Tinnitus is a perception of noise, commonly described as ringing, in the ears. It is a neural response to a change in the hearing nerves. This can come from a variety of sources: hearing loss, some medications, stress, fatigue, or even too much coffee.
The problem with tinnitus arises, not from the actual tinnitus, but from the negative mental and emotional response to tinnitus. I explain this response to my patients like this: our brains are wired to keep us safe. If our brain perceives a sound (tinnitus) that it cannot see, it alerts us. Because tinnitus is persistent, the brain is constantly alerting us to this noise, causing us to focus on the noise. When the tinnitus does not go away, frustration and anxiety increase making the tinnitus even more distressing. There are a number of effective ways to manage tinnitus and reduce its impact on daily life.
In ears with hearing loss, tinnitus is a common and unpleasant side effect. The tiny nerves in the cochlea, or inner ear, are active. These nerve cells generate an acoustic signal in response to sound. This nerve impulse is then sent up to the brain. Tinnitus occurs when these nerve cells are injured or damaged. The nerves then generate a persistent sound – tinnitus—which is perceived by the brain. Hearing aids amplify sound and improve the inner ear’s ability to route sound to the brain. This improvement in hearing can reduce the perception of tinnitus. In addition, most hearing aids have special programs specifically for tinnitus management. These programs can be set up to generate a quiet sound like wind or white noise. This noise refocuses the brain’s attention, shifting it from the annoying sound of tinnitus to a more pleasant neutral sound.
When explaining sound therapy, I ask my patients to imagine a candle in a very dark room. The candle will appear very bright and your eyes will focus on it. But if the same candle is put in a well-lit room, the candle will not seem particularly bright and will fade into the background. The candle didn’t change, the room changed. Sound therapy is used to enrich the acoustic environment and shift attention away from tinnitus. Many people find persistent sounds like fan or wind noise helpful. Others find soothing sounds like ocean or rain work best. What is most important is to avoid silence. When the environment is very quiet, our perception of tinnitus becomes more pronounced. Using any pleasant sound at a quiet level can help reduce this negative attention. The best sound is the sound that reduces your tinnitus.
There are a variety of sound machines from simple to elaborate. Any of them can work well for tinnitus management. It is important to know that sound machines may not work for all people with tinnitus. I encourage people to experiment with quiet sounds like a fan to see if this reduces their tinnitus. I have a “white noise” app on my smart phone, it’s easy to use any time I find my tinnitus annoying.
Tinnitus occurs in the inner ear, usually in response to hearing loss or other injury to the ear. While antidepressants can help some people cope with tinnitus, there is no medication or surgery that treats tinnitus. The best treatment for most people is first to understand tinnitus and hearing loss, then to work with their hearing healthcare provider to find the best combination of hearing aids, sound therapy and cognitive behavioral therapy to reduce their perception of tinnitus and its impact on their daily life.
There is no research to show that any supplement is useful in reducing or eliminating tinnitus. Avoiding nicotine, caffeine, alcohol, and aspirin may improve tinnitus symptoms. Limiting exposure to loud sounds is very important. Finally, getting enough sleep, regular exercise, and relaxation activities like yoga and meditation can have a significant positive impact on tinnitus.
Tinnitus is a frustrating and common issue for many adults. Evaluation of your ears and hearing is the first step in managing your tinnitus. I encourage you to talk with your hearing health care provider and begin your journey to a quieter, more peaceful life!
