Summary: New pooled evidence shows that hearing problems are widespread among musicians. A large meta-analysis of 67 studies covering more than 28,000 musicians across 21 countries found that tinnitus, hearing loss, and hyperacusis occur far more often in musicians than in non-musicians. Tinnitus affected 42.6% of musicians—over three times the rate seen in control groups—while hearing loss and sound sensitivity were also markedly elevated.
The analysis shows that auditory risk is not confined to any single genre. Classical orchestra members and pop/rock performers showed similar rates of tinnitus, hearing loss, and hyperacusis. Instead, factors such as instrument type, seating position in an ensemble, rehearsal and performance environment, and personal use of hearing protection appear to drive the increased risk.
Key Facts
- Triple the Risk: 42.6% of musicians reported tinnitus versus 13.2% of non-musicians.
- Hearing Loss: 25.7% of musicians reported hearing loss compared with 11.6% of control populations.
- Hyperacusis Surge: 37.3% of musicians reported hyperacusis, versus 15.3% of non-musicians.
- Genre Neutrality: No significant difference in auditory symptoms between classical and pop/rock musicians was found.
- Undiagnosed Cases: About 63% of musicians who reported hearing loss did so subjectively; only roughly 37% had objective audiometric confirmation.
- Environmental Drivers: Seating, room acoustics, instrument proximity, rehearsal duration, and inconsistent hearing protection use are key contributors to risk.
Source: AAO
A major systematic review and meta-analysis published in Otolaryngology–Head and Neck Surgery confirms that musicians face substantially higher rates of tinnitus, hearing loss, and hyperacusis than the general population.
The review included 67 studies with a combined sample of 28,311 participants. Musicians in the pooled data had a mean age of 34.7 years, while control participants averaged 30.2 years.
Specifically, 42.6% of musicians reported tinnitus (ringing in the ears), compared to 13.2% of controls. Hearing loss was reported by 25.7% of musicians versus 11.6% of controls, and hyperacusis—an increased sensitivity to everyday sounds—was reported by 37.3% of musicians compared to 15.3% of non-musicians.
“Many musicians quietly live with ringing ears, sound sensitivity, or reduced hearing, whether they perform in a symphony hall or a small club,” said Shaun A. Nguyen, MD, Professor of Otolaryngology–Head and Neck Surgery. He noted that much of the existing literature relies on self-reported symptoms and often lacks detailed information about other noisy activities, specific instruments, and consistent use of hearing protection.
The analysis found that most musicians who experience tinnitus describe it as intermittent—about 76.3%—while 15.6% reported persistent, constant tinnitus. Among those reporting hearing loss, roughly 63% based their assessment on subjective symptoms; only around 37% had audiometric confirmation, suggesting objective testing may uncover additional cases.
Importantly, the study challenges the assumption that rock musicians are uniquely at risk. Rates of tinnitus, hyperacusis, and hearing loss were comparable between classical and pop/rock musicians, indicating that cumulative exposure and acoustic environment matter more than musical genre.
Key Question Answered:
A: Classical musicians frequently rehearse and perform for many hours in high-decibel settings such as rehearsal halls, orchestra pits, and concert stages. Proximity to loud instruments like brass and percussion can produce sound levels similar to a rock stage, and the cumulative exposure over years increases auditory risk.
A: Hyperacusis is a heightened sensitivity to everyday sounds, where ordinary noises—such as clattering dishes or a vacuum—can feel uncomfortably loud or painful. It can arise when the auditory system compensates for hearing damage by amplifying perceived volume, making normal sounds distressing.
A: High-fidelity earplugs can reduce exposure while preserving sound quality, but some musicians avoid them because they alter the perceived balance and feel of music. The study emphasizes the need for musician-focused hearing protection strategies that lower risk without compromising performance quality.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The full journal paper was reviewed for this summary.
- Additional context was provided by editorial staff to clarify implications for musicians and clinicians.
About this auditory neuroscience research news
Author: Tina Maggio
Source: AAO
Contact: Tina Maggio – AAO
Image: The image is credited to Neuroscience News
Original Research: Open access. “Auditory Symptoms Among Musicians: A Systematic Review and Meta-analysis” by McCray, L.R.; Ripp, A.T.; Nguyen, S.A.; Pelic, J.C.; Labadie, R.F.; and Meyer, T.A. Published in Otolaryngology–Head and Neck Surgery. DOI: 10.1002/ohn.70094
Abstract
Auditory Symptoms Among Musicians: A Systematic Review and Meta-analysis
Objective
To quantify the prevalence of tinnitus, hearing loss, and hyperacusis among recreational and professional musicians and to compare these rates with non-musician control populations.
Data Sources
Comprehensive searches of CINAHL, Cochrane Library, PubMed, and SCOPUS identified English-language studies published through November 19, 2024, that reported auditory symptom prevalence among adult musicians.
Review Methods
Included studies were cohort and cross-sectional designs reporting auditory symptom prevalence in musicians aged 18 and over. Studies limited to children or only noise exposure data were excluded. Two reviewers independently extracted data and resolved disagreements through discussion. Risk of bias was assessed using established tools appropriate to each study design. Primary outcomes included proportions and mean values with 95% confidence intervals.
Results
Sixty-seven studies (n = 28,311) met inclusion criteria. Musicians had significantly higher prevalence of tinnitus (42.6% vs 13.2%), hearing loss (25.7% vs 11.6%), and hyperacusis (37.3% vs 15.3%) compared with controls. No significant differences in these auditory symptoms were observed between classical and pop/rock musicians.
Conclusion
At least one in three musicians reports tinnitus or hyperacusis, and roughly one in four reports hearing loss. The findings support routine auditory screening and tailored prevention counseling for musicians, with attention to environmental controls, instrument-specific risks, and personalized hearing protection strategies.