Objectives Stress is a suspected cause of tinnitus and studies relying on self-reported stress measures have supported this hypothesis. Self-report studies may, however, have validity problems. The objective of this study was to investigate if salivary cortisol, as an objective indicator of stress activation of the HPA axis, was associated with tinnitus.

Methods In a cross-sectional study, we analysed data from a Danish survey from 2010, including 632 white- and blue-collar workers from 10 manufacturing trades, children day care units and financial services. Associations between cortisol measures (awakening cortisol, awakening+30 cortisol, cortisol awakening response, evening cortisol, cortisol slope and area under the curve) and tinnitus were analysed using logistic regression.

Results Overall, no statistically significant associations were observed between cortisol measures and tinnitus. Weak associations between a steeper cortisol slope across the day (reflecting higher awakening cortisol and lower evening cortisol) and tinnitus were indicated.

Conclusions This observational study did not support the hypothesis that salivary cortisol, as a reflection of HPA axis activity, is associated with tinnitus. Weak indications of an association between a steeper slope of cortisol and tinnitus warrants further study.