AbstractTinnitus is primarily an auditory symptom. Yet not only patients and clinicians, but also current pathophysiological models relate the onset and maintenance of tinnitus to stress. Here physiological and psychological stress reactivity was investigated in 19 patients with subjective chronic tinnitus and 19 comparable healthy controls. All participants underwent five consecutive measurements in one session including three resting conditions and two stress tasks in between (mental arithmetic and concentration on tinnitus/ear noise). Stress reactivity was assessed by heart rate (HR), heart rate variability (HRV) and subjective ratings for each of the five measurements. In patients with tinnitus, mean HR was overall decreased and blunted in response to acute stress induced by mental arithmetic compared to controls. HRV measures did not differ between both groups. Tinnitus sufferers indicated more subjective stress and increased awareness of tinnitus after the mental arithmetic task (during both resting and concentration on tinnitus measurements), but perceived similar levels of stress during mental arithmetic stress. In contrast to controls, HR and HRV were not correlated and also strain reports and physiological data were not associated in tinnitus. Our data show hints for a de-synchronization of physiological and psychological stress reactivity in chronic tinnitus.