sound in the ears or head — within the previous year, according to a new study.

More than a third of those adults say they have almost constant symptoms.

The study also found that tinnitus is significantly more likely to occur among people who have been regularly exposed to a noisy environment, either on the job or during leisure pursuits.

These findings are concerning, for, as the study points out, people “with intolerable and bothersome tinnitus often experience sleep disturbance and poor quality of life, which can lead to mental distress, worsened anxiety and depression symptoms, and disability.”

Yet, “despite this evidence,” write the study’s authors, “we found that most [people with tinnitus] had not discussed their problem with a physician, and many more had never tried any form of remedy.”

The study was published last week in the journal JAMA Otolaryngology-Head & Neck Surgery.

Key findings

For the study, a team of researchers led by Dr. Harrison Lin of the University of California, Irvine, analyzed data collected from a representative national sample of more than 75,000 adults, aged 18 and older, who participated in the 2007 National Health Interview Survey, which is administered by the U.S. Census Bureau and the Centers for Disease Control and Prevention. That year’s survey was chosen because it specifically asked participants about tinnitus symptoms and behavior related to the condition’s treatment.

Of those 75,000 survey respondents, 9.6 percent said they had experienced a tinnitus episode lasting at least five minutes within the previous 12 months. And 36 percent of the people who acknowledged such episodes said the “ringing, roaring or buzzing” sounds were nearly constant.

More than half — 56 percent — of those with constant symptoms said the tinnitus had lasted for more than five years, while 27 percent said it had had prevailed for more than 15 years.

Tinnitus was more common among the men surveyed (10.5 percent) than among the women (8.8 percent). The researchers also found a direct correlation between the prevalence of tinnitus and increased age. The mean age for people who answered “yes” to having tinnitus was 53, while it was 45 for those who answered “no.”

Exposure to loud noise was also identified as a risk factor in this study. Almost 20 percent of the survey’s respondents with a history of regular exposure to loud noise at work had symptoms of tinnitus compared with about 7 percent of those with no such history. In addition, about 17 percent of the respondents who reported being exposed to loud recreational noise at least once a month had “ringing” or other symptoms compared with 7 percent of those without such exposure.

Few seek care

Interestingly, only 7.2 percent of the survey’s respondents with tinnitus said their symptoms were a “big” or “very big” problem. Many — 42 percent — described the symptoms instead as a “small” problem.

“For many patients with chronic tinnitus, the severity of symptoms may actually be tolerable, and they may not require any intervention,” the study’s authors write.

Those findings may explain why only 49 percent of the people with tinnitus had discussed their symptoms with a physician.

When people did discuss their symptoms with a physician, the most commonly offered treatments were medications, such as antidepressants, anticonvulsants or steroids. Patients were also frequently advised to try alternative medicine, especially dietary supplements such as Ginkgo biloba, melatonin or zinc.

Yet, as Lin and his study co-authors point out, those approaches are not recommended by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) in its guidelines for the treatment of routine tinnitus. No drug or supplement has been proven to be effective in reducing the condition’s symptoms. Such treatments have, however, been found to raise the potential for harm.

The AAO-HNSF instead recommends cognitive behavior therapy, stress-management techniques, and tinnitus-related education and counseling to help patients manage their symptoms. 

The organization’s guidelines also suggest that some patients be evaluated for a hearing aid-like device that can deliver sound therapy to mask the unwanted “ringing” sounds.

“Unfortunately,” write Lin and his colleagues, “these adjunctive therapies were seldom discussed with patients who presented to a physician with tinnitus symptoms.”

FMI: You’ll find an abstract of the new study on the JAMA Otolaryngology-Head & Neck Surgery website, although the full study is behind a paywall. For more information about tinnitus, including how it is diagnosed and various options for treatment, go to the AAO-HNSF website.

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