• Mike Schmidt, Au.D.

Tinnitus - Is There Hope to Rid the Noise?

If you have tinnitus, I am sure you have been told at some point in your life, “there’s nothing you can do about tinnitus, you just have to live with it.” This statement is just simply untrue and can lead to unnecessary suffering. While there is no “cure” or pill you can take to eliminate your tinnitus, there are treatments that can greatly mitigate the effects of it. A realistic approach to reducing a person’s suffering is to take their awareness away from tinnitus. Before we get into specific treatments, it is important to understand why tinnitus occurs.

Tinnitus, sometimes characterized by ringing, hissing, roaring, buzzing, etc., is believed to be a direct response to changes to your auditory system. Many people mistakenly believe their tinnitus is the cause of their hearing loss. A common notion is, “if I didn’t hear this constant noise, I would be able to hear a lot better.” I completely understand why people feel this way. If I didn’t have an education focused on this topic, I would probably agree with this. The truth is, your hearing loss (or changes to your auditory system) led to the production of your tinnitus. To best treat tinnitus, we must treat the cause - hearing loss.

There is still a lot unknown about the origins of tinnitus, but one concept is greatly agreed upon – hearing loss almost always precedes tinnitus. For those with normal hearing at birth, our brains are trained to expect very specific information being delivered by our ears and auditory nerves. When there is a disruption in this signal (i.e. hearing damage), the brain then tries to compensate for this change. The unfortunate byproduct in some cases, is an unwanted perception of noise, or tinnitus. This sound can vary in pitch or loudness, it can be either constant or episodic, or can be single-sided or occurring in both ears. Another way tinnitus can vary from person to person is how it affects their quality of living.

Many people can very easily live with their tinnitus and not let it affect them. If tinnitus exists, this is obviously the best-case scenario. For these individuals, life goes on with little distraction from their tinnitus. But for those who truly suffer from it, their quality of living can be adversely affected. Tinnitus can cause stress, strain on relationships, difficulty focusing, trouble sleeping, depression and isolation. This raises the questions, “why can some people deal with this better than others?” or “why can’t I just learn to live with my tinnitus?” It all comes down to how the brain is responding to these changes. Imaging studies, such as CAT scans, can determine If the emotional center of the brain, the limbic system, is being triggered by the tinnitus. If the brain interprets the tinnitus as an unwanted, obnoxious sound, this may trigger involvement of our limbic system, possibly causing a flight-or-flight response. This negative reaction to tinnitus can increase stress, which in turn can increase the severity of the tinnitus. This results in a vicious circle of stress and tinnitus. The goal of our treatments is to train the brain to react neutrally to the tinnitus, preventing this loop of stress and frustration.

The most effective way to combat tinnitus is some variation of sound therapy. A very common sentiment I hear is tinnitus is most noticeable at nighttime or when it is very quiet. An analogy I like to make is comparing tinnitus to a candle; if a candle is the only source of light in an otherwise dark room, the candle appears extremely bright. When you introduce other sources of light into that room, the candle will appear to dim. This applies to tinnitus; if tinnitus is the only sound in an otherwise silent room, the tinnitus will sound especially loud. When we introduce other forms of sound, the tinnitus will appear to lessen in intensity. This belief is the foundation of most forms of therapy for tinnitus.

If you suffer from hearing loss and tinnitus, then hearing aids will most likely provide you with enough sound enrichment to effectively reduce your awareness of your tinnitus. Most people experience enough improvement with amplification alone, while others need a few additional features to get them relief. Modern, professional-grade hearing aids are often equipped with tinnitus masking capabilities. Tinnitus masking refers to the presentation of a form of white noise through a hearing device for the purpose of reducing a person’s awareness to their tinnitus. A common question I get is “why would I want to replace one annoying sound with another?”. The answer is simple. People are much more likely to respond negatively to tinnitus, while responding neutrally to white noise. As stated earlier, our goal is to live with tinnitus while not triggering that negative, emotional reaction of the limbic system. Masking can come in many forms, and hearing aid manufacturers all have their proprietary methods of dealing with tinnitus. Additionally, many hearing aids are Bluetooth enabled, meaning they can be used as wireless streaming devices for any mobile phone/tablet. Using your hearing aids to stream Bluetooth audio allows you to stream one of the many tinnitus relief apps available on apple or android devices. As a consumer, it can be a daunting, near-impossible task to assess the market of hearing aid technology to decide what is best for you, that is why it is the audiologist’s role to choose the correct hearing device for your specific needs.

For those of you who suffer from tinnitus but do not have hearing loss that requires treatment, I recommend a different form of sound enrichment. If your tinnitus bothers you at night, I suggest running some form of noise in the room. Running a fan, humidifier, sound generator, nature sounds, music, etc., can be effective in taking your awareness off your tinnitus. If your tinnitus bothers you during the day, you may choose to purchase an affordable hearing device from an audiologist that focuses on tinnitus without the bells and whistles needed for treating sensory hearing loss. Again, discuss these options with your audiologist for best success.

No information for reducing tinnitus would be complete without talking about stress management. Stress has been proven to exacerbate tinnitus and as mentioned above, increased stress leads to increased tinnitus, which leads to increased stress, and so on. Making a concerted effect to reduce stress can go a long way in dealing with tinnitus. Relaxation exercises, mindfulness therapy and meditation all can help - and the worst that can happen is your mental health gets a boost.

What is my first step?

Contact a local hearing professional and mention you want to schedule an evaluation and consultation for tinnitus and/or hearing loss. We will take the time to listen to your story, evaluate your hearing and tinnitus, and discuss the findings and recommendations. I am here to tell you there is hope in managing your tinnitus and I look forward to helping you learn to reduce it and/or peacefully coexist with it.