How we Hear

 Tinnitus is a condition where people experience noises in the ears or head when no physical noise is present. Each individual’s tinnitus experience is unique and commonly tinnitus is described as a ringing, buzzing, humming, cicadas, roaring, waves rolling or whistling in the ears. It is often affected by noise, stress or tiredness. It is usually 3-10dB louder than the softest sound a person can hear. 

The term tinnitus is Latin in origin and means ringing or tinkling like a bell. Tinnitus typically arises in the auditory system as a result of hearing loss which may have a number of causes. Tinnitus can be a symptom of a problem within your auditory system and is often associated with hearing loss. Once the signal is generated in the auditory system, the limbic system, attaches an emotional response to the tinnitus and it becomes more than just a sound.

Most people experience tinnitus at least once in their lifetime. Approximately 20% of the Australian adult population experience some form of tinnitus varying from mild to severe and often it is constantly there. For people over the age of 55, the incidence increases to over 30%. For many people the tinnitus experienced is of mild annoyance and only a temporary experience. It is also common for tinnitus to fluctuate and for some it is less bothersome (and sits in the background) when they are calm, relaxed, well-rested and focused on other tasks or sounds. If tinnitus has been constant for 6 months or longer, it is likely to stick around.

Over time, often tinnitus appears to lessen and become quieter, people often become more used to it and only hear it if they specifically listen for it. This process is known as habituation and is the goal of tinnitus management. Not only does the tinnitus become less noticeable but the degree of distress and annoyance associated with the sound is also decreased. Many people habituate to their tinnitus spontaneously whereas for others their tinnitus becomes intrusive and causes increasing irritation and  distress. In these cases tinnitus can be an unpleasant condition which can impact significantly on general well-being, and can have a negative impact on people’s work, family and social life.  

Tinnitus can be caused by a variety of factors making each individual case unique

• Exposure to loud noise
• Medical ear problems such as middle ear infection, viral, otosclerosis, Meniere’s
• Some drugs (as a side effect)
• Idiopathic (No known cause)
• Hearing loss
• Undiagnosed medical condition

There are often no medical or surgical solutions for tinnitus, but there are successful strategies to help you manage it. If it is affecting your quality of life (e.g. severe sleep problems), please seek help from your GP to ascertain the cause of your tinnitus when possible. 

Lifestyle changes-Avoidance of the following may help your level of tinnitus remembering each case is unique and tinnitus is highly variable person to person:

• Reduce exposure to loud noise-includes nightclubs, lawn mowers, power tools and loud machinery as noise exposure damages the sensitive hair cells in the organ of hearing. Wear ear muffs or other hearing protection devices for noisy activities to protect your hearing and not exacerbate tinnitus. 
• Reduce stress and fatigue-strong evidence suggests these can make your tinnitus worse. where possible, keep busy, active and interested in hobbies. 
• Exercise-helps reduce stress levels. Walking is beneficial in lowering stress levels and helps with sleep because of associated physical tiredness and exhaustion. 
• Learn deep relaxation techniques-Perform daily. Try various therapies such as tai-chi, yoga or massage. 
• Stop social drug participation / smoking-Smoking narrows blood vessels which limits the supply of oxygen to the sensory hair cells in your ears. 

Dietary Changes (which have helped some people):

• Reduce your intake of caffeine-Includes tea, coffee, chocolate and coca-cola as these can exacerbate some people’s tinnitus if consumed in excess quantities for some people. 
• Reduce your intake of alcohol-Alcohol (particularly red wine) can exacerbate tinnitus if consumed in excess. 
• Reduce or avoid intake of tonic water (quinine).
• Reduce your intake of salt-High salt diets can exacerbate tinnitus. Note that fast foods generally have a higher salt content. 
• Spicy foods-may also cause a temporary increase in tinnitus levels. 

Other Relaxation techniques

Build your own collection of relaxing sounds-explore what sounds make you feel most relaxed. This may include music or nature sounds especially those with sea, surf, rain, waterfalls and running streams. Some such resources may be available at your local library, online or within free relaxation apps including Widex Zen Tinnitus App or Starkey Relax app. 

Mindfulness/deep breathing-Try this to help you be calm and counter negative thoughts with neutral or positive thoughts so as to not alert your limbic system and exacerbate the tinnitus.

Improve your sleep routine-have a standard sleep & wake time, have a comfortable bedroom temperature and maintain darkness, don't watch tv, eat or read in bed and have a set bedtime routine. If tinnitus is stopping you from getting to sleep, you can try using a timed sound with a 30 minute sleep function on a clock radio or with Tinnitus apps listed above. Once asleep, tinnitus will not wake you up. An outside environmental noise (i.e. cat fight in the middle of the night, fast car noise, etc) may wake you up but tinnitus may prevent you from going back to sleep. Use the timed (hopefully relaxing) sound to put you back to sleep again.

Cognitive behaviour therapy (CBT)-may also help with relaxation if you find you are struggling with your tinnitus. Consult a clinical psychologist to help change the way you think about your tinnitus and you will learn to cope more effectively.

Hearing aid masker sounds-modern hearing aids have a particular setting which can activate a sound from the aid which blends with your tinnitus (so you hear both tinnitus and the 'masker' sound-which can be white noise, ocean-like sounds, or shaped to better match with the tinnitus sound). The masker sound can be turned up or down with the volume controls (if programmed accordingly) and people find this useful  as a therapy for when they are bothered by their tinnitus and not in a conversation, but rather doing something in quiet such as reading.

For more information: 

Tinnitus Australia  https://tinnitusaustralia.org.au/