About 95% of people with tinnitus do not hear the phantom sound while dreaming, confirming earlier reports. In a survey of 148 tinnitus patients who could recall dreams, only 5.4% heard their tinnitus during dreams; these individuals tended to have higher tinnitus burden, more stress, and more often had hearing loss or related health conditions. Among the 12.2% who experienced lucid dreams, 38% could perceive their tinnitus during those dreams, strongly linked to also hearing external sounds in the lucid state. Upon waking, most perceived tinnitus instantly, though 17.2% reported being awakened by it and 10% said it could temporarily stop during nocturnal awakenings. The findings suggest that gating of external auditory information during dreams acts as a tinnitus on-off switch.
Tinnitus, the perception of sound without an external source, lacks effective treatments. Psilocybin, a psychedelic, shows promise by activating 5-HT2A receptors, boosting glutamate release, and upregulating BDNF, which increases dendritic spine density and synaptic proteins in the hippocampus and prefrontal cortex, restoring neural plasticity. This review connects these neuroplasticity mechanisms to tinnitus-related neural changes, highlighting psilocybin's regulatory effects on excitatory (glutamate, dopamine) and inhibitory (GABA) neurotransmitters and their receptors, suggesting a novel therapeutic pathway.