Tinnitus: Everything you need to know

Tinnitus is the term for the sensation of hearing a sound in the absence of any external sound. Symptoms of tinnitus include hearing different types of sound, for example, ringing, whooshing, humming or buzzing in the ear. These can be continuous, or they can come and go.

The Tinnitus might seem like it’s in one ear or both, in the middle of the head, and sometimes it can even be difficult to pinpoint. Some people may think the noise is coming from outside and hunt for it until they discover it’s actually inside them!

Who gets Tinnitus?

Tinnitus is very common and is reported in all age groups, even young children. About 30% of people will experience tinnitus at some point in their lives, but the number of people who live with persistent tinnitus is approximately 10%. Tinnitus is more common in people who have hearing loss or other ear problems, but it can also be found in people with normal hearing. The experience of tinnitus is different for different people.

Most people find that it doesn’t affect them in any way. Some people find it moderately annoying, while others find it very troublesome.

What causes Tinnitus?

While we do not know the exact answer to what causes tinnitus, we know that it is not a disease or an illness.

It is agreed that tinnitus results from some type of change, either mental or physical, not necessarily related to hearing. When we hear, sound travels into the ear, and then the hearing nerves take the signals to the brain. The brain is then responsible for putting it all together and making sense of the sound. Because the ears don’t know what’s important and what’s not, they send a lot of information to the brain. This is too much information for us to process, so the brain filters out a lot of unnecessary ‘activity’ and background sound, such as clocks ticking or traffic noise.

If there is a change in the system, for example, a hearing loss or ear infection, the amount of information being sent to the brain changes. The brain then responds to this change in levels by trying to get more information from the ear, and the extra information you may get is the sound we call Tinnitus. The tinnitus is therefore actually brain activity and not the ear itself!

It isn’t only a change in the ear that can result in tinnitus, but it could be due to a change in our stress levels, for example, with tinnitus being noticed after periods of significant stress, a change in life circumstances or general well being. People often say that they are aware of noises in the ears when they have a cold, an ear infection or wax blocking the ear.

Sometimes people become aware of Tinnitus following a stressful event and once they’re aware of it, seem to notice it more and more, but this usually fades once these things have passed. However, some people continue to notice the Tinnitus, for example after an infection has cleared up.

What should I do?

The first person to talk to is your audiologist, who will be able to rule out any medical factors (or refer you to a GP or ENT). They assess your hearing and provide you with some information about what Tinnitus is and how best to manage it.

The most important thing to do is to keep doing the things you enjoy. If you start living your life differently to accommodate the Tinnitus, it’s just going to seem more of a problem. You may need to do things differently, for example reading with some background music on, but it’s important that you do them nonetheless.

Remember it does improve.

When you first experience tinnitus, you may naturally be worried and very aware of this new sound. Hearing Tinnitus for the first time can be quite frightening if you think it means that something is wrong with you, or that it might change your life. It’s a new sensation, and you need to give yourself time to adapt.

Most people find that their Tinnitus does seem to settle down after this initial period, even without doing anything in particular. You might hear this being referred to as habituation. It’s a bit like walking into a room with a noisy fan or air conditioner. Initially, it seems loud, and then after a while, you stop noticing it as much.

Initially, it’s more noticeable, but you gradually notice it less than you did before. The first time you realise it is in the background is a great step in managing your reaction – it confirms that there are times when it’s less noticeable, this thought actually helps you to keep doing the things that you enjoy doing.

Things that can help:

Talking to someone:

People around you may not understand what Tinnitus is and how it affects you, so they may not be able to give you the support you need. It can be really helpful to talk to someone who has experience of Tinnitus.

Meeting people who have been through the same things you are going through right now is very helpful. There are Tinnitus Support Groups available online. Not only can you pick up tips from others, but you can gain (and give) support simply by sharing your story with people who understand because they’ve been there themselves.

Becoming Less Reactive:

It is quite common to feel anxious and afraid when you first experience Tinnitus. By relaxing more, you may be able to feel less stressed and simultaneously notice your Tinnitus less.

Learning to relax is one of the most useful things you can do to help yourself. An easy way to relax is to find a peaceful space and to simply slow your breathing down (feel free to have some sound on in the background). You can take a few slow deep breaths and pay full attention to the feeling of the breath entering your body, filling your lungs and leaving your body. When we use deep breathing to relax, we feel calmer and more able to manage the tinnitus.

Using Your hearing aid:

Loss of hearing is often an unnoticeable and gradual process, and many people are surprised when they are told that they have a hearing loss. If you have hearing loss, using hearing aids can be helpful for Tinnitus because they are restoring what you can’t otherwise hear.

Using And Understanding Sound:

Tinnitus is usually more noticeable in a quiet environment. It’s a bit like candles on a birthday cake – in the lights, the candles aren’t very bright, but if you turn the lights off, the candles seem much brighter. With Tinnitus, when there is other sound, it doesn’t seem that loud, but when you turn all the other sound off, the tinnitus seems much more noticeable.

A lot of people have found that using background sound helps them – this can be a radio, music, or using natural sounds. People are good at figuring out ways of making things better for themselves, and you might already be aware that you don’t notice the Tinnitus as much when there is background noise. By using sound at other times, you’re just using other ways of doing what you already know to be helpful.

Addressing Sleep Deprivation:

People who live with Tinnitus might have difficulty falling or staying asleep. To sleep well, our bodies and our minds need to be relaxed. Worrying about the Tinnitus, or about how much sleep you’re getting (or missing out on), is unhelpful.

Most people with Tinnitus sleep well and are unaffected by it during the sleep cycle. The biggest differentiator here are the worriers, if you have a tendency to stress at night about the workload or family dramas you are less likely to put your brain in rest mode. Working through problems during waking hours is better than in the middle of the night when you have nothing else to occupy you.

It helps to make use of relaxation techniques to prepare the body for sleep. Once your body and mind are relaxed, sleep will come easier. Having soft sounds in the bedroom can help some people with Tinnitus sleep better. The type of sound you use is up to you – as long as it is pleasant or neutral.

Seek Professional Support:

Cognitive Behavioural Therapy (CBT) is one psychological approach that can be useful in managing Tinnitus. Generally speaking when you became aware of your Tinnitus, you responded to it negatively. Your first instinct might be to believe there is something seriously wrong with your hearing, this belief naturally leads to emotions of anxiousness and your reaction to this emotion is to change your behavior in order to feel better,and you do this by avoiding silence.

these beliefs and/or behaviors may be unhelpful but CBT will help you to recognise them, and then to work together with your clinician (usually a psychologist and/or an audiologist) to find different ways of responding to the Tinnitus so it becomes less bothersome.

Some beliefs and behaviors are helpful, and that’s great – keep doing them.

Mindfulness:

This is a meditation technique that is used frequently for pain management, and more recently for Tinnitus. The idea is that we tend to resist unpleasant sensations (eg: hearing tinnitus). If we stop resisting and allow the unpleasant sensation, this alters our awareness to include more sensations.

We start to notice that sensations become less dominant once our attention moves away from them and focuses on a different part of the body. All of this can change in a moment, simply by changing our awareness.

If we use mindfulness effectively, we can create space for the Tinnitus and in that space, we can decide how we’re going to respond to it. It’s a wonderful way of achieving ‘peace and quiet’ in your overall life experience.

Love your hearing by understanding it.