Autonomic Conditions in Tinnitus and Implications for Korean Medicine

Abstract

Tinnitus patients suffer from not only auditory sensations but also physical, mental, and social difficulties. Even though tinnitus is believed to be associated with the autonomic nervous system, changes in autonomic conditions in tinnitus patients are not receiving much research attention. The aims of this study were to investigate the autonomic condition of tinnitus patients and to consider Korean medicine in the treatment of tinnitus with an evidence-based approach. We performed a retrospective chart review and compared the heart rate variability (HRV) parameters of 40 tinnitus patients (19 acute and 21 chronic) and 40 healthy controls. In tinnitus patients, the power of the high frequency component and total power of the HRV significantly decreased (P < 0.05), and the low frequency to high frequency ratio significantly increased (P < 0.05). There was no significant difference between the acute and chronic patients. When comparing each group with the controls, there was a tendency that the longer the duration of tinnitus was, the larger the observed HRV change was. In conclusion, tinnitus patients have vagal withdrawal and sympathetic overactivity, and chronic tinnitus more strongly affects autonomic conditions than acute tinnitus. This study provides evidence for Korean medical treatments of tinnitus, such as acupuncture and Qi-training, that cause modulation of cardiac autonomic function.

Risk of tinnitus in patients with sleep apnea: A nationwide, population‐based, case‐control study

“…The associations between sleep apnea syndrome and its consequences could be explained by several pathophysiological mechanisms, including cardiovascular variability, intrathoracic pressure changes, inflammation, and elevated sympathetic activity . Previous research has also shown that tinnitus could chronically induce sympathetic overactivity . Therefore, it is plausible that sleep apnea‐related increase in sympathetic activity and cochlea and/or brain hypoxia could play a role in the pathogenesis of tinnitus.…”

“…33 Previous research has also shown that tinnitus could chronically induce sympathetic overactivity. [34][35][36] Therefore, it is plausible that sleep apnea-related increase in sympathetic activity and cochlea and/or brain hypoxia could play a role in the pathogenesis of tinnitus. The strengths of this study included the large sample size, and that the diagnoses of sleep disturbance and sleep apnea were collected before that of tinnitus.…”

Outcomes of Triple-Combination Therapy for Chronic Tinnitus

“…Patients with tinnitus suffer from not only auditory dysfunction, but also physical, mental, and social difficulties. Patients with tinnitus also often have symptoms consistent with vagal withdrawal and sympathetic overactivity (2). Many factors have been reported to be related with the occurrence and/or severity of auditory tinnitus.…”

“…Any individual treatment for this complex disease may not achieve a satisfactory result. Thus, combined therapy, including tinnitus retraining therapy (TRT), sound therapy, acupuncture and/or psychotherapy, are applied in patients with chronic tinnitus (2,(6)(7)(8). TRT, which includes directive counseling and sound therapy, is used by patients with chronic tinnitus with success (8).…”

“…TRT, which includes directive counseling and sound therapy, is used by patients with chronic tinnitus with success (8). It has been suggested that sound therapy could mask symptoms associated with tinnitus, acupuncture may improve the autonomic nervous dysfunction of tinnitus patients, and psychotherapy could relieve tinnitus-related emotional distress (2,(6)(7)(8).…”