Ringing, roaring, buzzing, pulsing. However, it sounds to you, tinnitus can be hard to ignore, especially at night when everything else goes quiet. If you’ve been lying awake wondering what’s going on and whether it’ll ever settle, you’re far from alone. Around one in seven people in the UK live with some form of tinnitus.
Tinnitus usually has a cause. Once you understand what’s driving yours, it becomes a lot easier to do something about it. Below, we explain what tinnitus is, the most common causes, when it’s worth getting checked, and how our audiologists can help.
What is tinnitus?
Tinnitus is hearing a sound that doesn’t come from anything around you. Nobody else can hear it, but that doesn’t make it any less real.
Tinnitus isn’t a condition in its own right; it’s a symptom, a sign that something in your hearing system has changed.
It helps to think of your brain as always listening. When less sound reaches it than usual, perhaps because your hearing has shifted or your ear is blocked, it turns up its own internal volume to compensate. Researchers call this “central gain”. With the volume turned up, the brain starts to notice its own background activity, and that’s the sound many people hear as tinnitus.
What does tinnitus sound like?
There’s no single tinnitus sound. People describe ringing, whistling, a high-pitched hiss, buzzing, humming, static, or a low rumble like a distant engine. For some, it’s there all the time. For others, it comes and goes, often creeping in when the room is quiet or life gets stressful. If yours seems to come and go, or gets louder at certain times, our guide to what makes tinnitus worse looks at the most common triggers.
Some people hear a rhythmic whooshing or thumping that keeps time with their heartbeat. This is called pulsatile tinnitus. It can sometimes be linked to changes in blood flow, so it’s always worth getting it checked by your GP or an ENT specialist. We can recommend ENT consultants who specialise in it.
What causes tinnitus?
Everyone’s tinnitus is different, and there’s often more than one thing behind it. These are the most common causes we see in the clinic.
Changes in your hearing
As we get older, the tiny hair cells in the inner ear gradually wear, usually affecting higher pitches first. This is called presbycusis, and it’s one of the most common reasons for tinnitus. Lots of people don’t realise their hearing has changed until they have a test. Tinnitus doesn’t cause hearing loss, but the two often turn up together.
Loud noise
Gigs, clubs, power tools, noisy workplaces and loud headphones can all strain the delicate structures of the inner ear. Ringing after a night out often fades within a day or two. Repeated exposure, though, can lead to tinnitus that sticks around. Through our musicians’ hearing services, our team has spent more than 25 years helping performers and industry professionals protect their hearing, and we make custom hearing protection for all kinds of lifestyles.
Ear wax and blocked ears
Sometimes the cause is refreshingly simple. A buildup of ear wax, or fluid from a cold or ear infection, can prevent sound from reaching the inner ear properly, and the brain turns up its volume in response. Once the blockage is cleared, the tinnitus often eases too. Our audiologists offer ear wax removal by microsuction and irrigation, usually with same-day appointments available.
Ear infections and pressure changes
Middle ear infections can bring on tinnitus, as can barotrauma, the pressure damage that can happen when flying or diving.
Stress and anxiety
Stress doesn’t usually cause tinnitus on its own, but the two are closely connected. Stress can make tinnitus feel louder and more intrusive, and tinnitus can make you feel more anxious, so it’s easy to get caught in a loop.
Hormonal changes and menopause
Some women notice tinnitus starting, or changing, around perimenopause and menopause. Research is still developing; however, hormonal shifts can affect circulation, sleep and stress levels, all of which can play a part. Find out more in can menopause cause tinnitus?
Jaw, neck and muscle tension
The nerves around your jaw and neck are closely linked to your hearing pathways. Clenching your jaw, grinding your teeth at night, having a stiff neck, or suffering from a whiplash injury can all affect how loud your tinnitus seems. Some people find they can change the sound just by moving their jaw.
Medications
Some medicines can trigger or worsen tinnitus. These include high doses of aspirin, some antibiotics, certain diuretics and some chemotherapy drugs. If you think a medication might be involved, please don’t stop taking it without talking to your GP or pharmacist first.
Tinnitus in one ear only
Tinnitus in just one ear often has a local cause, such as wax or an infection on that side. Because it can occasionally point to something that needs further investigation, it’s always worth getting it checked. Our guide to causes of tinnitus in one ear only explains more.
When should you get it checked?
Most tinnitus isn’t a sign of anything serious, but it’s still worth speaking to your GP or an audiologist if it’s:
• lasted more than a few weeks, or keeps coming back
• in one ear only
• getting worse
• affecting your sleep, mood or concentration
• you hear a rhythmic sound in time with your heartbeat
How is tinnitus diagnosed?
A tinnitus assessment with us starts with a conversation. We’ll ask when the sound started, what it’s like, what makes it better or worse, and about your medical history, sleep and any noise exposure. From there, our audiologists conduct a thorough examination of your auditory system using specialised tests and a comprehensive hearing test.
It’s relaxed and unhurried. It also gives us the full picture we need to build a treatment plan around you.
How can tinnitus be treated?
We’ll be honest, there isn’t a cure for tinnitus right now. But there’s a lot that can help, and most people reach a point where it bothers them far less. The aim is habituation, helping your brain learn to treat the sound as unimportant background noise.
Sound therapy
Gentle background sound reduces the contrast between your tinnitus and silence. This might be a fan at night, or nature sounds. Our Sound Therapy Package uses a wearable noise generator, a small device similar to a hearing aid, which plays soft, unpredictable fractal tones (a bit like wind chimes) or broadband noise.
Tinnitus Retraining Therapy
This combines sound therapy with tinnitus-focused cognitive behavioural therapy (CBT). It works on the sound itself and on the emotional reaction that can make tinnitus feel worse.
Hearing aids for tinnitus
If your tinnitus comes with some hearing loss, hearing aids can help with both by bringing back the everyday sounds your brain has been missing. As an independent clinic, we work with all the leading manufacturers to find the right fit for you.
Lenire®
This at-home treatment pairs sound played through wireless headphones with gentle electrical pulses to the tongue, designed to help reduce the brain’s focus on tinnitus over time. Find out more about Lenire® tinnitus treatment.
Help with sleep
If quiet nights are the hardest, Ozlo Sleepbuds can block out background noise and play soothing masking sounds as you drift off.
Getting help with your tinnitus
Tinnitus can feel isolating, but you don’t have to work it out on your own. Understanding what’s behind the sound is often the first real step towards feeling more in control.
Our clinical audiologists at Harley Street Hearing can help you get to the bottom of your tinnitus and find an approach that works for you. Book a tinnitus assessment today.
