In this nationally representative sample of US adults, negative sleep characteristics were significantly associated with bothersome tinnitus. Report of bothersome tinnitus was associated with less hours of sleep per night, being diagnosed with sleep disorders, report of trouble with sleeping, and OSA symptoms.

References: Awad M, Abdalla I, Jara SM, Huang TC, Adams ME, Choi JS. Association of Sleep Characteristics with Tinnitus and Hearing Loss. OTO Open. 2024 Feb 28;8(1):e117. doi: 10.1002/oto2.117. PMID: 38420352; PMCID: PMC10900921.

Potential risk factors identified in the literature include pathologies of middle and inner ear structures, bone or nerve malformations, rhino sinusitis, and social factors such as poor diet.

References: Hoare DJ, Smith H, Kennedy V, Fackrell K. Tinnitus in Children. J Assoc Res Otolaryngol. 2024 Jun;25(3):239-247. doi: 10.1007/s10162-024-00944-3. Epub 2024 May 6. PMID: 38709437; PMCID: PMC11150219.

Animal-model studies have demonstrated that after noise exposures that lead to some damage of the cochlea, neurons in both the dorsal and ventral divisions of the first auditory brain station, the cochlear nucleus, show increased Spontaneous firing rate.

References: 1) Bledsoe SC Jr, Koehler S, Tucci DL, Zhou J, Le Prell C, Shore SE. Ventral cochlear nucleus responses to contralateral sound are mediated by commissural and olivocochlear pathways. J Neurophysiol. 2009 Aug;102(2):886-900. doi: 10.1152/jn.91003.2008. Epub 2009 May 20. PMID: 19458143; PMCID: PMC2724362.; 2) Kaltenbach JA, Afman CE. Hyperactivity in the dorsal cochlear nucleus after intense sound exposure and its resemblance to tone-evoked activity: a physiological model for tinnitus. Hear Res. 2000 Feb;140(1-2):165-72. doi: 10.1016/s0378-5955(99)00197-5. PMID: 10675644.