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Health News Archive 241 - Tinnitus
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Melatonin Effective Against Tinnitus

Building upon previous research that showed promise for melatonin in the treatment of tinnitus, 10 researchers gave 24 patients 3 mg of melatonin per day for four weeks, followed by four weeks of observation.

Patients had idiopathic, troublesome, unilateral or bilateral, nonpulsatile tinnitus of at least 6 months' duration.  Patients completed The Tinnitus Handicap Inventory (THI) and the Pittsburgh Sleep Quality Index (PSQI) to measure tinnitus severity and sleep quality.  Patients had to score 25 or more, out of a possible 100, on the Tinnitus Handicap Inventory to be eligible for inclusion in the study. Patients with tinnitus related to cochlear implantation, retrocochlear lesion or other known anatomic and structural lesions of the ear and temporal bone were not eligible for the study.

There was a statistically significant, but not clinically significant, decrease in the Tinnitus Handicap Inventory score between the beginning of the study and the end of treatment (p=0.02) and between the beginning of the study and four weeks after the end of treatment (p=0.006).

There was a statistically significant and clinically significant decrease in the Pittsburgh Sleep Quality Index score between the beginning of the study and the end of treatment (p<0.0001) and between the beginning of the study and four weeks after the end of treatment (p<0.0003), indicating an improvement in sleep quality.

There was a statistically significant association between the change in the Pittsburgh Sleep Quality Index and the change in the Tinnitus Handicap Inventory between the beginning of the study and the end of treatment, but not between the beginning of the study and four weeks after the end of treatment.

Researchers found both the mean THI and PSQI scores “decreased significantly” during both four-week periods. And despite the study being an open-label study (where the patients knew what they were taking), the researchers concluded that “Melatonin use is associated with improvement of tinnitus and sleep”, that “there was an association between the amount of improvement in sleep and tinnitus”, and that “the impact of melatonin on sleep was greatest among patients with the worst sleep quality.”

Comment by Alan R. Gaby MD

The results of this study indicate that melatonin may be an effective treatment for idiopathic tinnitus. Melatonin is known to improve sleep quality in some patients.  However, it is not clear whether the improvement in tinnitus in this study was due to better sleep or to some other mechanism.  The improvement in tinnitus is noteworthy, because this condition is frequently refractory to treatment.  Of note, tinnitus continued to improve after melatonin was discontinued and, after the improvement in sleep resulting from melatonin therapy, reverted partially back toward the baseline value during the second four-week period.  This suggests that a four-week course of melatonin may have produced a lasting benefit. 

Source: Megwalu UC, Finnell JE, Piccirillo JF. The Effects of Melatonin on Tinnitus and Sleep. Otolaryngology: Head and Neck Surgery 2006; 134(2): 210-213.

Comments by Dr Gaby reprinted with exclusive permission of The Townsend Letter for Doctors and Patients July 2005.