Ringing in the ears, or Tinnitus, is extremely common and affects about 10% of the population. 40% of those with hearing loss, also have tinnitus.
WHAT IS TINNITUS?
Tinnitus is the perception of sound without an external sound source. It is often referred to as “ringing in the ears” although the sound can also be described as hissing, roaring, buzzing, whistling, chirping or clicking. Tinnitus can be constant or intermittent, can be in one or both ears, or have the sense of coming from somewhere within the head.
HOW MANY PEOPLE HAVE IT?
More than 50 million people in the US have reported experiencing some form of tinnitus. Studies have shown that about 10-15% of all adults have permanent tinnitus. The chance of tinnitus increases with age and is more prevalent among men than women and more in those with high BMI, or history of noise exposure, hypertension, diabetes, anxiety, or high cholesterol. Most people with tinnitus are not bothered by it.
WHAT CAUSES TINNITUS?
Tinnitus is not a disease, but rather a symptom associated with number of causes and aggravating co-factors. The exact cause is not known; although there are several likely sources, which can trigger or worsen already existing tinnitus. Tinnitus is generated in the auditory portion of the brain in response to external factors which may include noise trauma, wax blocking the ear canals, pain relievers, medications/medication interactions, alcohol, tobacco, caffeine, allergies, TMJ or teeth grinding, head trauma, neck issues, diet, general health, relaxation, recreational drugs, fatigue and sleep deprivation, stress and anxiety.
Hearing loss is most commonly associated with tinnitus. When the brain is no longer stimulated by certain pitches, it starts to fire randomly on it own. This spontaneous firing (when done at the same time) is thought to be the origin of the phantom perception that is tinnitus.
IS THERE A CURE?
No. There is currently no cure for tinnitus (although research is being done on this). For now, we try to manage the symptom of tinnitus by changing our reactions to it. We want to take bothersome tinnitus and turn it into non-bothersome tinnitus. Studies have shown that a reduction in tinnitus loudness does not correlate to a reduction in how bothersome the tinnitus is. In fact, most tinnitus is measured around 5dB above your hearing threshold, even when it is perceived to be as loud as a jet engine.
Tinnitus management may involve a combination of different doctors working together to help you, including an otolaryngologist, psychologist, neurologist, or dentist. You first need to see an Otolaryngologist if you have tinnitus that pulses with your heartbeat or breathing, you have ear pain or drainage, you have dizziness/vertigo, you have facial weakness/paralysis, you have a sudden unexplained hearing loss.
Limit or avoid exposure to loud noise. If you must be around loud noise, use hearing protection. Be careful with the volume when using headphones or ear-buds for music. Reduce or eliminate alcohol, caffeine, or tobacco and see if your tinnitus improves. Maintain a healthy weight and practice stress-free living and good sleep hygiene.
Many people have been told in the past that “nothing can be done” or they “have to learn to live with” their tinnitus. This is not true. Even simply knowing that there are strategies to manage your reaction to tinnitus can help. Understanding what tinnitus is (not a disease) and how to manage it is the first step.
There are many methods of using sound stimulation but the basic idea is to distract your brain from focusing on the tinnitus. It is important to note, we do not want to “mask” the tinnitus, when using sound therapy you must still be able to barely hear your tinnitus, or the brain wont be able to learn to habituate, a fancy word for get used to it.
The ability to change your thoughts and feeling in general can be very challenging and take work and practice, like exercise for the brain. But the ability to change your feelings and reactions about your tinnitus can be the most powerful method to managing your tinnitus. Ways to do this include relaxation exercises, good sleep hygiene, stress management, and thought changing exercises.