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Research Author: Ohio State University Medical Center Last Updated: Aug 29, 2007 - 12:28:16 PM



Sleep Aid Studied for Effects on Ringing in Ears
By Ohio State University Medical Center
Aug 29, 2007 - 12:25:19 PM

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SLEEP AID STUDIED FOR EFFECTS ON RINGING IN EARS



(HealthNewsDigest.com) - COLUMBUS, Ohio – Melatonin may be taken as a supplement to help regulate sleep, but an Ohio State University Medical Center physician is testing its effectiveness in another arena – the ear.

Dr. Abraham Jacob, an otolaryngologist at Ohio State’s Medical Center, has begun a study testing whether melatonin can decrease tinnitus, a disorder characterized by the perception of sound in the absence of any external source. The sound typically manifests as ringing, chirping or roaring.

Previous retrospective studies have suggested that melatonin may reduce ringing in the ears, but Jacob’s prospective research will compare the supplement to placebo in order to determine whether this is, in fact, real relief.

The study will involve 60 patients diagnosed with tinnitus that has lasted for more than six months. These patients will be evaluated objectively with specific measures and questionnaires. Thirty will receive melatonin and 30 will receive placebo during the first segment of the trial, and then the study medications will be reversed so patients on placebo will receive the actual supplement and melatonin users will receive the placebo.

“We’d like to see whether a readily available product used for years as a supplement can be used as a therapy for a common problem,” Jacob said.

Tinnitus is common, affecting about 10 percent of the U.S. population, but Jacob considers it under-diagnosed and under-evaluated.

“That may relate to each patient’s perception of the severity of the disorder,” he said. “Just 1 percent of those affected by tinnitus feel significantly bothered by it to have it evaluated.”

While tinnitus often starts with damage to the inner ear, chronic tinnitus is more likely a central, neurologic phenomenon. Jacob explained that brain pathways designed to interpret sound also have connections to other areas of the brain that help determine how people feel about environmental stimuli. When sound pathways in the brain are activated in the absence of external sound, many people perceive the sensation as unpleasant. Patients who cope well with adverse stimuli probably won’t have as serious a problem with tinnitus.

“If you’re less able to ‘de-focus’ from the ringing or divert your attention to other activities, you are more likely to perceive your tinnitus or develop an aversion to it. Unfortunately, many people just can’t help but focus on it,” he said.

Tinnitus can occur after slow, cumulative exposure to loud noises or sudden, short exposures to extremely loud stimuli.

Several patients Jacob has evaluated for tinnitus have had an interest in singing and music. “Unfortunately, such individuals are highly attuned to sound and tend to be more bothered than most by tinnitus,” he said.

He said people using newer portable MP3 players, however, should not fear developing tinnitus as long as they keep the volume at a reasonable level. “The ear is meant to hear,” Jacob said. “There’s nothing wrong with listening to and enjoying music. However, moderation is best.”

There is no cure for subjective tinnitus, which is a patient’s perception of sound that cannot be heard by an examiner. Objective tinnitus, or a sound that can be heard by the examiner using a stethoscope, is treated by removing the offending cause of the noise. Ringing that is present in just one ear, matches one’s heartbeat, is associated with asymmetric hearing loss, or is accompanied by balance abnormalities deserves further medical evaluation to rule out sinister causes such as tumors or vascular malformations, Jacob said.

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