Tinnitus is the perception of hearing noises that not caused by an external source.
Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:
The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear an external sound. Tinnitus may be present all the time, or it may come and go.
Tinnitus is prevalent in Australians. It approximately affects 10% of the population. Every 1 in 10 people will suffer from it.
Tinnitus can be brought on by many factors including age, noise exposure, ototoxic medicines, people that suffer from blood vessels diseases, genetic inclination, jaw disorders, or as a consequence of other diseases, such as inner ear disease or infection.
Both men and women seem to be equally affected, and although tinnitus is more common in the elderly, it can occur at any age.
Causes of tinnitus
The more common causes of tinnitus include:
- exposure to loud sounds
- extreme stress or trauma
- degeneration of the hair cells in the cochlea
- ear problems, such as otosclerosis (abnormal bone growth in the middle ear)
- Meniere’s disease (swelling of a duct in the ear)
- some medications.
Types of Tinnitus
Tinnitus can be categorised as bothersome or non-bothersome. This distinction will influence your doctor’s decision on how to manage your tinnitus. Bothersome tinnitus negatively affects a person’s sleep, concentration, emotional wellbeing and their ability to interact socially.
Management of Tinnitus
If tinnitus is due to an underlying cause such as the build of wax or infection, it is essential to treat the primary source first.
Often tinnitus is associated with symptoms of vertigo, insomnia and psychological disorders such anxiety and depression.
If hearing loss is present, then further examination of the ear is required.
When tinnitus is bothersome, then tinnitus specific management may be needed. These are some strategies used to treat tinnitus
- hearing aids due to hearing loss.
- Counselling therapies
- Education and information about managing the condition.
Other strategies for managing bothersome tinnitus include sound, sleep and relaxation therapy. The evidence base is most vital for a combination of sound therapy and cognitive behavioural therapy-based counselling
Hearing aids & tinnitus
Tinnitus is often associated with hearing loss: 90% of people with tinnitus have some hearing loss. The hearing loss is usually mild and of gradual onset, which may explain why many people are unaware of their hearing loss. Interestingly, some people with audiometrically normal hearing will present with bothersome tinnitus, while those with hearing loss may be unaffected. People with tinnitus who strain to hear may notice their tinnitus emerge or worsen. Correcting any hearing loss allows the person to listen more efficiently, and generally reduces the level of the tinnitus.
Hearing aids are useful even if the hearing loss is relatively mild and at a level where aids would not usually be considered. Even in the absence of marked hearing loss, hearing aids can provide some relief to people with tinnitus.
Hearing aids amplify peripheral and objective sounds and help manage tinnitus by making the sound less noticeable.
Counselling & Tinnitus
Counselling may be useful for some people with tinnitus. People with tinnitus, especially those who find tinnitus bothersome, need support.
Massage Therapy & Tinnitus
Massage may help to reduce muscular issues such as jaw clenching, tooth grinding, prior injury or muscle tension in the neck. These factors sometimes make tinnitus more noticeable. A therapist may ask the person to tighten muscle or move the jaw or neck in specific ways to see if this changes the sound. If so, tight muscles are part of the problem, and massage therapy may help relieve it.
Sleep & Tinnitus
Sleep can be a significant problem for many people with tinnitus. Tinnitus can impact people to get to sleep and stay asleep. However, there may be other factors that can affect a person’s ability to fall asleep and stay asleep, leading to insomnia.
A person with tinnitus who has difficulty getting to sleep or staying asleep may want to try:
- Identify other causes contributing to sleep problems
- Simple relaxation exercises
- Listening to soft music when in bed including monotonous sounds, such as rain on a roof can stop you focusing on your tinnitus
Factors that contribute to insomnia for a person with tinnitus
Sleep disturbance usually involves a combination of:
- health problems – for example, arthritis, migraines or asthma
- psychological factors – for example, stress or emotional crisis
- drug use – for example, alcohol or sleeping medication
- disturbing environments – for example, an uncomfortable bed or intrusive lighting
- conditioning – for example, the more you associate bed with struggling to get to sleep, the harder it is to relax there.
To successfully improve your sleep patterns, you will need to look at all the contributing factors.
Research has shown that relaxation techniques, such as yoga, meditation, biofeedback and progressive relaxation, can work well. Experiment and find a method that works for you. You might like to try a regular relaxation class or use a self-help relaxation app.
It may also help if you:
- try and get up at the same time every day
- reserve your bed for sleeping – avoid arguments or severe discussions in bed
- avoid naps during the day
- experiment with low-intensity background noises in the bedroom, for example, leave the radio playing softly or play tape recordings of the ocean surf.
When you go to bed for the night, if you are not asleep after half an hour, get up and go into another room. Do something that engages your brain (this does not mean watching TV). Write a list of things to do, plan a holiday or write a letter or email. After about 20 minutes you will be able to go back to bed and go to sleep. The same applies if you wake up in the night.
Remember, don’t go to bed if you don’t feel sleepy. Do something quiet and relaxing until you do feel sleepy.
It may help you to sleep if you avoid eating heavy meals just before bedtime. It is also a good idea to reduce your late afternoon and evening consumption of:
- tea, coffee and caffeinated soft drinks
Regular exercise helps you to cope better with stress and reduce fatigue, both of which can make sleeping more difficult or disturbed.
Lifestyle & Medications & Tinnitus
There is no evidence that lifestyle changes or medications may help improve tinnitus. However, people with or without tinnitus should be encouraged to follow a healthy diet and to exercise regularly. The use of complementary agents such as ginkgo Biloba, melatonin, zinc is discouraged.
Prevention and Tinnitus
Tinnitus cannot be cured, but in some situations, can be prevented. Tinnitus prevention involves the safe listening of sound to protect hearing. The intensity of sound and the duration and frequency of listening can impact the hearing. Listening to loud, high-frequency sound for long periods can cause hearing loss or tinnitus.
People should protect their hearing. If a person is exposed to high levels of noise in their workplace or during recreational activities, it would be best to protect their hearing to reduce the risk of tinnitus.
Best to reduce sound levels to less than 80 decibels and regularly take breaks from noise exposure and use noise-cancelling earplugs where possible.
Tinnitus is a common condition that affects 1 in 10 Australians. Prevention and management strategies will reduce the risk and severity of tinnitus.