Increments in physical activity relate to reductions in tinnitus severity: a 2-year prospective observational study

Abstract

Introduction Tinnitus, the perception of sound without external stimuli, affects approximately 14.4% of adults, significantly impacting quality of life. Previous cross-sectional research has shown that individuals who engage in greater levels of physical activity (PA) reported lower tinnitus severity. While these findings are promising, they are limited by the inherent constraints of cross-sectional designs. Hence, the current study investigated whether longitudinal changes in PA are associated with concurrent changes in tinnitus severity. Methods In an observational longitudinal study, 2,751 individuals with subacute and chronic tinnitus were recruited through an online survey. Data were collected at baseline and three annual follow-ups (T2, T3, or T4), assessing demographic variables, tinnitus severity (Likert scale), and PA using the International Physical Activity Questionnaire (IPAQ). Associations between changes in PA and tinnitus severity were analyzed using discrete-time Cox proportional hazards regression, adjusted for demographic and health-related confounders, such as age, sex, hearing loss, noise exposure, stress, anxiety, and depression. Results Higher levels of leisure-time vigorous-intensity physical activity were associated with a lower hazard of reporting stable or increased tinnitus severity relative to baseline during follow-up (HR = 0.966; 95% CI: 0.957-0.975, p < 0.001). Participants who were physically inactive at baseline but increased their physical activity to meet World Health Organization recommendations at any follow-up time point exhibited a 64.2% lower hazard of reporting stable or increased tinnitus severity relative to baseline (HR = 0.358; 95% CI: 0.310-0.413, p < 0.001). Conversely, participants who became physically inactive during follow-up showed a 60.7% higher hazard of reporting increased tinnitus severity relative to baseline (HR = 1.607; 95% CI: 1.215-2.127, p < 0.001). Conclusion In this longitudinal observational study, higher and sustained levels of physical activity-particularly vigorous-intensity leisure-time activity-were consistently associated with more favorable tinnitus severity trajectories over time, whereas reductions in physical activity were associated with worsening tinnitus severity.