Mahana Tinnitus App: New Tools for Reducing the Effects of Bothersome Tinnitus

Mahana Tinnitus is a new digital program designed for people with bothersome tinnitus. It is self-guided, self-paced, and delivered via an app on a smartphone or tablet, essentially making it a personalized toolkit for managing the impact of tinnitus on your life—whether it’s improving sleep, reducing anxiety and worry, increasing focus and concentration, or just putting tinnitus into the backseat.

The Mahana Tinnitus program was developed with the assistance of audiologists and psychologists, many of whom are the world’s foremost tinnitus clinicians and researchers. To ensure the practicality of their approach, Mahana also listened to those living day to day with bothersome tinnitus. Using a Cognitive Behavioral Therapy (CBT) approach, the company has designed a program that gives you fundamental tinnitus education and guides you to the skills needed for finding relief from the impact of tinnitus.

In this article, we’ll explore Mahana Tinnitus, providing details about its development, who it might help, and some emerging scientific evidence for its effectiveness. We've also interviewed leading scientists in the field about Mahana so that you can determine if it’s right for you.

Taking charge of your tinnitus

If you’re reading this, you or a loved one probably have bothersome tinnitus. While there are several reasons why tinnitus may be bothersome, it might help to know you’re certainly not alone. Chronic tinnitus afflicts about 25 million people in the United States, of which some 2.7 million are veterans (tinnitus is the #1 service-connected disability among U.S. veterans). About 5 million people have burdensome tinnitus, and 2 million characterize it as debilitating.¹

There are scads of sketchy online pills, remedies, and devices for tinnitus—many of which are little more than placeboes or flimflam. “It can be difficult to find accurate and credible information about tinnitus,” says James Henry, PhD, a leading tinnitus scientist who works at the VA’s National Center for Rehabilitative Auditory Research (NCRAR) in Portland, Ore. “The internet is full of unwarranted claims about different treatments and ‘cures’ for tinnitus.”

A recent study suggests that 61% of Mahana Tinnitus users reduced the impact of tinnitus on their quality of life after 6 weeks of use. “Mahana Tinnitus works through CBT, which essentially can be described as ‘You learn things, you practice them, and then you turn them into helpful habits while moving away from unhelpful habits,’” says Mahana Chief Commercial Officer Justin Zamirowski.  “And, if you practice healthy habits for over a 3-month period, you’ll generally acquire habits that stick.”

Who is Mahana Therapeutics?

Founded in San Francisco in 2018, Mahana Therapeutics uses digital therapeutics (DTx)—a fancy word for online, app-based interactive education and treatment programs—to help people manage their chronic conditions and lead fuller lives. The company collaborates closely with researchers, medical professionals, and patients to advocate for high-quality treatment standards and expanding digital treatment options where possible.

Mahana is best known for Mahana IBS, the first 3-month prescription digital therapeutic cleared by the FDA as a treatment to reduce the severity of Irritable Bowel Syndrome (IBS). Initially known as Regul8, Mahana IBS is based on 20 years of clinical research developed by scientists at Kings College in London and the University of Southampton. They have shown that Mahana IBS can help adults change certain behaviors and thoughts related to IBS symptoms that occur when gut-brain interactions are disrupted. The program is now widely used by gastroenterologists.

Now, the company is looking to duplicate its successful digital therapeutic IBS program for patients with tinnitus through Mahana Tinnitus.

Who is Mahana Tinnitus for?

The Mahana Tinnitus program was designed to help anyone seeking assistance for their bothersome tinnitus. Everyone’s tinnitus is different, and there are a lot of different techniques to tackle it. Not only do the pitches and loudness of tinnitus differ from person to person, but so can people’s reactions to it—even from day to day.

Provided by a hearing care professional or tinnitus expert, Mahana Tinnitus helps educate and guide you—at your own pace and according to your own schedule. It presents what tinnitus is, how and when it might affect you most, and what you can do about it. Mahana Tinnitus might be considered as a “tinnitus coach” who can help train you to take control over and alleviate your tinnitus.

“I think the Mahana Tinnitus app is probably best suited for people with moderate tinnitus who have limited knowledge about the various treatments, are having difficulties finding a provider, and/or are just looking for a place to start,” says Richard Tyler, PhD, an audiologist and professor at the University of Iowa and author of The Tinnitus Handbook, Tinnitus Treatments, and A Consumer Handbook of Tinnitus.^2-4 Although Dr. Tyler is optimistic about people being helped with online programs, he cautions it’s not for everyone. “Some patients can be helped remotely; others will need to see a professional in person,” he says.

Dr. Henry, who is the author of The Tinnitus Book for consumers,⁵ is excited about how the new app improves access to treatment for people struggling with tinnitus. “To me, the most compelling aspect of the Mahana Tinnitus app is the fact that it resides on smartphones, which means it can be used by just about everyone at any time and in any place,” he says. “Further, the app uses the method with the most research evidence for treating tinnitus. It was developed by psychologists who have expertise in CBT with oversight by other tinnitus experts.”

Mahana Tinnitus: A scalable, evidence-based approach to tinnitus relief

The Mahana Tinnitus app can be used on its own or in combination with other tinnitus-relief strategies, as recommended by a hearing care professional or tinnitus expert. It is not intended to replace the care of your provider, and it is a safe digital program with no known side effects.

Some evidence-based solutions do help alleviate tinnitus symptoms, including hearing aids, tinnitus maskers, certain FDA-cleared tinnitus devices, and products like sound generators or sleep pillows. However, the effectiveness of these devices largely depends on the user's unique tinnitus profile and daily challenges. Additionally, most provide temporary relief, whereas CBT is designed to give you long-term coping solutions.

“Cognitive behavioral therapy is used for many conditions, including sleep disorders, anxiety, and depression, and has been adapted for use in treating bothersome tinnitus,” says Dr. Henry. “The method has cognitive components and behavioral components. Most simply, the cognitive strategies are intended to change a person’s thoughts about tinnitus to be more constructive and helpful. The behavioral strategies are intended to distract the person from thinking about tinnitus and to reduce the stress and anxiety that are associated with it.

“CBT involves learning strategies for minimizing the impact of tinnitus,” adds Dr. Henry. “These strategies need to be understood and practiced in order to receive maximum benefit. It’s not a ‘passive’ treatment like taking a pill. It requires time and effort to utilize the strategies in an effective manner.”

CBT for tinnitus is designed to help people better manage tinnitus and reduce its annoyance. It is not intended as a cure or an approach to making tinnitus quieter.

Limitations in today’s tinnitus management options—and why a scalable online program is needed

Despite strong evidence that CBT is one of the most effective treatments for tinnitus, studies have found that less effective medications are discussed 50% of the time by medical professionals. In comparison, CBT is discussed only 0.2% of the time.^6,7 This is most likely due to the limited number of professionals who provide CBT for tinnitus. Finding a tinnitus specialist in rural America and outside metropolitan areas can be particularly challenging.

Dedicated professional tinnitus help can also be expensive. Tinnitus Retraining Therapy (TRT), a close cousin to CBT that usually involves sound therapy devices, can cost as much as $6,000-$9,000 per year. FDA-approved neuromodulation devices can cost $4,000-$6000 per year. CBT and TRT are relatively labor-intensive for both the patient and provider, usually involving multiple office visits and many activities to attain success. (See Dr. Henry’s article for detailed information.)

Reimbursement for clinics can also be an issue. A typical in-office audiology visit for a person with tinnitus involves a comprehensive hearing examination, tinnitus evaluation, multiple follow-up visits, and possible referrals. Because healthcare insurance doesn’t always cover tinnitus counseling and related devices, people with bothersome tinnitus may avoid treatment for financial reasons, and hearing providers often find it difficult to offer comprehensive tinnitus care.

Tinnitus is widely prevalent and arises from problems related to the auditory system that involve both the ears and the brain. It often leads to negative thoughts and strong emotional reactions. For this reason, audiologists specializing in tinnitus treatment, neurologists, and psychologists—three groups of professionals in very short supply—often team up to help their patients.

“In general, whether you’re talking about audiologists, psychologists, or neuroscientists, everyone understands there is a workforce shortage in [treating tinnitus], and we’re all seeking different ways to try to fulfill our patients’ needs,” says John Coverstone, AuD, a Minneapolis-based audiologist who specializes in tinnitus treatment, serves as the editor of Tinnitus Today, and regularly writes and co-hosts podcasts for the American Tinnitus Association. “We just don’t have enough providers out there for people with tinnitus, so some are turning to telemedicine and distance/virtual therapy strategies.”

Drawing on its experience with IBS patients, Mahana saw an opportunity in this challenge. It believes the “gold standard” for a person with bothersome tinnitus is first to undergo a hearing test and tinnitus evaluation from a professional with training in tinnitus management. These providers can also rule out any serious medical conditions associated with tinnitus and recommend highly effective and personalized solutions right from the get-go. Then if deemed appropriate, Mahana Tinnitus can be offered as a part of a tinnitus management plan.

Getting started with the Mahana Tinnitus app

After downloading and starting the Mahana Tinnitus app, you’ll be given an assessment to identify how tinnitus affects your real-world life, such as your sleep habits, concentration, mood, work/school performance, and relationships. This is a “getting to know you” phase since everyone's experience with tinnitus is different. It then surveys you with questions like how often tinnitus interferes with your daily activities, your goals, and what you’d like to achieve from the program.

Once the assessment is completed, you’ll then move through a series of sequential sessions tailored to build your knowledge and skills about tinnitus and introduce you to tools from the Mahana Toolkit.

“I think Mahana did a really nice job with their use of the sessions,” says Dr. Coverstone. “They broke it up into logical, easy-to-use modules. That’s important, not just because of the information it imparts, but also because it gives users ‘little wins.’  When you're working through a complicated problem like tinnitus, it’s important to see progress. Mahana Tinnitus is not some big, long process you need to slog through; with the five sessions, you're going through very manageable modules that you can get through in just a handful of hours. And then you've achieved [a worthwhile learning goal]. Even if it doesn’t immediately make your tinnitus substantially better that day, at least you've successfully completed and learned something you can use now and in the future, and I think that's meaningful to people.”

Adds Dr. Coverstone: “I also like that you can go back to the sessions or tools and revisit any of them, reinforcing the concepts as you work through a program like this. Because who's going to remember everything, right? So being able to go back to the sessions you found valuable is a nice touch as well.”

Sessions within the Mahana Tinnitus app

Mahana Tinnitus is segmented into five sessions, using a step-by-step progression that allows you to progress at your own pace. Typically, the program takes about 10 minutes per day and is designed to:

• Retrain the brain to be less bothered by tinnitus sounds.
• Offer strategies to improve sleep, focus, and daily function.
• Teach skills that reduce stress and the impact of tinnitus on daily life.
• Shift habits, thinking patterns, and emotional responses.

According to Mahana, the program can be completed in as little as 6 weeks, although most people take 10-12 weeks because they take breaks and revisit sessions that have benefited them most.

Session 1: Symptoms & Stress

• Starts with a Tinnitus Survey to understand your tinnitus journey
• Introduces basics about tinnitus and its cycle of stress and worry
• Provides tools like breathing videos

Session 2: Behavior & Sounds

• Teaches sound management strategies like how to focus away from tinnitus
• Includes exercises for attention-shifting and managing tinnitus at night
• Adds tools like Body Scan Meditation and Progressive Muscle Relaxation

Session 3: Thoughts

• Focuses on thoughts and how they impact tinnitus
• Teaches you to challenge unhelpful thoughts and develop helpful ones
• Introduces the Thought Record tool and Loving-kindness Meditation

Session 4: Emotions

• Helps you identify and process emotions related to tinnitus
• Teaches strategies to manage emotional reactions
• Adds the Emotions Record and other emotional management tools

Session 5: Long-term Plan

• Provides tips for communicating about your tinnitus
• Prepares you for future tinnitus spikes and setbacks
• Includes another Tinnitus Survey to measure your progress

Emerging evidence that Mahana Tinnitus can help people with bothersome tinnitus

Dr. Coverstone presented results from a pilot study⁸ using Mahana Tinnitus at the 2024 American Auditory Society (AAS) Scientific and Technology Meeting in Scottsdale, Ariz. The study involved 97 participants with bothersome tinnitus and explored the acceptability, safety, and clinical outcomes of Mahana Tinnitus.

Coverstone and his colleagues found that 61% of those who used the Mahana Tinnitus program experienced clinically significant and measurable improvement (per the Tinnitus Functional Index or TFI) in their tinnitus. These participants saw gains in tinnitus-related activities such as sleep and concentration. Following the 6 weeks, they also registered positive changes in their perceptions of annoyance, distress, loudness, and coping relative to their tinnitus.

Although the study authors caution that additional research is needed, they concluded that Mahana Tinnitus shows considerable promise for individuals struggling with bothersome tinnitus:

“Mahana Tinnitus holds substantial potential to impact clinical practice by providing a scalable, accessible, and effective intervention for tinnitus management.”
—Scott, Tyler, Schreiner, et al

Dr. Coverstone told HearingTracker, “Frankly, I wasn't really surprised by the positive study results because CBT is still really the one treatment for tinnitus that is empirically proven to benefit patients consistently. You know, I think most of us audiologists do believe there are other things that can help in our counseling…Mahana, of course, has already had success in the IBS world, and the company is chock full of psychologists and experts who really get it—I think they've done a very nice job.”

Cost of the Mahana Tinnitus app and where to buy it

Although prices will vary by location, the Mahana Tinnitus app costs around $300 for a one-year subscription and is FSA/HSA eligible. To gain access, you’ll need to go through a qualified audiologist, hearing care professional, or other tinnitus specialist. Currently, about 275 practices throughout the US are offering it, and Mahana predicts this number will double by the end of 2024. To find the closest tinnitus specialist in your area, visit the Mahana Tinnitus “Find a Clinician Near Me” webpage.

However, because Mahana Tinnitus is new and professionals who offer tinnitus services are scarce, you may need help finding a practice near you. If this is the case, Mahana told us you could also set up a virtual visit with a group like Bluemoth, or bring a form provided on the Mahana website to a local hearing care provider. According to Mahana, the form allows the provider to enroll in the Mahana Tinnitus program in about 2 minutes and be set up within a day to distribute the app.

Final verdict

Frankly, there aren't many easy ways for consumers to gain access to good tinnitus counseling, and many professionals are not capable of offering the breadth of tinnitus services they know their patients need. From a consumer perspective, Mahana Tinnitus appears to be an effective and relatively inexpensive way to increase your knowledge and arm yourself against the adverse effects of tinnitus. It should at least be beneficial for people with moderate levels of tinnitus severity. From a professional perspective, it shows great promise as a scalable tool in practices looking to assist patients with tinnitus or to improve the consistency and quality of their current tinnitus care services.

Mahana Tinnitus won’t be effective for everyone, and in-person professional tinnitus care remains the gold standard. Bothersome tinnitus can be an exceptionally complex problem, but Mahana Tinnitus should supplement the knowledge base and provide more tools for those seeking help.