Ringing. Buzzing. Roaring. That’s what tinnitus sufferers hear when others hear silence. About half of those with tinnitus hear the sounds all the time — for others, the sounds are intermittent, without a predictable pattern.
Tinnitus can make it difficult to concentrate, sleep and hear what other people are saying. But there are strategies that can help…
The most common cause of tinnitus is exposure to loud noise. It also can occur as part of the normal aging process. In addition, tinnitus can be a symptom of other health conditions, including vascular problems such as high blood pressure… nervous system disorders (including multiple sclerosis)… middle-ear infections… and sometimes depression. Treating the health condition may lessen the severity of the tinnitus.
It’s estimated that 10% to 15% of adults worldwide experience some degree of tinnitus. Men tend to have problems with tinnitus more often than women, especially as they get older. (They’re more likely than women to be exposed to excessive noise.) There are no drugs that can cure tinnitus, and the approaches that do work are unpredictable. What’s effective for one patient might not work for someone else, so you may need to try several of the following strategies.
Low-volume background music causes partial masking, in which the sounds of tinnitus become less noticeable. Music masking “distracts” the brain’s neural circuits. Even when you’re not consciously aware of the background music, it draws your attention away from the tinnitus sounds.
The music should be soft and something that you can easily ignore. Quiet instrumental music often is a good choice. Set the volume so that you can barely hear it. If the tinnitus sounds still are prominent, increase the volume just a little. Keep doing this until the sounds of tinnitus start to fade.
The majority of people with tinnitus have some degree of hearing loss and must strain to hear normal sounds. When they do this, the severity of tinnitus also can increase.
Using a hearing aid often helps. It allows you to hear normal sounds more clearly, which diverts attention from the tinnitus sounds. The amplification of sounds also may make the brain’s sound-processing regions less likely to produce tinnitus sounds. In addition, hearing aids produce their own low-level sounds, which can mask tinnitus. In patients with both hearing loss and tinnitus, about 50% notice an improvement in the tinnitus when they start using a hearing aid.
Many patients with persistent severe tinnitus experience emotional problems, such as anxiety, depression and feelings of helplessness. They also may have trouble concentrating and sleeping. Between 70% and 80% of patients who work with a professional report a significant reduction in tinnitus-related stress. The best way to get treatment is to contact an audiologist or the American Tinnitus Association (ata.org). Some psychologists, otologists and psychiatrists also can be helpful. A professional might recommend the following…
Progressive muscle relaxation. This is a relaxation technique in which patients are taught to first contract and then relax the muscles in the legs, abdomen, chest, arms and face. Each muscle is contracted for about 10 seconds and relaxed for 20 seconds. Patients who do this daily experience less emotional stress. This usually doesn’t eliminate tinnitus, but it does lessen its effects.
Improving concentration skills. Most patients with tinnitus report that the noise makes it difficult to focus on daily tasks, such as reading and listening to others. I recommend that they take frequent breaks and find ways to reward themselves when they have completed tasks. Taking notes or asking questions also can help a tinnitus patient stay actively engaged in a task.
About half of the patients who attend tinnitus clinics report that they sleep poorly. Persistent insomnia invariably causes daytime fatigue, which may increase awareness of tinnitus sounds.
Thirty minutes before bedtime, relax with progressive muscle relaxation (described above) or other soothing activities, such as deep breathing or listening to music. You’ll sleep better, and the tinnitus probably will be less intrusive.
Other sleep strategies…
Don’t bathe immediately before bedtime. It raises body temperature, which can amplify tinnitus sounds.
If you go to bed and don’t fall asleep in 20 minutes, get up and do something else. Try again when you feel sleepy.
If you feel anxious at night, set aside 20 minutes earlier in the evening to write down your concerns. People who set aside a specific “worry time” tend to fall asleep more quickly when they go to bed.
Use sound enrichment. Tinnitus patients usually sleep better when they have some kind of low-level sound enrichment in the bedroom. This could be produced by a “white noise” or “sound relaxation” machine, a radio set between stations or a fan or air purifier.
Dozens of prescription and over-the-counter drugs are ototoxic — they can affect inner-ear hair cells and cause both tinnitus and hearing loss. Aspirin is one of the most common culprits. Others include antibiotics (such as gentamicin and vancomycin), drugs used in chemotherapy (such as vincristine) and diuretics used to lower blood pressure.
Most drugs cause tinnitus only when they’re taken in high doses and for extended periods of time. Aspirin, for example, is unlikely to cause problems when patients follow the label directions or are on daily low-dose aspirin therapy.
If you start experiencing tinnitus after starting a new medication, talk to your doctor. In most cases, the tinnitus will go away when you stop taking the drug, lower the dose or switch to a different medication.
Loud noise is not only the main cause of tinnitus, it also can increase the risk that existing tinnitus will get worse.
Use some form of ear protection, such as earmuffs or earplugs, when you are in any very noisy environment. This includes any time you are around noisy outdoor equipment, such as lawn mowers, leaf blowers and snowblowers, as well as household appliances, such as vacuum cleaners and blenders.
