Are you one of the 12 million Americans who are vexed by a constant, unrelenting and often distracting ringing in the ears? Tinnitus. I myself have had a high-pitched, steam-radiator sound hissing in my noggin for as long as I can remember. I’m used to it, but it can literally drive a person crazy, like it did for a relative of mine who was in the music business and was beside himself with frustration and grief when tinnitus got him.
I was often told by doctors that the cause of tinnitus is unknown and nothing can be done about it—even the otolaryngology textbooks used to say so. But this isn’t true. For one, a technique called sound stimulation, which doesn’t cure the tinnitus but can make it a lot less annoying, is popular. Lots of sound stimulation products are available, but there is a more effective way to use these products than many people do. I reached out to a tinnitus specialist for his take on sound stimulation and what to do if you, like me, are sick of Hell’s bells ringing in your ears…
Each case of tinnitus is different and often as individual as a fingerprint, Richard S. Tyler, PhD, a professor of otolaryngology at the University of Iowa Carver College of Medicine, told me. Dr. Tyler runs the Tinnitus and Hyperacousis Clinic there. In fact, tinnitus is actually a collection of symptoms, not a “disease” in itself. There is no outright cure…and remedies, such as ginkgo biloba and zinc supplements, and many other treatments advertised on the Internet and elsewhere, have not been shown to be better than placebo, according to Dr. Tyler and current thinking in traditional medicine. Naturopathic practitioners, however, argue that if the physical source of the tinnitus can be traced to a peripheral neuropathic, circulatory or inflammatory problem, natural treatments can be successful in minimizing or eliminating tinnitus.
The cause of tinnitus is unclear, but it can be related to noise exposure, head injury, aging, general ear problems and problems as unrelated as vascular disease or use of certain medications. This means that the management approach has to be as unique as the person seeking treatment.
Although tinnitus is considered a problem in the ears, the real source of the trouble is probably in the brain, Dr. Tyler said. Tinnitus is associated with at least some hearing loss in nearly all (slightly more than 90%) of its sufferers. People with tinnitus lose tiny nerve fibers in the cochlea, the part of the ear that responds to sound vibrations. Recent studies have detected hyperactivity in nerve fibers in the brain that correspond with cochlear nerve fibers in people who constantly hear sound. This hyperactivity may be the brain’s way to compensate for the loss of cochlear nerve fibers—the theory being that the brain fills in some of the hearing loss with the sensation of sound—similar to how the brain may create a “phantom limb” when an arm or leg is lost.
Although researchers predict that a cure for tinnitus eventually will be found, what should you do about it now? Past advice for people with tinnitus, like me, has been to distract themselves from the ringing by listening to pleasant music or to a constant, low-level “ambient” sound—such as recorded sounds of nature (waves lapping, rain falling) or so-called white noise, often generated by tabletop machines or smartphone apps. This has worked for me somewhat. Although both of my ears are always ringing and the tinnitus is getting in the way of hearing as I age, it does not grab my attention so much and has mostly become like white noise or ambient sound itself.
But in the past five years or so, new devices—fashioned like in-the-ear hearing aids and promising sound stimulation—have appeared on the market. They can work pretty well—or they can work very well, according to Dr. Tyler, if you know how to optimize their use.
These sound generators work by covering up the tinnitus with a different sound. The so-called “masking” sounds are usually “easy to listen to but also easy to ignore,” said Dr. Tyler. He described them as ambient noise, whirring or nature-type sounds. “Five years ago, only three or four sounds were available, but now there are probably 15 or 20 sounds you can choose from,” he added. (Gee, sort of like having a New Age ambient music station in your head…)
“These devices break the vicious habit of mentally fighting and being annoyed by the tinnitus noise,” said Dr. Tyler, adding that it can take several months before a benefit is noticed, so patience is required. Some of the devices combine a hearing aid with sound stimulation technology because studies have shown that addressing any hearing loss associated with tinnitus can help lessen the tinnitus as well.
But these devices can cost anywhere from $600 to several thousand dollars, and they are usually not covered by insurance. If you decide to invest in one, it might be wise not to do it by mail order based on an Internet advert. The quality of such devices may be iffy…and even if your device is OK, you might not be able to fit and adjust it for the most benefit.
Instead, Dr. Tyler said, it’s well worth paying for the services of a qualified audiologist—just as you would if you were hard of hearing and needed a hearing aid. An audiologist will help you select a device, fit it and adjust and readjust it, if necessary, until its sound character and level are at their most comfortable and effective for you. You can find an audiologist who specializes in tinnitus through the American Academy of Audiology or the American Tinnitus Association, where you can also find a tinnitus support group in your area.
And if you really want to optimize use of a sound stimulation device and have greater success in tinnitus management, Dr. Tyler recommends that you combine use of it with counseling from an audiologist or psychologist who can help you change the way you think about tinnitus to better cope with it.
Sound stimulation devices simply become a part of life for some people—they find that their tinnitus is reduced, but only as long as they wear the devices. Others find that the tinnitus recedes after six months of use and they no longer need the contraption, but, again, results are as individual as each person and his or her tinnitus, Dr. Tyler said. So, if you have tinnitus, you don’t have to suffer for lack of silence. You can actually to learn to live well with it until a surefire cure is found.
