Tinnitus
Tinnitus is a condition in which a person hears sound constantly, even in the absence of noise. The sounds have been described as a “ringing in the ears” but also frequently present as a buzzing, hissing, or clicking. The volume of the sound can range from barely perceptible to very loud and can be low- or high-pitched.
Tinnitus is common. As many as 15 percent of people will experience it in some form in their lives. It’s much more prevalent in older people and people with hearing loss.
Researchers do not fully understand what causes tinnitus, although noise-induced hearing loss and cognitive dysfunction in particular areas of the brain are some hypotheses.
There is no gold standard treatment for tinnitus, but ongoing research indicates there may be in the future. For now, treatment mostly focuses on improving the psychological and quality-of-life symptoms.
The primary symptom of tinnitus is the perception of a constant sound, even in the absence of any external noise. The sound can vary among people and has been described as ringing, hissing, humming, roaring, whooshing, and clicking.
This experience can cause headaches, difficulty sleeping, and hamper one’s ability to communicate with others, all of which can lead, in some cases, to social isolation and loneliness.
Tinnitus can have mental health effects, as well. Those with tinnitus may experience depression and anxiety. Additionally, they may also develop somatic symptom disorder, or excessive worry about their condition.
Those with severe mental health conditions are more likely to experience greater distress from tinnitus. It’s not clear whether psychological conditions exacerbate tinnitus, if tinnitus magnifies psychological distress, or if the two factors are both symptoms of an underlying disorder.
As much as 15 percent of the population will experience tinnitus to some degree at some point in their lives. Roughly one-tenth of those who have tinnitus describe it as debilitating and life-altering.
Research has found tinnitus to be more common among men, but more severe among women, who also report more mental distress.
Types of tinnitus include objective tinnitus and subjective tinnitus. Objective tinnitus is when the functions of the body, most often the heart beating, are audible to a patient. It accounts for less than 1 percent of tinnitus cases. Subjective tinnitus, which accounts for the other 99 percent, is the perception of sound even in the absence of external noise. Objective tinnitus typically has a physical, rather than neural, cause.
A somatosound is the experience of hearing bodily functions, such as your heart beating. Somatosounds are also called objective tinnitus or pulsatile tinnitus in the case of hearing one’s heartbeat, which is most common. Pulsatile tinnitus is typically caused by an underlying condition, such as atherosclerosis, that can be treated medically.
The cause of tinnitus and the mechanism by which it functions are not fully understood by researchers, and there may be multiple causes and mechanisms at work.
Common reasons some people develop tinnitus include:
- Noise-induced hearing loss. Studies have found more than half of participants with tinnitus also have some degree of hearing loss. Noise-induced hearing loss comes as a result of damage to structures of the ear. Damage can be done gradually, for instance, if people listen to music too loudly or work in a loud environment. Damage can also occur while hearing an explosion at close range.
- Age-related hearing loss. Hearing degrades as the body ages. People aged 65 and older are considerably more likely to develop tinnitus and more likely to experience it with more severity.
- Neural circuitry dysfunction. Some research indicates tinnitus could be a result of dysfunction in specific areas of the brain that process auditory and sensory information (the dorsal cochlear nucleus, primarily). This dysfunction could be a result of the damage of hearing loss, but some tinnitus cases develop even in the absence of hearing loss.
- Medications. Some drugs, including antibiotics, antidepressants, and others, include tinnitus as a possible side effect in some patients. The reason for this is poorly understood, but in the case of selective serotonin reuptake inhibitors, researchers are studying a link between tinnitus and serotonin levels in the brain and its effect on cells in the dorsal cochlear nucleus.
Tinnitus is the most commonly reported disability among veterans, particularly those who served in combat. This is likely due to noise-induced damage to the structures of the ear as a result of extraordinarily loud events, such as hearing an explosion.
Yes. Among people who experience visual snow, a constant visual static in their field of vision, 75 percent also report tinnitus. Visual snow has been likened to the visual version of tinnitus, although it is much more rare.
There is no generally accepted treatment for tinnitus, although that may be changing. Instead, treatment largely focuses on improving the symptoms of the condition.
Talk therapy is the most common treatment for anxiety, depression, and somatic symptom disorder. Popular therapy types for these conditions include cognitive behavioral therapy and mindfulness-based therapy. These treatments can help patients feel more at peace with their condition, decrease feelings of guilt, and improve people’s abilities to cope with the challenges of the condition.
Physical treatments for tinnitus include hearing aids and white noise machines, which serve to mask, or cancel out, the sound. A device called Lenire, which combines auditory stimulation and tongue stimulation, is gaining popularity as a treatment. In 2023, it became the first device approved by the U.S. Food and Drug Administration for the treatment of tinnitus. It has been available in Europe since 2019. Clinical trials show significant decreases in the severity of tinnitus with the device.
Experimental research also offers promise for the future of tinnitus treatment. One research team was able to significantly reduce the volume of tinnitus among participants in a randomized clinical trial through a treatment that combines sound with minor electric pulses to the head. Participants in this trial reported an abatement in the volume and severity of their tinnitus even after the treatment ended. More research needs to be done before this technique reaches the public.
There is no cure for tinnitus, and it does not go away on its own. New advances in treatment, however, offer the possibility of diminishing the intensity of tinnitus.
People with tinnitus should avoid situations in which they’ll experience noise at high volume. One of the most likely causes of tinnitus is noise-induced hearing loss, which occurs as a result of damage to the structures of the ear done by noise at high volumes. Further damage may increase the severity of tinnitus.