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The Apple Hearing Study is sharing new insights on tinnitus in one of the largest surveys to date.

Through the study, University of Michigan researchers reviewed a cohort of more than 160,000 participants who answered survey questions and completed app-based assessments to characterise their experience of tinnitus. This research aims to improve understanding of tinnitus characteristics and inform future research on potential treatments.

“Roughly 15 per cent of our participants experience tinnitus daily,” said Rick Neitzel, University of Michigan School of Public Health’s professor of environmental health sciences. “Tinnitus is something that can have a large impact on a person’s life. The trends that we’re learning through the Apple Hearing Study about people’s experience with tinnitus can help us better understand the groups most at risk, which can in turn help guide efforts to reduce the impacts associated with it. The Apple Hearing Study gives us an opportunity that was not possible before to improve our understanding of tinnitus across demographics, aiding current scientific knowledge that can ultimately improve management of tinnitus.”

Tinnitus, or the perception of sound that others do not hear, can happen to many people in one or both ears. With tinnitus, the sounds can take many forms but are most commonly described as a ringing sound and can be momentary or occur over longer durations. The symptoms and experience of tinnitus can vary significantly from person to person and can change for an individual.

Tinnitus can impact a person’s overall quality of life, for example, disrupting a person’s sleep, concentration or ability to hear clearly.

A first step towards advancing understanding of tinnitus is to learn more about who experiences it, how the experience differs between people and within an individual over time, the potential causes, and the methods for managing tinnitus and their perceived effectiveness.

A graphic reads, “Among participants in the Apple Hearing Study… 77.6% have experienced tinnitus in their life.”
A graphic reads, “Among participants in the Apple Hearing Study… Roughly 15% experience tinnitus daily.”
A graphic reads, “Among participants in the Apple Hearing Study… 35.8% of those ages 55 and older constantly experience tinnitus.”
A graphic reads, “Among participants in the Apple Hearing Study… 20.3% cited noise trauma as the cause of their tinnitus.”
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Tinnitus Prevalence 

The study found that 77.6 per cent of participants have experienced tinnitus in their life, with the prevalence of daily tinnitus increasing with age among many. Those ages 55 and up were 3x more likely to hear tinnitus daily compared to those 18–34 years old. Additionally, 2.7 per cent more male participants reported experiencing daily tinnitus compared to females. However, 4.8 per cent more males stated they had never experienced tinnitus.

Management of Tinnitus  

In the Apple Hearing Study, participants reported mainly trying three methods to ease their existing tinnitus: using noise machines (28 per cent), listening to nature sounds (23.7 per cent) and practising meditation (12.2 per cent). Less than 2.1 per cent of participants chose cognitive and behavioural therapy to manage their tinnitus.

Cause of Tinnitus

While there’s no guaranteed method to prevent tinnitus given its complex causes, practising hearing protection and managing stress levels can lower the chances of tinnitus. In the study, participants cited “noise trauma”, or exposure to excessively high levels of noise, as the primary cause of tinnitus (20.3 per cent), followed closely by stress (7.7 per cent).

Characterising Tinnitus

The majority of participants experience brief episodes of tinnitus, compared to 14.7 per cent who reported constant tinnitus. The reported duration of tinnitus significantly increases with age among participants 55 and older: 35.8 per cent of participants ages 55 and older constantly experience tinnitus. Male participants experience constant tinnitus nearly 6.8 per cent more than females.

As for tinnitus levels, the majority found it to be faint, with 34.4 per cent calling it noticeable compared to 8.8 per cent who found it very loud or ultra loud. Ten per cent of participants reported that their tinnitus has moderately or entirely interfered with their ability to hear clearly.

In addition to the survey questions, participants who experienced tinnitus also completed an app-based sound test to better characterise their experience of tinnitus, matching the type and quality of the sounds they experience.

iPhone 15 Pro shows a screen from the Apple Hearing Study that says “Tinnitus Check-in”, followed by instructions.
iPhone 15 Pro shows a screen from the Apple Hearing Study that says “Select a Tinnitus Type”, followed by the choices: Crickets, Electric, Pulse, Pure Tone, Static and Tea Kettle.
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The majority of participants described their tinnitus as either a pure tone (78.5 per cent) or white noise (17.4 per cent). Among those who described a pure tone, 90.8 per cent reported a pitch at four kilohertz or above, similar to the tones in a songbird’s call. Additionally, for those who described a pure tone, 83.5 per cent identified their tinnitus as a single tone and 16.5 per cent identified it as a teakettle tone — a high-pitched, whistling sound.

For participants who matched their tinnitus to a white noise, 57.7 per cent identified it as a static tone, 21.7 per cent compared it to a cricket tone, 11.2 per cent said it was an electric tone and 9.4 per cent identified it as a pulse tone.

The Apple Hearing Study is one of three landmark public health studies in the Research app on iPhone, which launched in 2019 and is ongoing.

Conducted in collaboration with the University of Michigan, the Apple Hearing Study advances the understanding of sound exposure and its impact on hearing health. Researchers have already collected about 400 million hours of calculated environmental sound levels supplemented with lifestyle surveys to analyse how sound exposure affects hearing, stress and hearing-related aspects of health. Study data will also be shared with the World Health Organization as a contribution to its Make Listening Safe initiative.

How Apple Products Can Help

Apple technology provides a number of features to support hearing health with just a tap.

Noise app: With the Noise app, Apple Watch users can enable notifications for when environmental noise levels might affect their hearing health. The Health app on iPhone keeps track of a user’s history of exposure to sound levels, and informs whether headphone audio levels or environmental sound levels have exceeded those recommended by World Health Organization standards.

iPhone 15 Pro displays environmental sound levels over the course of a week and “Okay” under “Exposure”, and Apple Watch Series 9 displays environmental noise levels in decibels and “Okay.”

Environmental sound reduction: Apple Watch users can see when the environmental sound level is reduced while they are wearing AirPods Pro and AirPods Max.

Active Noise Cancellation and Loud Sound Reduction mode: Active Noise Cancellation uses the microphone to detect external sounds, which AirPods Pro then counter with anti-noise, cancelling the external sounds before a user hears them. For those looking to still enjoy surrounding sounds, Loud Sound Reduction with AirPods Pro (2nd generation) helps reduce loud noises while still keeping the fidelity of sound.

Reduce loud audio: To set a headphone volume limit, users can go into Settings, then tap Sounds & Haptics (on iPhone 7 and later) or Sounds (for earlier models). They’ll then tap Headphone Safety, where they can turn on Reduce Loud Audio and drag a slider to a preferred decibel level.