Tinnitus #3: The Effect on Quality of Life

March 8, 2019

The effect that tinnitus has on quality of life is quite variable. This is largely due to the diversity
of tinnitus presentations: it can be acute or chronic, constant or intermittent, subtle or intense.
The impact on tinnitus sufferers is therefore correlated with each patient’s individual
experience. While many sufferers report minimal reduction in quality of life resulting from
tinnitus (Teixeira et al., 2017), others report severe effects. For example, in a large cross-
sectional study in Korea, 21% of tinnitus sufferers reported suicidal ideations, and 1.2%
reported suicide attempts (Seo et al., 2016).


A survey of its members conducted by the American Tinnitus Association (ATA) in 2014
revealed many of the ways that tinnitus can impact a patient’s quality of life. More than 1,100
people with tinnitus responded, using a scale of 1 to 10 to describe how much tinnitus impacts
their lives on a daily basis (1=low; 10=high). 20% of respondents rated the impact of tinnitus as
8, 9, or 10, and 54% rated the impact at 5 or higher. They also were asked what single symptom
best describes how tinnitus affected their day-to-day lives. Only 38% responded that tinnitus
was “annoying” but did not significantly impact their lives, or hard to notice. Of the remaining
members, 18% described sleep problems, 16% mentioned trouble concentrating, 13%
described anxiety, 7% chose social isolation or ongoing depression, and 2% described inability
to work as their primary tinnitus-related complaints. The ATA also points out that family
members, friends, and coworkers share the effects of tinnitus on each patient, as difficulty
socializing and communication problems from tinnitus lead to frustration and irritability on the
part of supporters (ATA website).


A common instrument for evaluating the impact of tinnitus is the Tinnitus Handicap Inventory
(THI), which is composed of 25 questions related to how tinnitus interferes with daily life. When
compared to the results of the World Health Organization Quality of Life (WHO QOL)
questionnaire (which defines quality of life as “the individual’s perception of their life position
within the context of culture systems and values in which they are inserted and related to their
objectives, expectations, standards, and concerns” (Teixeira et al., 2017)), several THI questions
were found to be especially predictive of a patient’s quality of life. Specifically, patients who
rated highest with “feeling confused from tinnitus”, “trouble falling asleep”, “interference with
job or household responsibilities”, “getting upset from tinnitus”, and “feeling of being
depressed” had the lowest overall quality of life as measured by the WHO QOL questionnaire
(Zeman et al., 2014).


It is clear that tinnitus is associated with immense suffering but that it is highly variable from
person-to-person, affecting patients to different degrees and in different ways. All patients are
at risk of diminished quality of life, though, and clinicians should be aware of the most common
consequences of tinnitus that reduce quality of life (sleep problems, trouble concentrating,
sleep issues, etc.). Clinicians could also play a more effective role by learning the best ways to
ask about the effects of tinnitus, and sharing with patients the hope that improved quality of
life and relief might be possible through therapies that help the sufferer learn to control or
accept the condition. But learning to accept a medical symptom like tinnitus is not a satisfying

resolution. It clearly isn’t sufficient to just learn to accept your high blood pressure, your
memory problems, sleeping issues, or depression, so why would it be acceptable to just learn to
accept your tinnitus? We must keep marching forward until we find an effective cure for
tinnitus.


References
American Tinnitus Association: Impact of Tinnitus (2018) (available at
https://www.ata.org/understanding-facts/impact-tinnitus).


Seo, J.H., Kang, J.M., Hwang, S.H., Han, K.D., & Joo, Y.H. (2016). Relationship between tinnitus
and suicidal behaviour in Korean men and women: a cross-sectional study. Clin Otolaryngol,
41(3), 222-227.


Teixeira, A.R., Rosito, L.P.S., Goncalves, A.K., Nunes, M.G.P., Dornelles, S., & Olchik, M.R. (2017).


Tinnitus in elderly individuals: discomfort and impact in the quality of life. Int Arch
Otorhinolaryngol, 21, 66-71.


Zeman, F., Koller, M., Langguth, B., Landgrebe, M., & Tinnitus Research Initiative Database
Study Group. (2014). Which tinnitus-related aspects are relevant for quality of life and
depression: results from a large international multicentre sample. Health Qual Life Outcomes,
12(7), 1-10.


Authors
David Hicks, M.D.: Dr. Hicks directs business development at Turner Scientific, and has
significant training and experience in clinical treatment of ear disorders. Contact:
dhicks@turnerscientific.com


Jeremy Turner, Ph.D.: Dr. Turner is the founder and Chief Scientific Officer at Turner Scientific.
He completed his Ph.D. in auditory neuroscience, and has more than 22 years’ experience in
preclinical hearing loss, tinnitus, and ototoxicity research. Contact:
jturner@turnerscientific.com

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