Musicians, Tinnitus and Hearing Health: What Research Says About Antioxidants
Musicians spend their lives surrounded by sound, from rehearsals and studio sessions to stage monitors, in-ear monitors, amplifiers, drum kits, and live audiences.
That relationship with sound is part of what makes music possible. But repeated exposure to high sound levels can also place unique demands on the auditory system.
Research consistently shows that professional and recreational musicians experience tinnitus and other hearing-related symptoms at meaningful rates.[1,2]
A recent systematic review and meta-analysis involving 67 studies and more than 28,000 musicians found that musicians had a significantly higher prevalence of tinnitus than comparison populations.[1] Earlier research involving professional musicians has similarly identified tinnitus as one of the most commonly reported auditory symptoms.[2]
For musicians, protecting hearing is therefore an important part of maintaining long-term auditory wellness.
At the same time, scientists continue to investigate the biology behind noise-related auditory stress, including the role of oxidative stress and whether antioxidant strategies may have relevance to hearing health.[3,4]
Why Tinnitus and Hearing Health Matter for Musicians
Tinnitus is the perception of sound without a corresponding external sound source. It is commonly described as ringing, buzzing, humming, or other sounds.
Musicians can encounter substantial cumulative sound exposure over the course of rehearsals, performances, recording sessions, and personal listening.
A large historical cohort study published in Occupational & Environmental Medicine compared professional musicians with the general population. Researchers found that professional musicians had a higher risk of hearing disorders, including a substantially elevated risk of noise-induced hearing loss.[3]
A systematic review involving 4,618 professional musicians also found tinnitus to be the most commonly reported audiological symptom among the musicians studied.[2]
More recently, a systematic review and meta-analysis involving 28,311 musicians reported tinnitus in 42.6% of musicians compared with 13.2% of controls.[1]
These findings reinforce an important message:
Hearing wellness deserves the same attention musicians give to their instruments, technique, and performance.
Sound Exposure and Tinnitus in Musicians
The relationship between music exposure and tinnitus isn’t simply theoretical.
A study of symphony orchestra musicians published in Ear and Hearing examined tinnitus severity in relation to cumulative sound exposure.[5]
Researchers found an association between tinnitus severity and sound exposure among the musicians, independent of measured hearing impairment.[5]
This is particularly relevant because musicians can accumulate substantial sound exposure over many years—even when music does not necessarily feel uncomfortably loud during every individual session.
Sound level, exposure duration, frequency of exposure, individual susceptibility, and recovery time can all influence auditory risk.
What Happens in the Inner Ear After Excessive Sound Exposure?
The cochlea is a highly specialized structure within the inner ear that converts sound-related mechanical vibrations into signals used by the auditory system.
Excessive sound exposure can place significant stress on these delicate structures.
One area receiving substantial scientific attention is oxidative stress.
Reactive oxygen species (ROS) are naturally produced during cellular metabolism. Under normal circumstances, the body has antioxidant systems that help maintain oxidative balance.
Following excessive acoustic exposure, however, research has identified increased ROS production and inflammatory signaling as biological mechanisms associated with noise-induced cochlear stress.[4]
A 2024 systematic review examining noise-induced hearing loss described oxidative stress, inflammatory responses, and related cellular pathways as important components of acoustic injury.[4]
This biological connection is one reason scientists have become interested in antioxidants and hearing research.
Antioxidants and Hearing Health: What Does the Research Say?
Antioxidants help participate in the body’s defense against oxidative processes.
Because oxidative stress has been implicated in noise-related cochlear injury, researchers have investigated whether antioxidant compounds might influence some of the biological effects associated with excessive noise exposure.[4,6]
A systematic review examining vitamins and antioxidants in occupational noise exposure evaluated research involving several antioxidant interventions.[6]
The findings provide scientific support for continuing to investigate antioxidant strategies in noise-exposed populations.
However, antioxidant research should be interpreted carefully. Different studies have investigated different compounds, doses, populations, and exposure conditions. The evidence does not establish that antioxidant dietary supplements prevent noise-induced hearing loss or treat tinnitus.
Instead, the research points to an important and evolving scientific question:
Could supporting normal antioxidant balance have relevance to auditory wellness in people regularly exposed to high sound levels?
Researchers continue to investigate that question.[4,6]
Why Oxidative Balance Is an Important Area of Research
The concept of oxidative balance is more nuanced than simply labeling free radicals as “bad” and antioxidants as “good.”
Reactive oxygen species are part of normal biology. Problems can arise when reactive species are generated at levels that exceed the body’s ability to regulate them effectively.
In the auditory system, excessive noise exposure has been associated with biological processes involving ROS, inflammation, mitochondrial stress, and cellular injury.[4]
That makes antioxidant biology particularly interesting in the context of musicians and others who regularly experience substantial sound exposure.
But nutrition should be viewed as complementary to hearing conservation—not a replacement for it.
The most established strategy remains reducing potentially harmful sound exposure.
Hearing Protection Comes First
For musicians, hearing protection remains one of the most practical tools for reducing sound exposure.
Musicians sometimes hesitate to wear earplugs because they worry that hearing protection will alter pitch, timbre, dynamics, or the quality of their performance.
Research provides some encouraging findings.
A study evaluating musicians performing with and without musicians’ earplugs found no consistent disadvantage in pitch accuracy. Listeners also did not identify a clear deterioration in tone quality, intonation, or dynamic contrast when musicians performed while wearing the earplugs.[7]
Another study found that although musicians generally preferred performing without hearing protection, most rated their experience using earplugs positively—and listeners were unable to distinguish music performed with versus without hearing protection.[8]
Different hearing protectors can provide different amounts and patterns of attenuation, however. Research evaluating hearing-protection devices in musicians found substantial variability between individuals and emphasized the importance of appropriate fit and selection.[9]
For musicians, this means hearing protection does not necessarily have to mean sacrificing the musical experience.
Practical Hearing-Wellness Strategies for Musicians
A comprehensive hearing-wellness routine can include:
- Use appropriate hearing protection. Musician-oriented earplugs are designed to reduce sound while attempting to preserve a more balanced frequency response.[7– 9]
- Pay attention to cumulative exposure. Rehearsals, performances, studio work, concerts, and personal listening all contribute to total sound exposure.
- Keep monitoring levels reasonable. More volume isn’t necessarily better monitoring.
- Allow recovery time after loud sessions. Reducing additional sound exposure after particularly loud rehearsals or performances can decrease cumulative exposure.
- Consider baseline hearing evaluations. Musicians who regularly work around high sound levels may benefit from discussing appropriate hearing monitoring with an audiologist or other qualified hearing professional.
- Prioritize overall nutrition and wellness. A balanced diet provides vitamins, minerals, and naturally occurring antioxidant compounds important for normal physiological function.
- Don’t rely on supplements as hearing protection. No dietary supplement should replace earplugs, appropriate sound-level management, or professional hearing care.
What About Tinnitus?
Tinnitus is not a single disease with a single cause.
Sound exposure is one important risk factor, particularly for musicians, but tinnitus can occur in association with numerous auditory and medical factors.
For musicians who experience tinnitus, protecting hearing from additional excessive sound exposure is particularly important.
Persistent tinnitus should also be discussed with a qualified healthcare or hearing professional.
Prompt medical evaluation is especially important for sudden hearing changes, tinnitus that develops suddenly in one ear, tinnitus accompanied by sudden hearing loss, pulsatile tinnitus, significant dizziness or vertigo, or other new neurological or ear symptoms.
The Future of Antioxidant Research and Hearing
Our understanding of noise exposure and the inner ear has advanced substantially.
Researchers now understand more about the cellular processes associated with acoustic stress, including oxidative pathways and inflammatory signaling.[4]
That has opened an interesting area of research into antioxidants and other compounds that may interact with these biological processes.
The evidence is still developing, and antioxidants should not be viewed as a proven treatment for tinnitus or a substitute for hearing protection.
But the research into oxidative stress, antioxidant biology, and auditory health provides a scientifically meaningful area for continued investigation particularly for populations such as musicians who may experience substantial cumulative sound exposure.[4,6]
For musicians, the strongest approach is comprehensive:
Protect your hearing. Manage sound exposure. Pay attention to changes in your ears. Support overall wellness. And take your auditory health as seriously as your music.
References
1. Auditory Symptoms Among Musicians: A Systematic Review and Meta-analysis. Systematic review and meta-analysis of 67 studies involving 28,311 musicians; reported higher prevalence of tinnitus, hearing loss, and hyperacusis among musicians compared with controls.
PubMed – Auditory Symptoms Among Musicians
2. Di Stadio A, Dipietro L, Ricci G, et al. Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review. International Journal of Environmental Research and Public Health. 2018. PMID: 30261653.
PubMed – PMID 30261653
3. Schink T, Kreutz G, Busch V, Pigeot I, Ahrens W. Incidence and relative risk of hearing disorders in professional musicians. Occupational and Environmental Medicine. 2014;71(7):472–476. doi:10.1136/oemed-2014-102172. PMID: 24790053.
PubMed – PMID 24790053
4. Santaolalla Sanchez FJ, Gutierrez Posso JD, Santaolalla Montoya F, et al. Pathogenesis and New Pharmacological Approaches to Noise-Induced Hearing Loss: A Systematic Review. Antioxidants (Basel). 2024;13(9):1105. doi:10.3390/antiox13091105. PMID: 39334764.
PubMed – PMID 39334764
5. Schmidt JH, Paarup HM, Bælum J. Tinnitus Severity Is Related to the Sound Exposure of Symphony Orchestra Musicians Independently of Hearing Impairment. Ear and Hearing. 2019;40(1):88–97. doi:10.1097/AUD.
PubMed – PMID 29757798
6. Abbasi M, Pourrajab B, Tokhi MO. Protective effects of vitamins/antioxidants on occupational noise-induced hearing loss: A systematic review. Journal of Occupational Health. 2021;63(1):e12217. doi:10.1002/1348-9585.12217.
PubMed Search – Article Title
7. Thomas KS, Smith R, Teglas S, Hodges DA. Musicians’ Earplugs: Do They Affect Performance or Listeners’ Perceptions? Medical Problems of Performing Artists. 2020;35(4):188–195. doi:10.21091/mppa.2020.4027. PMID: 33257920.
PubMed – PMID 33257920
8. Nelson NL, Killion MC, Lentz JJ, Kidd GR. Hearing Protection Success: Musicians Have a Favorable Response to Hearing Protection and Listeners Are Unable to Identify Music Produced by Musicians Wearing Hearing Protection. Journal of the American Academy of Audiology. 2020;31(10):763–770. doi:10.1055/s-0040-1719128. PMID: 33740821.
PubMed – PMID 33740821
9. Evaluation of hearing protection device effectiveness for musicians. International Journal of Audiology. 2022. doi:10.1080/14992027.2022.
PubMed – PMID 35143376