A Cochrane review of 28 randomized trials and 2,733 participants found that cognitive behavioral therapy (CBT) may reduce the impact of tinnitus on quality of life by about 10.91 points on the Tinnitus Handicap Inventory compared with no intervention, well above the 7-point minimal important difference (Cochrane, Fuller et al. 2020). The need is large: a 2022 JAMA Neurology meta-analysis puts adult tinnitus prevalence at 14.4%, more than 740 million adults worldwide, and tinnitus is the single most common service-connected disability among US veterans, with 3,583,295 recipients in fiscal 2025. Yet the treatment reaches few people: only 0.2% of US adults with tinnitus reported CBT among the treatments they discussed with a doctor in national survey data. Tinnitus often travels with other hearing problems, from the cochlear damage covered in our hidden hearing loss and synaptopathy statistics to noise injury at work. We aggregated data from the Cochrane Library, JAMA Otolaryngology-Head and Neck Surgery, The Lancet, JAMA Neurology, the US Department of Veterans Affairs, the NIDCD, the AAO-HNSF guideline panel and more than a dozen peer-reviewed trials and meta-analyses.
TL;DR
- CBT may cut tinnitus handicap by 10.91 THI points versus no intervention, across 28 trials and 2,733 people (Cochrane, Fuller et al. 2020).
- No trial has shown CBT reduces tinnitus loudness; benefits are in distress and mood (Cochrane, Martinez-Devesa et al. 2010).
- Pooled adult tinnitus prevalence is 14.4%, more than 740 million adults (JAMA Neurology, Jarach et al. 2022).
- 3,583,295 US veterans receive compensation for tinnitus, the most prevalent service-connected disability (VA Annual Benefits Report FY2025).
- Specialised CBT-based care beat usual care in a 492-patient Lancet trial (THI difference -7.506, d = 0.45) (Cima et al., The Lancet 2012).
- Guided internet CBT was noninferior to face-to-face care, with a 5.18-point TFI difference against a 13-point margin (JAMA Otolaryngology, Beukes et al. 2018).
- 51% of internet CBT users reached clinically significant improvement vs 5% of controls (Ear and Hearing, Beukes et al. 2018).
- A smartphone CBT app reached Cohen’s d = 1.38 after 9 months (JMIR, Walter et al. 2025).
- Tinnitus retraining therapy showed no difference from standard of care at 18 months (JAMA Otolaryngology, TRT Trial 2019).
- CBT for insomnia gave more than 80% of tinnitus patients clinically meaningful sleep gains vs 20% in a support group (Cognitive Behaviour Therapy, Marks et al. 2023).
- Only 0.2% of US adults with tinnitus reported CBT among treatments discussed with a physician (JAMA Otolaryngology, Bhatt et al. 2016).
- Only 17% of a UK specialist clinic’s patients completed a full six-session CBT course (International Journal of Audiology, Aazh and Moore 2018).
1. The Burden CBT Is Meant to Treat: Prevalence and Severity
Tinnitus is common, but the population that needs therapy is a much smaller slice of it. More than 740 million adults worldwide have tinnitus (pooled prevalence 14.4%), yet severe tinnitus affects 2.3% (JAMA Neurology, Jarach et al. 2022). That gap is the whole case for CBT: the sound itself is rarely the disability; the distress, sleep loss and attention capture around it are. One estimate in a 2025 review puts the share who need CBT at roughly 1 in 52 people with tinnitus (Brain Sciences, Aazh 2025).
Prevalence climbs steeply with age, from 9.7% among adults aged 18 to 44 to 23.6% at 65 and older. In Europe, a 12-country survey of 11,427 adults found 14.7% with tinnitus and 1.2% with severe tinnitus, which extrapolates to 65 million people in the EU28, 26 million of them with bothersome symptoms (The Lancet Regional Health Europe, Biswas et al. 2022). In the US military population the burden is structural: tinnitus tops the list of service-connected disabilities with 3,583,295 recipients, 7.7% of all compensated disabilities, and 287,138 new recipients in FY2025 alone (VA Annual Benefits Report FY2025). Much of that is noise-related, a pattern also visible in civilian trades, as our construction worker hearing loss statistics show.
| Metric | Value | Source |
|---|---|---|
| Global adult tinnitus prevalence | 14.4% (95% CI 12.6% to 16.5%), more than 740 million adults | JAMA Neurology, Jarach et al. 2022 |
| Severe tinnitus prevalence | 2.3%; more than 120 million people perceive tinnitus as a major problem | JAMA Neurology, Jarach et al. 2022 |
| Prevalence by age | 9.7% (18-44), 13.7% (45-64), 23.6% (65+) | JAMA Neurology, Jarach et al. 2022 |
| Europe, 12 countries (11,427 adults) | 14.7% any; 1.2% severe; range 8.7% (Ireland) to 28.3% (Bulgaria) | Lancet Regional Health Europe, Biswas et al. 2022 |
| EU28 extrapolation | 65 million with tinnitus, 26 million bothersome, 4 million severe | Lancet Regional Health Europe, Biswas et al. 2022 |
| US veterans compensated for tinnitus | 3,583,295 (7.7% of disabilities, ranked first) | VA Annual Benefits Report FY2025 |
| New veteran tinnitus recipients, FY2025 | 287,138 (9.8% of new recipients’ disabilities) | VA Annual Benefits Report FY2025 |
| Share of people with tinnitus estimated to need CBT | About 1 in 52 | Brain Sciences, Aazh 2025 |
Context note: estimates depend heavily on the question asked. The NIDCD cites surveys showing 10 to 25% of adults have tinnitus (NIDCD, Tinnitus), and the UK charity Tinnitus UK (formerly the British Tinnitus Association) says around 30% of people experience it at some point and about one in seven live with persistent tinnitus (Tinnitus UK).
2. What the Cochrane Evidence Shows
The Cochrane verdict is consistent across two editions: CBT changes how much tinnitus hurts a person’s life, not how loud it is. Against no intervention or a waiting list, CBT lowered tinnitus-related quality-of-life scores by a standardized mean difference of -0.56, equivalent to 10.91 THI points, against a 7-point minimal clinically important difference (Cochrane, Fuller et al. 2020). The review covered 28 studies with 2,733 participants, mostly European, with average ages of 43 to 70 and tinnitus lasting at least 3 months; CBT ran 3 to 22 weeks, in hospitals or online.
The weaker numbers matter as much as the headline. Against other active treatments the advantage shrinks to 5.84 THI points (SMD -0.30), below the 7-point threshold, and most comparisons were rated low certainty. The review also found an absence of evidence at 6 or 12 months of follow-up, so long-term durability rests on individual trials, not pooled data. The earlier 2010 edition, with 8 trials and 468 participants, reported no evidence of a difference in subjective loudness between CBT and no treatment or another intervention (Cochrane, Martinez-Devesa et al. 2010).
| Metric | Value | Source |
|---|---|---|
| Trials and participants | 28 studies, 2,733 participants | Cochrane, Fuller et al. 2020 |
| CBT vs no intervention/waiting list (quality of life) | SMD -0.56 (95% CI -0.83 to -0.30); 10 studies, 537 people; low certainty | Cochrane, Fuller et al. 2020 |
| THI equivalent vs no intervention | 10.91 points lower (MCID 7 points) | Cochrane, Fuller et al. 2020 |
| CBT vs audiological care | MD -5.65 (95% CI -9.79 to -1.50); 3 studies, 444 people; moderate certainty | Cochrane, Fuller et al. 2020 |
| CBT vs other active controls | SMD -0.30 (95% CI -0.55 to -0.05), about 5.84 THI points; 12 studies, 966 people | Cochrane, Fuller et al. 2020 |
| Depression vs no intervention | SMD -0.34 (95% CI -0.60 to -0.08); 8 studies, 502 people | Cochrane, Fuller et al. 2020 |
| Serious adverse effects vs no intervention | RR 3.00 (95% CI 0.13 to 69.87), rare; moderate certainty | Cochrane, Fuller et al. 2020 |
| Earlier review, 2010 | 8 trials, 468 participants; no difference in loudness | Cochrane, Martinez-Devesa et al. 2010 |
Context note: most recent available pooled data: Cochrane, 2020. The 2020 review states tinnitus affects up to 21% of adults with an estimated 1% to 3% experiencing severe problems, a wider range than the 2022 JAMA Neurology figure.
3. Landmark Clinic Trials: CBT Against Usual Care and Newer Rivals
The largest single trial remains the strongest real-world signal. In a randomized trial of 492 patients, specialised treatment based on CBT beat usual care on the Tinnitus Handicap Inventory by 7.506 points (d = 0.45) over 12 months (The Lancet, Cima et al. 2012). The effect sizes are moderate, not dramatic, and no adverse events were reported, which is why CBT anchors most guidelines despite modest per-patient gains.
Newer challengers have started to post head-to-head wins in small samples. A 43-patient trial in Radiology found functional MRI neurofeedback reduced THI by 28.21 points at 6 months versus 12.09 for CBT, and by 30 versus 4 points at 12 months (Radiology, Gninenko et al. 2024). Device-based acoustic stimulation fared differently: in a 61-person randomized trial, Desyncra and CBT both cut Tinnitus Questionnaire scores by 5 to 15 points, with between-arm differences of only 1 to 2 points (International Journal of Audiology, Theodoroff et al. 2022). Small samples on both sides mean none of these overturn the pooled evidence.
| Metric | Value | Source |
|---|---|---|
| Patients screened and enrolled | 741 screened, 492 enrolled (245 specialised care, 247 usual care) | The Lancet, Cima et al. 2012 |
| THI difference vs usual care | -7.506 (95% CI -10.661 to -4.352); d = 0.45 | The Lancet, Cima et al. 2012 |
| Tinnitus Questionnaire difference | -8.062 (95% CI -10.829 to -5.295); d = 0.43 | The Lancet, Cima et al. 2012 |
| Health Utilities Index gain | 0.059 (95% CI 0.025 to 0.094); d = 0.24 | The Lancet, Cima et al. 2012 |
| fMRI neurofeedback vs CBT, THI change at 6 months | -28.21 vs -12.09 (P = .005; 21 vs 22 patients) | Radiology, Gninenko et al. 2024 |
| fMRI neurofeedback vs CBT, THI change at 12 months | -30 vs -4 (P = .01) | Radiology, Gninenko et al. 2024 |
| Desyncra vs CBT (61 participants) | TQ fell 5 to 15 points across arms; differences -2.0 and -1.0 points by stratum | International Journal of Audiology, Theodoroff et al. 2022 |
Context note: the Lancet trial ran from September 2007 to January 2011 with assessments at 3, 8 and 12 months, so it is most recent available large-trial data rather than current practice data.
4. Tinnitus Retraining Therapy and Sound Therapy: The Comparison Arm
Sound-based approaches remain the main alternative to CBT, and their trial record is thinner. The US Tinnitus Retraining Therapy Trial, 151 participants at 6 military hospitals, found no difference between full TRT, partial TRT and standard of care at 18 months (JAMA Otolaryngology-Head and Neck Surgery, Scherer et al. 2019). All three arms improved substantially (effect sizes -1.32, -1.16 and -1.01 on the Tinnitus Questionnaire), which says more about structured counseling and time than about the sound generators. The Cochrane CBT review found one small comparison (42 participants) where CBT outperformed TRT by 15.79 points, with low certainty.
Sound therapy alone has weak evidence: the Cochrane review of hearing aids and sound generators included 8 studies with 590 participants and rated all outcomes low quality (Cochrane, Sereda et al. 2018). The more promising signal is combination care. A 2026 meta-analysis of 4 RCTs and one cohort (610 participants) found CBT plus sound therapy lowered THI by 8.72 points versus comparators, and 11.19 points in RCTs only (European Archives of Oto-Rhino-Laryngology, Albannai et al. 2026). The wider evidence on sound-based relaxation is covered in our sound therapy for anxiety and stress statistics.
| Metric | Value | Source |
|---|---|---|
| TRT Trial size and arms | 151 participants: TRT 51, partial TRT 51, standard of care 49 | JAMA Otolaryngology, Scherer et al. 2019 |
| TQ effect size at 18 months | TRT -1.32; partial TRT -1.16; standard of care -1.01 | JAMA Otolaryngology, Scherer et al. 2019 |
| Clinically meaningful change at 18 months | TFI -13 or more: 46.8%; THI -7 or more: 56.8%; TQ -7 or more: 77.55% | JAMA Otolaryngology, Scherer et al. 2019 |
| CBT vs TRT (single trial) | MD -15.79 (95% CI -27.91 to -3.67); 42 participants; low certainty | Cochrane, Fuller et al. 2020 |
| Sound therapy evidence base | 8 studies, 590 participants; low-quality evidence | Cochrane, Sereda et al. 2018 |
| CBT plus sound therapy, THI | MD -8.72 (all studies); -11.19 (RCTs only); 610 participants | Eur Arch Otorhinolaryngol, Albannai et al. 2026 |
| CBT plus sound therapy, TFI | MD -5.11 (95% CI -8.14 to -2.09) | Eur Arch Otorhinolaryngol, Albannai et al. 2026 |
| Smartphone CBT plus customized sound therapy, TFI improvement | 16.7 vs 1.9 points in controls; 38.3% improved 20+ points (92 patients) | Annals of Otology, Rhinology and Laryngology, Goshtasbi et al. 2025 |
Context note: the TRT Trial enrolled from 2011 to 2017 in a military population (107 of 151 participants were men), which limits generalization to civilian clinics.
5. Internet and Smartphone CBT: Scaling the Therapist
Digital delivery is where the evidence has grown fastest, because it attacks CBT’s main bottleneck: trained clinician hours. In a UK randomized trial of 146 adults, 51% of those using audiologist-guided internet CBT reached clinically significant improvement after 8 weeks, against 5% of a weekly-monitoring control group (d = 0.7) (Ear and Hearing, Beukes et al. 2018). A companion 92-person trial found guided internet CBT noninferior to face-to-face clinical care (JAMA Otolaryngology-Head and Neck Surgery, Beukes et al. 2018).
The US replication was smaller in effect but held up: in 158 randomized adults, internet CBT ended at a mean TFI of 36.57 versus 46.31 for monitoring (d = 0.46) (JMIR, Beukes et al. 2022), and at 1-year follow-up the tinnitus severity effect was d = 1.06 (Internet Interventions, Beukes et al. 2022). App-based programs report even larger within-program effects: a 187-patient smartphone CBT trial reached d = 1.1 at 3 months and a Tinnitus Questionnaire drop of 18.48 points by 9 months, d = 1.38 (JMIR, Walter et al. 2025).
| Metric | Value | Source |
|---|---|---|
| UK internet CBT trial, clinically significant improvement | 51% vs 5% of controls; d = 0.7 (146 participants) | Ear and Hearing, Beukes et al. 2018 |
| Internet CBT vs face-to-face, TFI difference | 5.18 points (95% CI -4.17 to 14.53); 13-point noninferiority margin; 92 participants | JAMA Otolaryngology, Beukes et al. 2018 |
| US internet CBT vs weekly monitoring | TFI 36.57 vs 46.31; d = 0.46 (95% CI 0.14 to 0.77); 158 participants | JMIR, Beukes et al. 2022 |
| US internet CBT at 1 year | Tinnitus severity d = 1.06 (95% CI 0.80 to 1.32) | Internet Interventions, Beukes et al. 2022 |
| Internet hearing interventions meta-analysis | 15 studies, 1,811 participants; tinnitus d = 0.59 vs inactive, 0.32 vs active | Trends in Hearing, Beukes et al. 2019 |
| Smartphone CBT, 187 participants | d = 1.1 at 3 months (PLOS Digital Health 2023); TQ -18.48 and d = 1.38 at 9 months (JMIR 2025) | Walter et al. 2023 and 2025 |
| Internet/mobile CBT meta-analysis, TFI | MD -12.48 (95% CI -16.43 to -8.54); 9 studies | Explore, Xian et al. 2025 |
| Internet CBT vs ACT vs control, THI | CBT d = 0.70; ACT d = 0.68 vs control (99 participants) | J Consult Clin Psychol, Hesser et al. 2012 |
Context note: the same 2025 meta-analysis found no significant pooled THI effect (MD -2.98, 95% CI -12.03 to 6.07) even as TFI improved, a reminder that results shift with the questionnaire chosen (Explore, Xian et al. 2025). The 2019 meta-analysis reported a 1-year effect of d = 0.45 (Trends in Hearing, Beukes et al. 2019).
6. Sleep, Mood and Anxiety Outcomes
For many patients the worst hours of tinnitus are at night, and the sleep data are among the most convincing in the field. In a 102-patient randomized trial, more than 80% of those given CBT for insomnia made clinically meaningful sleep improvements, compared with 47% in audiology-based care and 20% in a sleep support group (Cognitive Behaviour Therapy, Marks et al. 2023). A systematic review of 5 trials found CBT reduced Insomnia Severity Index scores by 3.28 points with zero heterogeneity (I² = 0%) (Sleep Medicine Reviews, Curtis et al. 2021).
Mood outcomes are smaller but consistent. Digital CBT trials report modest anxiety and depression gains, in the 1 to 2 point range on standard scales, while the US internet program kept anxiety (d = 0.54), depression (d = 0.46) and insomnia (d = 0.47) gains at 1 year. Sleep loss from tinnitus also overlaps with other sleep disorders; screening context is in our obstructive sleep apnea prevalence statistics.
| Metric | Value | Source |
|---|---|---|
| CBT for insomnia, clinically meaningful improvement | More than 80% vs 47% (audiology care) vs 20% (support group); 102 participants | Cognitive Behaviour Therapy, Marks et al. 2023 |
| Insomnia Severity Index change, meta-analysis | -3.28 (95% CI -4.51 to -2.05); 4 trials pooled; I² = 0% | Sleep Medicine Reviews, Curtis et al. 2021 |
| Internet/mobile CBT, Insomnia Severity Index | MD -2.65 (95% CI -3.64 to -1.67) | Explore, Xian et al. 2025 |
| Internet/mobile CBT, GAD-7 anxiety | MD -1.33 (95% CI -2.37 to -0.30) | Explore, Xian et al. 2025 |
| Internet/mobile CBT, HADS depression | MD -1.40 (95% CI -2.18 to -0.61) | Explore, Xian et al. 2025 |
| US internet CBT at 1 year | Anxiety d = 0.54; depression d = 0.46; insomnia d = 0.47 | Internet Interventions, Beukes et al. 2022 |
| CBT vs no intervention, depression | SMD -0.34 (8 studies, 502 people) | Cochrane, Fuller et al. 2020 |
Context note: psychological approaches beyond CBT, such as music-based interventions, are measured on different scales; see our music therapy clinical outcomes statistics for that evidence base.
7. Guidelines, Measurement and the Treatment Gap
Guidelines endorse CBT; practice has not caught up. In US National Health Interview Survey data, only 0.2% of adults with tinnitus reported cognitive behavioral therapy among the treatments discussed with a physician, against 45.4% for medications and 9.2% for hearing aids (JAMA Otolaryngology, Bhatt et al. 2016). That is the inverse of the guideline: the AAO-HNSF panel states clinicians should recommend CBT for persistent, bothersome tinnitus and recommends against routine antidepressants, anticonvulsants, anxiolytics, intratympanic drugs, supplements and transcranial magnetic stimulation (Otolaryngology-Head and Neck Surgery, Tunkel et al. 2014). The NIDCD adds that there are no FDA-approved drugs for tinnitus.
Even where CBT is offered, the funnel narrows quickly. At a UK specialist clinic, 68% of 266 patients were offered audiologist-delivered CBT, 45% of those offered continuing therapy declined, and only 17% of the total completed all six sessions (International Journal of Audiology, Aazh and Moore 2018). Outcome tracking is also a challenge: the 25-item Tinnitus Functional Index, now the main trial endpoint, treats a 13-point reduction as clinically meaningful (Ear and Hearing, Meikle et al. 2012), and the 2025 VA/DoD guideline addressed 20 clinical questions for adults with bothersome tinnitus (JAMA Otolaryngology, Sherlock et al. 2025).
| Metric | Value | Source |
|---|---|---|
| US adults with tinnitus in past 12 months (2007 survey) | 21.4 million (9.6%); 27% for more than 15 years; 36% nearly constant | JAMA Otolaryngology, Bhatt et al. 2016 |
| Discussed tinnitus with a physician | 49.4% | JAMA Otolaryngology, Bhatt et al. 2016 |
| Treatments discussed | Medications 45.4%; hearing aids 9.2%; wearable maskers 2.6%; CBT 0.2% | JAMA Otolaryngology, Bhatt et al. 2016 |
| US guideline prevalence estimate | More than 50 million people; 10% to 15% of adults | AAO-HNSF Clinical Practice Guideline: Tinnitus 2014 |
| UK specialist clinic CBT funnel | 68% offered; 45% declined continuing; 17% completed six sessions (266 patients) | Int J Audiol, Aazh and Moore 2018 |
| Tinnitus Functional Index properties | 25 items; Cronbach’s alpha 0.97; test-retest 0.78; 13-point meaningful reduction | Ear and Hearing, Meikle et al. 2012 |
| Internet CBT questionnaire completion (US trial) | 72.3% (T1), 61% (T2), 42% (T3) | JMIR, Beukes et al. 2022 |
| Predicting internet CBT success | 228 completers, 33 predictors; AUC 0.73 | Am J Audiology, Rodrigo et al. 2022 |
Context note: the Bhatt survey data come from the 2007 National Health Interview Survey, the most recent available national US data on tinnitus treatment patterns (published 2016). A 2024 scoping review found 30 eligible sources on audiologist-delivered CBT out of 267 screened, a small base for a guideline-recommended therapy (Audiology Research, Burke and El Refaie 2024).
Summary: CBT for Tinnitus by the Numbers
| Metric | Value | Source |
|---|---|---|
| Trials in Cochrane CBT review | 28 studies, 2,733 participants | Cochrane, Fuller et al. 2020 |
| THI reduction vs no intervention | 10.91 points (MCID 7) | Cochrane, Fuller et al. 2020 |
| THI reduction vs other active treatments | About 5.84 points | Cochrane, Fuller et al. 2020 |
| Effect on tinnitus loudness | No difference found | Cochrane, Martinez-Devesa et al. 2010 |
| Global adult tinnitus prevalence | 14.4%, more than 740 million adults | JAMA Neurology, Jarach et al. 2022 |
| Severe tinnitus prevalence | 2.3% | JAMA Neurology, Jarach et al. 2022 |
| European prevalence (12 countries) | 14.7% | Lancet Regional Health Europe, Biswas et al. 2022 |
| US veterans compensated for tinnitus | 3,583,295 | VA Annual Benefits Report FY2025 |
| Specialised CBT care vs usual care (THI) | -7.506; d = 0.45; 492 patients | The Lancet, Cima et al. 2012 |
| TRT vs standard of care at 18 months | No difference (151 participants) | JAMA Otolaryngology, Scherer et al. 2019 |
| CBT plus sound therapy (THI, RCTs) | MD -11.19 | Eur Arch Otorhinolaryngol, Albannai et al. 2026 |
| Internet CBT clinically significant improvement | 51% vs 5% | Ear and Hearing, Beukes et al. 2018 |
| Internet vs face-to-face CBT | Noninferior (5.18-point TFI difference, 13-point margin) | JAMA Otolaryngology, Beukes et al. 2018 |
| Smartphone CBT at 9 months | TQ -18.48; d = 1.38 | JMIR, Walter et al. 2025 |
| Internet/mobile CBT, TFI | MD -12.48 (9 studies) | Explore, Xian et al. 2025 |
| CBT for insomnia meaningful improvement | More than 80% vs 20% in support group | Cognitive Behaviour Therapy, Marks et al. 2023 |
| CBT discussed with physician (US) | 0.2% | JAMA Otolaryngology, Bhatt et al. 2016 |
| Completed full CBT course (UK clinic) | 17% of 266 patients | Int J Audiol, Aazh and Moore 2018 |
| Meaningful TFI change threshold | 13 points | Ear and Hearing, Meikle et al. 2012 |
Methodology and Sources
Every figure above was read during research for this article in a peer-reviewed abstract, a Cochrane review, a federal agency report or a patient organization page. Trial and review figures were taken from abstracts indexed in Europe PMC and are linked to their PubMed records. Statistics found only on blogs or listicles without a primary document were excluded. This roundup is factual and not medical advice; treatment decisions belong with a clinician.
- Cochrane: Cognitive behavioural therapy for tinnitus, Fuller et al. 2020; Cognitive behavioural therapy for tinnitus, Martinez-Devesa et al. 2010; Sound therapy for tinnitus, Sereda et al. 2018
- Prevalence: JAMA Neurology, Jarach et al. 2022; The Lancet Regional Health Europe, Biswas et al. 2022; JAMA Otolaryngology-Head and Neck Surgery, Bhatt et al. 2016
- US Department of Veterans Affairs: Annual Benefits Report FY2025, Compensation section
- National Institute on Deafness and Other Communication Disorders: Tinnitus (updated May 1, 2023)
- Tinnitus UK: What is tinnitus?
- Guidelines: AAO-HNSF Clinical Practice Guideline: Tinnitus, Tunkel et al. 2014; VA/DoD Clinical Practice Guideline for Management of Tinnitus, Sherlock et al. 2025
- Clinic trials: The Lancet, Cima et al. 2012; Radiology, Gninenko et al. 2024; International Journal of Audiology, Theodoroff et al. 2022; JAMA Otolaryngology, Scherer et al. 2019 (TRT Trial)
- Combination care: European Archives of Oto-Rhino-Laryngology, Albannai et al. 2026; Annals of Otology, Rhinology and Laryngology, Goshtasbi et al. 2025
- Internet and smartphone CBT: Ear and Hearing, Beukes et al. 2018; JAMA Otolaryngology, Beukes et al. 2018; JMIR, Beukes et al. 2022; Internet Interventions, Beukes et al. 2022; Trends in Hearing, Beukes et al. 2019; PLOS Digital Health, Walter et al. 2023; JMIR, Walter et al. 2025; Explore, Xian et al. 2025; Journal of Consulting and Clinical Psychology, Hesser et al. 2012
- Sleep: Cognitive Behaviour Therapy, Marks et al. 2023; Sleep Medicine Reviews, Curtis et al. 2021
- Access and measurement: International Journal of Audiology, Aazh and Moore 2018; Brain Sciences, Aazh 2025; Audiology Research, Burke and El Refaie 2024; American Journal of Audiology, Rodrigo et al. 2022; Ear and Hearing, Meikle et al. 2012
- Data watch: The pooled Cochrane evidence dates to 2020 and the Lancet trial to 2012 (most recent available data), so the 2025 and 2026 meta-analyses of digital CBT and combination care are newer but smaller. Prevalence figures conflict by design: up to 21% of adults (Cochrane 2020), 14.4% pooled (JAMA Neurology 2022), 10 to 25% (NIDCD), 10% to 15% (AAO-HNSF 2014), 9.6% in the past 12 months (NHIS 2007); they use different definitions and recall windows. Questionnaires disagree too: the 2025 Xian meta-analysis found a significant TFI effect but no significant THI effect. Several digital trials report high questionnaire attrition (42% completion at the last time point in the US internet CBT trial). The 1 in 52 estimate is an author’s estimate in a 2025 lecture paper, not a population survey. The full text of the 2025 VA/DoD guideline (JAMA Otolaryngology) and NICE guideline NG155 pages could not be read during research, so their specific CBT recommendations are not quoted; we found no published AAO-HNSF update of the 2014 tinnitus guideline in the indexes searched. VA disability counts reflect compensation awards, not clinical prevalence. Web search was unavailable during this refresh, so sources were located through the Europe PMC index and direct agency pages.
Last updated: October 3, 2026. We update this roundup quarterly, and the next refresh is expected when the VA publishes its FY2026 Annual Benefits Report and Cochrane or the AAO-HNSF publish updated tinnitus reviews or guidance.