Digital self-therapy for overlooked chronic conditions: why we’ve invested in Oto

October 17, 2023

Spoiler: Oto has been accepted into YC!

Marking one of only 2 healthtech start-ups from Europe joining the program in this year’s winter batch.

I have to admit that when I first spoke to Ed and George, Oto’s Co-founders, in July 2021, I knew very little about tinnitus. I had mostly heard about it in connection with heavy metal musicians, which made me think it was a somewhat obscure condition that not a lot of people suffered from. Well, I couldn’t have been more far off!

Tinnitus is the perception of sound that is not caused by an outside source, often experienced as a persistent ringing in your ears. It is for many a chronic condition — highly subjective and extremely sensitive to internal triggers (such as stress) and external ones (such as loud music or background noise). And around 10% of the world population has it. It is annoying at best, and extremely intrusive and debilitating at worst. Can you imagine having a high speed fan non-stop operating in your ears?

The market

According to the CDC, around 15% of the US population, or ~50 million people, suffer from some form of tinnitus. And there is no cure. There are a few tools, such as cognitive behavioral therapy or sound enrichment¹, that can help one “habituate” to the condition. This means the brain is slowly retrained to eventually no longer hear or pay attention to the intrusive sounds. However, the barriers to access these tools remain high — long waiting lists, high costs for in person therapy and a somewhat inefficient care/ referral process.

Managing the disease becomes a big economic burden for society and the healthcare system. In the USA the total cost of tinnitus is estimated to be $26 billion². Whilst, personal economic loss of an individual has been accounted for up to $30,000 annually³ — including loss earnings, productivity and health expenses.

The solution

Ed and George have experienced the condition firsthand as they both developed a form of mild tinnitus while working in the military. And with Oto they are changing the way therapy is delivered. Their digital self-help program makes tinnitus support available instantly to all.

Each therapy module is composed of an education piece and individual exercises — distributed via recorded audio which guide the user in their journey. The exercises are made up of a mix of cognitive behavioral therapy, mindfulness, and physical relaxation. And it works very well! Oto is helping thousands of people with tinnitus find relief, all over the world. With just 1 month of app use, 86% reported a reduction in tinnitus severity.

Our thesis

With the power shifting from provider to patient in healthcare, a growing number of startups are engaging directly with consumers through self-help solutions. Digitizing some forms of treatment, like CBT, can lower the barriers to treatment access, and speed up the patient journey. We are seeing these models already revolutionizing care in certain verticals, for example in mental health.

And we strongly believe Ed and George are the team to bring such a product to market because they understand the target group and their sufferings. This positions them far ahead in building something people both love and benefit from.

We are looking forward to continuing seeing Ed and George make more patients feel heard and healthy. And lead the way to new therapy standards for other overlooked health conditions!


[1]: Stockdale et al. BMC Health Services Research (2017) 17:577 DOI 10.1186/s12913–017–2527–2