What causes tinnitus - and what can I do if I have it?
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Hearing noises, such as ringing in the ears, despite there being no outside sounds, is commonly known as tinnitus.
The aggravating buzzing, humming, and grinding sounds in one or both ears can be challenging to cope with, but finding relief and living a normal life with tinnitus is possible. “Tinnitus is defined as the perception of sound without any external source, often described as a ringing, buzzing, or whistling in the ear,” says Clodagh Kelly, audiologist with Blackberry Hearing.
“Tinnitus is unique to the individual. It may be in one or both ears, intermittent, fluctuating, or persistent in nature, and the presentation of sound can greatly differ. Thus, tinnitus will affect individuals differently.
“For some, tinnitus has a minimal impact on daily life, while for others, it can disrupt sleep, their social life, affect focus and concentration, causing anger, frustration, and low mood.” As a result, the prolonged sounds which have also been described as chirping, hissing, or even roaring echoes can have negative outcomes on a person’s quality of life, with many facing challenges in finding relief or overcoming the anxieties and fears associated with the exasperating complaint.
Despite having lived with tinnitus since she was a teenager, writer Yvette Gorman says, “it is not something I have ever gotten used to, at least not to the point where I don’t hear it anymore.” Ms Gorman is living with permanent tinnitus after a spontaneous jaw dislocation resulted in a number of laparoscopies through the ear being needed to correct the dislocations.
“My audiologist believes that damage may have occurred which led to my tinnitus,” she says. Gorman describes ringing in the ear as being at a concert and standing too close to the speakers, only to find that when the music stops you feel a pressure in your head alongside a ringing or buzzing sound.
“This is my reality every single day,” she says. “Tinnitus presents itself as a constant buzzing in my head accompanied by the feeling of pressure, which is not localised to a particular side, though I do also have a feeling of fullness in the left ear with no obvious or fixable cause. Sometimes, I will experience a sudden loss of hearing that is replaced with a loud humming or whistling sound. The best way to describe it would be a long continuous single hoot sound. These usually last for several seconds before my hearing returns to normal.”
NO CURE FOR TINNITUS
There is no cure for tinnitus, which can stem from hearing loss or taking certain medications. This can be a difficult notion to consider when the effect of the symptoms become overwhelming and intrusive, so the natural desire for a cure takes root. Tinnitus can be temporary, with the ringing lasting for up to six months. If it lasts for longer than six months, it is said to be permanent.
“Where tinnitus is as a result of occluding wax in the canal, removal of the wax can often resolve the tinnitus,” says Kelly. “However, in most cases the sound is generated by activity in the brain. Unfortunately, there is no known cure, but there are recommended treatments to help reduce the impact of tinnitus on quality of life. Healthcare professionals will refer you for the appropriate medical investigations if indicated as well as providing solutions for you.”
New research indicates living by a busy road can increase a person’s chances of tinnitus. The paper published in Environmental Health Perspectives, included data on 3.5m Danish residents and found a potential link between road noise and tinnitus levels, with a 6% risk increase with every 10-decibel increase in road traffic noise, compared with controls. While the potential effects of residential noise exposure is an important factor to take into consideration, the potential causes of tinnitus are challenging to ascertain.
“In most cases, tinnitus is linked to hearing loss, excessive noise exposure, ototoxic medications, and stress, which can result in altered activity in the brain generating the tinnitus sound,” says Kelly.
A COMMON CONDITION
Tinnitus is a very common condition that has many causes and many risk factors, including loud noise exposure such as heavy equipment like chainsaws and firearms, and portable music devices, such as MP3 players played at prolonged, high volume which can cause noise-related hearing loss.
Age is another factor as the functioning nerves in the ears decline with age, creating possible hearing problems and tinnitus. Men are also more likely to experience tinnitus, while those who smoke and consume alcohol are at higher risk of developing tinnitus. Health issues such as a history of arthritis, high blood pressure, obesity, cardiovascular problems, or a head injury can all increase the risk of developing tinnitus.
Evidence from scientific studies have suggested there might be a connection between Covid-19 vaccines and rare cases of severe tinnitus, but this relationship between Covid-19 and tinnitus is unclear with pre-existing behavioural conditions making it more likely for patients to experience tinnitus due to stress.
The condition affects people differently, making it a very subjective experience with varying concerns affecting a person’s quality of life. Issues include stress, sleep problems, fatigue, memory problems, trouble concentrating, depression, headaches, anxiety, and irritability.
“Tinnitus sufferers may often try a number of remedies to find a solution that works best for them,” says Kelly.
“Most people with tinnitus will also have hearing loss. In this case, hearing aids can improve symptoms as they provide sound enrichment and make the tinnitus less noticeable. Counselling therapies like Cognitive Behavioural Therapy (CBT) address the negative emotional reaction associated with tinnitus, which reduces the level of annoyance caused. While others may benefit from relaxation techniques which reduce stress.”
DIFFICULT TO IGNORE
“I think the most difficult thing about tinnitus is not knowing the sound of silence anymore,” says Gorman, who was prescribed hearing aids a few years ago which have helped greatly with reducing her tinnitus. The disorientating distortion Gorman experiences is worse at night. “It is a continuous, never-ending, annoying sound,” she says.
“It is difficult to ignore and so makes it hard to fall asleep. The quieter the environment, the louder my head.” The early stages of tinnitus can bring many worries and fears. Taking the stress out of tinnitus can be as good a cure as any as a person regains their quality of life due to managing the noise.
The fears associated with the symptoms of onset tinnitus can have an emotional impact with most of those fears and worries easily allayed. Worrying that tinnitus will affect concentration, sleep, and quality of life is common, however, successfully managing tinnitus will see all areas of a person’s life with tinnitus improve positively.
Solutions include not focusing on or continually monitoring your level of tinnitus, accepting the fluctuations of tinnitus as a part of life, maintaining a focus on activities you enjoy, surrounding yourself with ambient sounds to offset the ringing, and using relaxation and stress management techniques.
Without managing these fears and overcoming a negative perception of tinnitus, a person may find themselves stuck in a vicious cycle of stress and anxiety as a result of the consistent buzzing.
Recognising that tinnitus is not ideal, but there are management methods, allows a person to break that cycle and improve their quality of life.
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