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Tinnitus

tinnitus
Do you think you hear sound when none is present? Does it sound like there’s a constant buzzing, hissing, whistling, swooshing or clicking noise in your ears?

If so, you might be experiencing tinnitus, or “ringing in the ears.”

What is Tinnitus?

Tinnitus is an audiological and neurological condition that affects nearly 15 percent of people, according to the U.S. Centers for Disease Control.

Simply put, tinnitus is a sign of damage to the ear. It signals a disruption in how sound is transmitted and processed in the brain.

These annoying sounds can get in the way of every day life, making it difficult to hear or allow the person to focus, but they can also cause more severe health issues if left untreated.

Tinnitus Symptoms

In most cases only the person who has tinnitus is the only one who can hear the noise.

These so-called “phantom noises” can vary in pitch and can be heard in one or both ears. People with tinnitus might hear a variety of sounds, including humming, roaring or even music. Some people may even hear multiple sounds.

Measuring Tinnitus

Even though tinnitus is generally subjective, there are ways to diagnose and measure it. For example, audiologists can perform a hearing tests to  determine the specific gaps in hearing. This hearing loss often correlates to the nature and quality of that patient’s tinnitus, according to the ATA.

An audiologist will likely use a supplemental set of tests to measure the patient’s perception of tinnitus sound, pitch and volume. There are also tests to gauge the impact of tinnitus on one’s daily life.

To get a tinnitus hearing test, you can find an audiologist near you

How long does tinnitus last?

Tinnitus can be a constant presence or intermittent.

Pay attention to your ears after you attend a loud concert, listen to loud music too long, or if you experience other loud sounds. If you experience ringing in the ears for even a small amount of time, it could be a warning sign of hearing damage.

It’s important always wear hearing protection when you’re around loud noises, and give your ears a rest if you experience loud noises for prolonged periods of time.

Read more: 10 tips to protect your hearing 

Types of Tinnitus

Tinnitus is usually classified as either subjective or objective.

Subjective Tinnitus

More than 99 percent of all reported tinnitus cases are subjective, which means the noises are only perceived by the patient. The person might hear a continuous or overlapping sound with different frequencies and volume.

Objective Tinnitus

Objective tinnitus is when the noises are heard by other people in addition to the patient. These sounds are usually produced internally due to the body’s blood flow and musculoskeletal movement systems.

What does tinnitus sound like?

The sound of tinnitus is most commonly described as “ringing in the ears.” However, it can also be perceived as a buzzing, hissing, whistling, swooshing or clicking sound.

To better understand what tinnitus sounds like, the American Tinnitus Association has compiled a playlist of the most common sounds.

Technically, there are three ways to describe how patients experience these sounds:

Tonal Tinnitus

Near-continuous sound or overlapping sounds with well-defined frequencies. The volume often fluctuates. This is generally associated with subjective tinnitus.

Pulsatile Tinnitus

Pulsing sounds, often in sync with the patient’s heartbeat.

Musical Tinnitus

Music or singing, sometimes the same tune on a constant loop. This is also known as “Musical Ear Syndrome” and is very rare.

Causes of Tinnitus

Tinnitus is often caused by noise-induced hearing loss, according to the ADA. But there are other common causes, including:

  • Earwax blocking the ear canal
  • Age-related hearing loss
  • Acoustic trauma, which means sudden exposure to loud noises (firecrackers, gunshot, emergency alarm, loud speakers at a concert)
  • Ototoxic drugs that damage the ear, like platinum-based drugs for cancer treatment, quinine-based medications, non-steroidal anti-inflammatory drugs, and some antidepressants
  • Head injury
  • Temporomandibular joint disorder (TMJ)
  • Stress

Certain demographic groups appear to be more susceptible to tinnitus. This includes males, older populations and Caucasians. High-risk groups include senior citizens, with about 30 percent experiencing symptoms. The age groups at risk for tinnitus peaks at 60-69, likely due to age-related hearing loss as well as accumulative noise-induced hearing loss. After age 69, incidents of tinnitus appear to decrease.

Read more: Why treat age-related hearing loss?

Other high-risk groups include active military personnel and veterans because of their exposure to loud noises. Hearing loss is the leading service-related disability among U.S. veterans.

Read more: An invisible injury: Hearing loss among U.S. veterans 

People employed in loud workplace environments, musicians and music lovers, motorsports and hunting enthusiasts are also at risk. This is yet another reason to beware of loud noises and protect your hearing as much as possible.

One last high-risk category involves people with a prior behavioral health issue. People with a history of depression, anxiety, and obsessive-compulsive disorder may be prone to tinnitus, and these health issues tend to exacerbate symptoms.

Tinnitus in Pop Culture 

Recently, there have been more discussions about tinnitus in pop culture. Two movies, “A Star is Born,” and “Baby Driver,” address the issue directly, showing how the condition can impact a person’s health and well-being.

In 2018’s “A Star is Born,” staring Lady Gaga and Bradly Cooper, Cooper’s character Jackson Maine has tinnitus from his career as a musician. Throughout the film,  his tinnitus gets worse, and he fails to manage it appropriately, which directly affects his mental health.

In the 2017 film, “Baby Driver,”  a young getaway driver played by Ansel Elgort, suffers from tinnitus after a car crash. He uses music to drown out the noise, always wearing earbuds to help distract himself from the ringing.

The dangers of tinnitus

As portrayed in these films, the experience of ringing in your ear can be more than a burden.

An estimated 48-78 percent of people with severe tinnitus also have depression, anxiety, or other behavioral disorders, according to the American Tinnitus Association. In severe cases, this can lead to suicide, according to the Hearing Health Foundation.

Tinnitus Diagnosis and Treatment

If you think you have tinnitus, the first step is to see an otolaryngologist (ear, nose, and throat doctor) to rule out other medical issues. Your physician might advise you to see an audiologist to have your hearing checked. Ideally, visit an audiologist who has been trained in tinnitus management.

Because most people with tinnitus have some hearing loss, determining your baseline hearing is important.

Unfortunately, there isn’t a proven cure for most cases of tinnitus. The good news is there are a lot of tools to help manage the condition. It’s important to remember that every case is different. One option might be more successful for you than for someone else or vice versa.

Natural Treatments

Diet

Improving your general well-being may help alleviate your symptoms. A healthy diet is an example. If you have tinnitus and Meniere’s Disease, a low-salt diet may be worth exploring. It might also be worth taking a look at how much caffeine you consume. If certain foods and drinks make your symptoms worse, you can consider changing the amount you consume.

Talk to your doctor about your diet and the foods that affect hearing.

Read more: How what I eat affects my sinuses – and my hearing 

Exercise

Exercising regularly reduces stress, which is known to exacerbate tinnitus. Some recreational activities and hobbies may actually help distract from the tinnitus.

However, because many patients feel socially isolated with their tinnitus, if they don’t address it they could end up in a vicious cycle. Try to socialize with others and surround yourself with support.

Relaxation

Other relaxation techniques sometimes referred to as cognitive behavioral therapy could help. Biofeedback teaches you how to control certain autonomic body functions like your pulse, muscle tension, and skin temperature. Hypnotherapy may be another option.

Medication

There are no FDA-approved drugs specifically for tinnitus. However, there are options to address the stress, anxiety, and depression that are caused by and can sometimes exacerbate tinnitus. Medications most often used are psychoactive drugs that treat the related behavioral issues.

Common antidepressants used for tinnitus include:

    • Clomipramine (Anafranil)
    • Desipramine (Norpramin)
    • Imipramine (Tofranil)
    • Nortriptyline (Pamelor)
    • Protriptyline (Vivactil)

Anti-anxiety medications:

    • Alprazolam (Xanax)
    • Clonazepam (Klonopin)
    • Diazepam (Valium)
    • Lorazepam (Ativan)

Use caution when medicating tinnitus, and most importantly, always work closely with your physician.

Sound Therapies

There are several therapies to mask tinnitus, which include:

Masker

A masker uses external noise to cover the sound of tinnitus. The traditional one is a single-function table-top or bedside device with several pre-set sound options, says the ATA. But any sound producing device can be used. Think personal media players, computers, radio, TV, or even electric fans.

There are also maskers that look like hearing aids, such as the Phonak Tinnitus Balance hearing aids.

Phonak Tinnitus Balance hearing aids uses sound enhancement, sound enrichment, and counseling to reduce stress and bring relief to people with tinnitus. The hearing aids come in a variety of form factors, all of which feature the Tinnitus Balance noise generator, which uses the principle of sound therapy. It works by delivering sound to the ear that distracts the patient from the tinnitus they perceive. As a result, the ringing of tinnitus can blend into the background.

Distraction

Diverting attention from the sound by distraction can help people forget about their tinnitus. Something as simple as going for a walk in nature, meditating or spending quite time reading a book might help distract people from their tinnitus.

“I’ve found that some activities help me focus less on my tinnitus, giving me some peace and quiet from the ringing in my ears,” says HLM author Angie Aspinall. She suggests these 5 ways to distract yourself from tinnitus.

Habituation

Habitation is the process to help the patient’s brain reclassify tinnitus as an unimportant sound that can be ignored. Work with a health care professional to receive this therapy.

Neuromodulation

Neuromodulation is the act of using specialized sound to minimize the neural hyperactivity thought to be the underlying cause of tinnitus. Some of these are also fall in the category of tinnitus retraining therapy.

 

Tinnitus Relief Apps

If you want something that helps with masking the sound, there are free apps.

The Phonak Tinnitus Balance app, works with any headphones and provides sound therapy support. With the app, the patient can select sounds from a default list, or combine them with music from their personal library. It also has a timer option so you can listen to sounds to help you fall asleep.

Other apps include Whist, Relax Melodies or White Noise Lite.

Read more: Talking about Tinnitus: Coping, Learning and Finding Relief

Tinnitus and Hearing Loss

Patients who have both tinnitus and hearing loss may find relief from using hearing aids and other sound amplification devices.

In fact, a 2007 survey of hearing health professionals found around 60 percent of tinnitus patients experienced at least some relief when wearing hearing aids. Nearly 22 percent found significant relief, according to the ATA.

“… 60 percent of tinnitus patients experienced at least some relief when wearing hearing aids”

Hearing aids help with tinnitus because they can be programmed to help mask the sound of tinnitus. Furthermore, they can increase the external volume to better hear over the sound of tinnitus.

Read more: How my hearing aids helped my tinnitus

Finding a Tinnitus Specialist

To find a tinnitus specialist, contact an hearing care professional near you.  Rest assured, there’s relief in sight!

 

Do you experienced tinnitus? What are some coping methods you’ve used?

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Author Details
The HearingLikeMe editorial team includes Jill von Bueren, Kirsten Brackett and Lisa Goldstein.
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The HearingLikeMe editorial team includes Jill von Bueren, Kirsten Brackett and Lisa Goldstein.