Abstract
The notion that stress can induce chronic tinnitus, or increase its
intensity, is predominant in the literature on tinnitus. However,
there is little empirical support for this claim, since previous
studies rely merely on subjective reports. In the present study,
we used an objective physiological measure of stress (i.e., basal
secretion of the stress hormone cortisol), in order to assess the
relationship between tinnitus and stress. We hypothesized that tinnitus,
a permanent internal sound, should behave as a stressor and should
be accompanied by chronically elevated cortisol levels in individuals
with severe tinnitus. In addition, we hypothesized that suffering
from severe tinnitus should generalize to an intolerance towards
external sounds. Two groups each comprised of 18 participants (with
and without tinnitus) matched on education and health status participated
in the study. Tinnitus severity, as assessed by tinnitus-related
distress, was high in half of the tinnitus participants, and low
in the other half. Basal cortisol levels were measured using saliva
samples (five saliva samples per day for 3 days within a week) taken
in the participant’s natural environment. Intolerance to external
sounds was assessed psychometrically. The high tinnitus-related distress
group had chronic cortisol levels greater than both the low tinnitus-related
distress and control groups, and also displayed greater intolerance
to external sounds. The low tinnitus-related distress and control
groups did not differ from each other on either of these measures.
Our study thus provides the first physiological and empirical evidence
of a link between intolerance to both internal (tinnitus) and external
sounds in persons with tinnitus, and is compatible with the clinical
observation that severe tinnitus is associated with high stress levels.
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