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1 Credit Quiz JAMA Otolaryngology–Head & Neck Surgery October 20, 2016

Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States

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Key Points

Question  How are the epidemiologic features and management of tinnitus before the implementation of the 2014 American Academy of Otolaryngology–Head and Neck Surgery Foundation clinical practice guidelines on tinnitus quantified?

Findings  Results from this cross-sectional analysis indicated that in 9.6% of respondents experienced tinnitus in the past year, 36.0% of whom had nearly constant symptoms. Fewer than half of the patients had discussed their problem with a physician, who most commonly provided medications for management of tinnitus.

Meaning  The national prevalence of tinnitus is approximately 1 in 10 adults, who were typically not treated in accordance with recent guidelines.

Abstract

Importance  Tinnitus is a common problem for millions of individuals and can cause substantial negative effects on their quality of life. A large epidemiologic study of tinnitus and its management patterns in the US adult population is lacking.

Objectives  To quantify the epidemiologic features and effect of tinnitus and to analyze the management of tinnitus in the United States relative to the 2014 American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines.

Design, Methods, and Participants  This cross-sectional analysis of the representative 2007 National Health Interview Survey (raw data, 75 764 respondents) identified a weighted national sample of adults (age, ≥18 years) who reported tinnitus in the preceding 12 months. Data were collected in November 2014 at the University of California, Irvine, and Harvard Medical School.

Main Outcomes and Measures  In addition to quantifying prevalence, severity, duration, and regularity of tinnitus, specific data regarding noise exposure and tinnitus management patterns during health care visits were analyzed.

Results  Among an estimated (SE) 222.1 (3.4) million US adults, 21.4 (3.4) million (9.6% [0.3%]) experienced tinnitus in the past 12 months. Among those who reported tinnitus, 27% had symptoms for longer than 15 years, and 36% had nearly constant symptoms. Higher rates of tinnitus were reported in those with consistent exposure to loud noises at work (odds ratio, 3.3; 95% CI, 2.9-3.7) and during recreational time (odds ratio, 2.6; 95% CI, 2.3-2.9). Years of work-related noise exposure correlated with increasing prevalence of tinnitus (r = 0.13; 95% CI, 0.10-0.16). In terms of subjective severity, 7.2% reported their tinnitus as a big or a very big problem compared with 41.6% who reported it as a small problem. Only 49.4% had discussed their tinnitus with a physician, and medications were the most frequently discussed recommendation (45.4%). Other interventions, such as hearing aids (9.2%), wearable (2.6%) and nonwearable (2.3%) masking devices, and cognitive behavioral therapy (0.2%), were less frequently discussed.

Conclusions and Relevance  The prevalence of tinnitus in the United States is approximately 1 in 10 adults. Durations of occupational and leisure time noise exposures correlated with rates of tinnitus and are likely targetable risk factors. Management options suggested by the recently published AAO-HNSF guidelines were followed infrequently.

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