AUTHOR=Probst Thomas, Pryss Rüdiger C., Langguth Berthold, Rauschecker Josef P., Schobel Johannes, Reichert Manfred, Spiliopoulou Myra, Schlee Winfried, Zimmermann Johannes TITLE=Does Tinnitus Depend on Time-of-Day? An Ecological Momentary Assessment Study with the “TrackYourTinnitus” Application JOURNAL=Frontiers in Aging Neuroscience VOLUME=9 YEAR=2017 URL=https://www.frontiersin.org/articles/10.3389/fnagi.2017.00253 DOI=10.3389/fnagi.2017.00253 ISSN=1663-4365 ABSTRACT=Only few previous studies used ecological momentary assessments to explore the time-of-day-dependence of tinnitus. The present study used data from the mobile application “TrackYourTinnitus” to explore whether tinnitus loudness and tinnitus distress fluctuate within a 24-h interval. Multilevel models were performed to account for the nested structure of assessments (level 1: 17,209 daily life assessments) nested within days (level 2: 3,570 days with at least three completed assessments), and days nested within participants (level 3: 350 participants). Results revealed a time-of-day-dependence of tinnitus. In particular, tinnitus was perceived as louder and more distressing during the night and early morning hours (from 12 a.m. to 8 a.m.) than during the upcoming day. Since previous studies suggested that stress (and stress-associated hormones) show a circadian rhythm and this might influence the time-of-day-dependence of tinnitus, we evaluated whether the described results change when statistically controlling for subjectively reported stress-levels. Correcting for subjective stress-levels, however, did not change the result that tinnitus (loudness and distress) was most severe at night and early morning. These results show that time-of-day contributes to the level of both tinnitus loudness and tinnitus distress. Possible implications of our results for the clinical management of tinnitus are that tailoring the timing of therapeutic interventions to the circadian rhythm of individual patients (chronotherapy) might be promising.