If you’re living with tinnitus, you may be desperate for a solution. Days on end with no relief, countless nights lying awake and increased anxiety or stress may be what you’re feeling. Although you may have reached the point where you don’t believe anything will help, it may be a good idea to try several treatment options before giving up.
Tinnitus—a frequent or constant ringing, buzzing, hissing or swooshing sound in the ears without any actual external sound present—affects about one in five Americans, according to the Mayo Clinic. Although there is no cure for tinnitus, partly because not all the causes are understood, there are many options to relieve symptoms.
The first step is to try to understand what is causing your tinnitus—you’ll want to visit a hearing care professional for an evaluation. A hearing professional will try to identify the cause of your tinnitus and determine if you need a referral to an ENT doctor or another healthcare professional. To get you prepared for your appointment, here is a list of common questions you may be asked.
- How long have you been having symptoms?
- Is the sound constant or regular? Does it get better/worse during certain times of day?
- Is it one ear or both?
- How loud is the noise? Is it high or low pitch?
- Is the noise very bothersome or slightly irritating?
- Does it get worse after certain conditions like increased noise exposure or drinking caffeine?
- Does the sound change?
During your visit, your hearing professional may perform a hearing test—your audiogram will show you a graphic representation of your degree of hearing loss. It measures how clearly you hear sounds measured by decibels (dB) at different frequencies measured by hertz (Hz). Other tests may include the pitch match test where different sounds are played and you pick the sound that best matches the pitch of your tinnitus, and the loudness match test where a sound is played at different decibel levels, and you choose the one that is most similar to your tinnitus.
After your evaluation, you should have a better idea of what is causing your symptoms. The following are the most common causes for tinnitus.
Hearing loss. The most common cause of tinnitus is damage to the sensory cells in the cochlea, which occurs as a result of noise induced hearing loss and presbycusis.
Ototoxic medications. Drugs like aspirin taken in high doses or over a long duration of time may contribute to hearing loss—which can result in tinnitus. Antibiotics, cancer medications and water pills also may cause or worsen tinnitus symptoms.
Impacted ear wax. This can result from pushing a Q-tip too deep into the eardrum. If you wear hearing aids or earplugs, you may also be more prone to earwax blockage. See your doctor—he or she may remove the excess wax for you or recommend an earwax removal method at home like over the counter softening drops (Debrox or Murine).
Meniere’s Disease. This inner ear disorder may cause vertigo, hearing loss and tinnitus.
Otosclerosis. This condition is a stiffening of the bones in the middle ear.
Multiple sclerosis. This disease can cause the nervous system to deteriorate.
Unhealthy habits. Eating a poor diet, smoking and drinking may also cause tinnitus in some individuals.
Blood vessel disorders. Head and neck tumors, turbulent blood flow and atherosclerosis may cause tinnitus that pulses with your heartbeat in rare cases.
Here are tips to help you relieve tinnitus symptoms.
Wear hearing aids. Hearing aids are thought to help tinnitus because they provide auditory stimulation. So, basically, the amplification of hearing aids minimizes tinnitus as other sounds in the environment. In addition to this benefit of using hearing aids, several hearing aid manufacturers provide masking programs to cover the sound of tinnitus like Oticon, Widex and Phonak.
Get enough sleep. More shuteye may help protect against hearing loss and tinnitus. Sleeping less leads to poorer circulation, which can negatively affect hearing.
Enjoy drinking moderately. Too much alcohol can cause a toxic environment in the inner ear, causing permanent hearing loss and may contribute to tinnitus.
Avoid artificial sweeteners. Aspartame, commonly found in diet soda, may harm your hearing. Researchers at the University of North Dakota suspect aspartame might have a connection to tinnitus.
Quit smoking or cut back. Research has shown that smokers have a 70% higher risk of hearing loss than non-smokers, and adolescents exposed to secondhand smoke are more likely to experience hearing loss. Nicotine, an “ototoxic” substance, can also cause tinnitus and may even affect your balance. Remember, high blood pressure may contribute to tinnitus so anything you can do to keep your blood pressure normal like avoiding tobacco and excessive alcohol, exercising, maintaining a healthy diet and decreasing stress, can also keep tinnitus in check.
Enjoy that hot cup of coffee…or not. Some research claims higher caffeine intake is associated with a lower risk of tinnitus, or ringing in the ears. Other research says caffeine may aggravate tinnitus symptoms. And yet another study found, that drinking coffee after attending a loud concert may hurt your hearing. Use your judgment—see how you feel after your morning or nighttime cup of coffee or tea.
Sleep with your head propped up in an elevated position. Use two extra pillows to lessen head congestion, which may make tinnitus less noticeable.
Mask the noise. Get a white noise machine. Tinnitus can be more irritating at bedtime when it’s quiet so using a white noise machine can distract the brain from focusing on the ringing or swooshing sounds. The machine allows you to adjust the volume to different levels. Options include the White Noise iPhone app which features ambient sounds of the environment to help you relax during the day and sleep at night. There’s also the SnoreMasker ($399 a pair), an earpiece, that fits snugly in your ear and blocks most outside sound. It even has a small speaker inside allowing you to listen to soothing white noise. You can even experiment with keeping the radio or the TV on at bedtime to see if it helps decrease symptoms and helps you fall asleep easier.
Love your music without damaging your ears. High noise levels can damage hearing permanently. Take breaks every hour for a few minutes from the music, or wear ear plugs. If you’re a musician, consider wearing custom ear protection, which lets you hear your own instrument and your blend with others. Ear protection may also enhance the music experience for audiences while protecting hearing. According to scientists at the Leibniz Institute for Prevention Research and Epidemiology, who studied the health insurance records of 7 million people from 2004 to 2008, working musicians had the highest incidence of hearing loss, and were about 57% more likely to suffer with tinnitus as a result of their jobs. If you experience ringing in your ears or speech sounds muffled, get your hearing checked.
Treat ear infections. If tinnitus is caused by a middle ear infection, a doctor can prescribe antibiotics which should eliminate symptoms.
Ear wax removal. Ear wax buildup may cause tinnitus. Your doctor can resolve the issue by removing the excess wax.
Surgery. Is the sound you’re hearing a pulsating noise? If so, it may be caused by the blood vessels around your ear or a heart condition which can require surgery, and may eliminate symptoms.
Medication. Talk to your physician about any medications you are taking to determine if a particular drug interaction may be causing your tinnitus.
Practice mindfulness. Mindfulness teaches individuals that changing their attitude about their affliction can minimize its impact on their life. The idea is to help people learn to control their focus and their stress so that when something out of their control happens, like a loud ringing in their head, they can keep calm and get on with their daily life. Studies have shown that combining mindfulness with cognitive behavioral therapy (CBT) can reduce the negative psychological impact of chronic tinnitus. There are courses online that offer mindfulness training for tinnitus treatment like this one, http://www.mindfultinnitusrelief.com.
Relax and breathe deep. Try meditation or yoga to help reduce stress and cope with anxiety, triggers known to increase tinnitus. Yoga eases stress, improves the circulation of blood, boosts your immunity and eases the stiffness and inflammation affecting joints. This, can in turn, lower the strain caused by tinnitus.
CBT therapy. If you’re feeling depressed, isolated or increasingly irritable and unhappy, it may be a good idea to schedule an appointment with a CBT counselor. A therapist trained in CBT will be able to help you change the way you think about tinnitus from negative to more positive. For example, someone with tinnitus may be limiting their activities because of negative thoughts around their tinnitus. Therapy helps them change a negative thought like, “The ringing in my ears is so terrible. I’ll never be able to enjoy meeting friends for dinner. I might as well stay home alone,” to a more positive thought like, “My tinnitus may be irritating me, but seeing friends may help me relax and I might not even notice the ringing as much. I’ll give it a shot. If I get tired I can always excuse myself early.” Patients also learn relaxation techniques, how to manage sleep better and ways to reduce their fear about encountering unpleasant sounds. In addition, some people worry they may have a mental illness because the noise is “in their head.” Reassurance by a specialist helps to calm such fears and anxieties.
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