What is tinnitus or ringing in the ears?
It is more than likely that anyone reading this article will, on more than one occasion during his or her life, have experienced the sensation often described as ringing in the ears. It is a common occurrence that, in many cases, is likely to be a temporary symptom lasting only a few minutes or so. The phenomenon is known as tinnitus, the perception of noises in the head and/or ear which have no external source. It originates from the Latin word for ‘tinkling or ringing like a bell’. Those living with the condition may have to endure a ringing, buzzing, hissing, whistling or other noise. The sensation can be in one or both ears, constant or intermittent and it can vary in volume.
Some people have ringing in their ears which has a beat in time with their heartbeat. This is called pulsatile tinnitus.
Who gets tinnitus?
Approximately 17 to 20 per cent of Australians suffer from varying degrees of tinnitus*.
Tinnitus is very common and is reported in all age groups, even young children. It 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 they can continue their normal day-to-day activities. However, a small percentage of people with ringing in their ears report it as severely affecting them.
What causes tinnitus?
Whilst we do not know the exact answer to what causes tinnitus, we know that it is not a disease or an illness. It is generally 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 do not 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 is generally accepted that 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 wellbeing.
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 really 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 GP. An Audiologist can assess your hearing and give you some information about what tinnitus is and how best to manage it. You may need to be referred to an Ear, Nose and Throat (ENT) Specialist, who will rule out any medical factors.
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 still do them, nonetheless.
Management of Tinnitus
“most people learn to manage and improve their tinnitus”
Many people are wrongly told that nothing can be done about their tinnitus and that they will just have to learn to live with it. Although there is no cure for tinnitus, you can learn to manage your tinnitus to the point where it is no longer a problem for you.
When you first experience tinnitus, you may be concerned and aware of this new sound. We constantly monitor our bodies and if anything changes, we become aware of the changes. Hearing tinnitus for the first time can be quite scary 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. 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. Tinnitus can often be much the same – initially, it’s more noticeable but you gradually notice it less.
Things that can help
It is quite common to feel anxious and afraid when you first experience ringing in the ears. By relaxing more, you may be able to feel less stressed and so notice your tinnitus less. Learning to relax is probably one of the most useful things you can do to help yourself.
Using a 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 significant hearing loss good quality and properly fitting hearing aids can:
- reduce your perception of tinnitus by improving your hearing
- take away the strain of listening.
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. You generally don’t notice the tinnitus as much when there is background noise.
You can download an App to your phone and use these sounds when you need them.
Addressing sleep problems
People who live with ringing in the ears might have difficulty falling asleep or staying asleep. To sleep well, our bodies and our minds need to be relaxed. Worrying about the tinnitus or worrying about how much sleep you’re getting , is unhelpful and will only make it more difficult to sleep.
It helps to make use of relaxation techniques to prepare the body for sleep. Sleep will come a bit easier when your mind and body is relaxed.
Having some soft sound in the bedroom can help some people with tinnitus sleep better.
Cognitive Behavioural Therapy (CBT)
This is one psychological approach that can be useful in managing tinnitus. The idea is that when you became aware of your tinnitus, you responded to it negatively.
For example, you may have thought there was something wrong with your hearing (a belief). This led to you being anxious (an emotion). You then tried to feel better, by avoiding silence (a behaviour). Some beliefs and behaviours are helpful. But some beliefs and/or behaviours are unhelpful and CBT helps you to recognise them. Then you work together with the clinician to find different ways of responding to the tinnitus so it becomes less bothersome.
Take care of your hearing
Frequent, prolonged exposure to loud noise increases the risk of getting tinnitus, or of making it worse. Take care to avoid very loud sounds, or protect your ears against them. Wear proper hearing protection it is also important if you watch live music or play in a band or orchestra.
Remove built up ear wax
Tinnitus symptoms are often caused by a build up of ear wax . Never put anything smaller than your elbow in your ear. If you believe ear wax might be contributing to your problem consult your GP.
If you suspect you suffer from tinnitus, it is important to have your ears and hearing checked. Book an appointment for a comprehensive hearing assessment by clicking on “request appointment” at the top of this page.
**Source: British Tinnitus Association