Apple’s Preliminary Study Insights Shed Light on Tinnitus

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 characterize their experience of tinnitus. This research aims to improve understanding of tinnitus characteristics and inform future research on potential treatments.

“Roughly 15 percent 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 toward 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.

The study found that 77.6 percent 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 percent more male participants reported experiencing daily tinnitus compared to females. However, 4.8 percent more males stated they had never experienced tinnitus.

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

While there’s no guaranteed method to prevent tinnitus given its complex causes, practicing 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 percent), followed closely by stress (7.7 percent).

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

As for tinnitus levels, the majority found it to be faint, with 34.4 percent calling it noticeable compared to 8.8 percent who found it very loud or ultra loud. Ten percent 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 characterize their experience of tinnitus, matching the type and quality of the sounds they experience.

The majority of participants described their tinnitus as either a pure tone (78.5 percent) or white noise (17.4 percent). Among those who described a pure tone, 90.8 percent reported a pitch at 4 kilohertz or above, similar to the tones in a songbird’s call. Additionally, for those who described a pure tone, 83.5 percent identified their tinnitus as a single tone and 16.5 percent identified it as a teakettle tone – a high-pitched, whistling sound.

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

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.

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, canceling 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.