Ringing in your ears?
Tinnitus is most often described as the sound of ringing or buzzing in one or both ears. It is defined as a perceived sound in the absence of an external noise. In other words, you may hear ringing in your ears but there is no external sound causing the noise. Tinnitus affects approximately 20% of the population and can be caused by a variety of factors such as:
- Disorders of the outer ear (excessive ear wax, foreign object in the ear canal, hole in the eardrum, hair touching the eardrum).
- Disorders of the middle ear (ear infection, otosclerosis, benign tumor).
- Disorders of the inner ear (noise exposure, hearing loss due to aging, Ménière’s Disease). For more information on the different parts of the ear, click here.
- Trauma to the head or neck (concussion, whiplash).
- Certain medications (aspirin, quinine, some sedatives and antidepressants, certain antibiotics and chemotherapy medications).
- Vestibular schwannoma/acoustic neuroma which is a small tumor on the vestibular nerve.
- High or low blood pressure
- Vascular disorders
- Temporomandibular joint (jaw joint) disorders
- Thyroid dysfunction
It is believed that most causes of chronic tinnitus are caused from damage to the hair cells in the inner ear. Some recent research suggests that tinnitus can be caused from issues at the brain level as well. It is important to remember that tinnitus is a symptom, not a disease in and of itself. While most people with tinnitus also have hearing loss, the presence of tinnitus does not necessarily mean that hearing loss exists as well.
There is currently no “cure” for tinnitus. Most people with tinnitus merely accept it and are able to ignore it and move on with their day. A small percentage of tinnitus suffers (5%) have a more difficult time coping. They dwell on it and become increasingly stressed about it, desperately searching for a cure. Unfortunately, stress can increase the loudness of tinnitus causing a vicious cycle to occur. The good news is there are many coping strategies that are very helpful for tinnitus management.
Although there is no cure for tinnitus, it can often be successfully managed.
Counselling - to reduce tinnitus associated stress, distraction and negative perception
Stress Management and Relaxation – There is a high correlation between stress and an increase in the loudness of one’s tinnitus. Many strategies aimed at reducing stress can be very effective at controlling tinnitus.
Change of Diet- Often high levels of salt, alcohol, and caffeine can cause an increase in the perception of the loudness of tinnitus.
Support Groups for Tinnitus – can offer emotional support by sharing experiences and strategies for dealing with tinnitus.
Auditory Habituation – Also known as “Tinnitus Retraining Therapy”, is a therapy whereby noise is presented via noise generators to both ears at a soft enough level such that the brain perceives both the noise and the tinnitus. Over 18-24 months of use, the brain may learn to de-emphasize its negative reaction to the tinnitus (habituation).
Amplification/Hearing Aids – People with tinnitus have found hearing aids to be very effective in relieving tinnitus even if they do not have hearing loss. Tinnitus specific hearing aid programs are now available by some hearing aid manufacturers.
Masking – The use of an electronic device to produce sound that covers up or masks tinnitus. Some examples are:
- Tinnitus masker (hearing aid-like device which only produces noise to mask tinnitus)
- Tinnitus instrument (a combined hearing aid plus tinnitus masker for people who also have hearing loss)
- Noise generator (bedside maskers, CD players, pillow speakers)
Medication – There is no single medication that works on all tinnitus patients. Some anti-depressants, anti-anxiety medications, and herbal medications have seen some success in treating anxiety/stress surrounding tinnitus.
Alternative Approaches - Some tinnitus patients have reported benefit from hypnosis, acupuncture, chiropractic treatment, naturopathy etc. although none have been proven scientifically.
- Avoid silence!
- Take concentration away from your tinnitus by keeping busy.
- Know that stress can have an affect on your tinnitus and try to control stress in your life.
- Maintain a healthy diet. Avoid or cut down on caffeine, nicotine, alcohol, ASA (aspirin) and excessive amounts of salt and sugar.
- Stay physically active and exercise (including breathing exercises).
- If you are having trouble falling asleep, try using sound therapy at a low level (relaxation/music/nature sounds). Pillow speakers are also available so that your partner will not be disturbed.
- Join a self-help group.
- Wear hearing protection in excessive noise. Loud sounds can make tinnitus louder temporarily and can permanently damage your hearing.
- Ensure your family, friends, family doctor and ENT specialists understand your tinnitus.
- Understand that if you have a hearing loss your world is quieter than it should be which allows your tinnitus to be more bothersome. Wearing hearing aids not only allows you to hear better but also masks (covers up) your tinnitus.
The following guidelines are directed towards altering your conscious and subconscious thoughts/attitude towards your tinnitus while trying to sleep.
Only use your bedroom to sleep at night.
- Do not use your bedroom for reading, watching TV, work, hobbies etc.
Avoid napping during the day. If you need to nap, use a room that is not your bedroom.
Remove all unnecessary electronics from your bedroom.
- Television, VCR, telephone, answering machine etc.
If you are unable to fall asleep after 15-20 minutes, get up! If you wake up in the middle of the night and cannot fall back asleep, get up!
- Leave your bedroom and read a book, watch TV, do a puzzle, drink a warm caffeine-free beverage etc. When you start to feel tired again, go back to bed.
AVOID SILENCE! Inexpensive bedside noise generators are available. They play a constant sound (e.g. ocean, tropical rain, stream, white noise etc.) that is loud enough for you to hear but softer or around the same loudness level as your tinnitus. You can also connect a pillow speaker to your noise generator if you are worried about keeping your partner awake.
Avoid caffeine, alcohol and tobacco during the day and especially after supper. Avoiding large meals before bedtime is also helpful.
For more information on tinnitus, visit the following websites: