Tired of Tinnitus: When Your Ears Keep Ringing

Many people love the pounding beats and unchained melodies of a good concert, but if you hear ringing in your ears long after the music stops, that is not a feeling that is desired -- or comfortable. If you hear ringing, buzzing, chirping or other repetitive sounds, you may have a condition known as tinnitus.

And, when you're tired putting up with this humming, ringing, or chirping in your head 24 hours a day, 7 days a week, then you definitely want to do something to solve the problem caused by this unnerving ailment. Tinnitus often goes hand in hand with hearing loss, and can induce anxiety, cause stress, and make your daily life seemingly unbearable. But fortunately there are some tried and true methods that will offer relief for this pesky problem. The best defence is a strong offence, so try some of the tricks below to make the auditory world inside your head quieter and more manageable. 

What is Tinnitus?

Tinnitus refers to hearing a sound that is not linked to an external source, such as buzzing, chirping, hissing, humming, or most commonly ringing. It might come and go, or it might be more constant. In addition to these factors, the sound might be steady or pulsating. Loud concerts, medications, and other circumstances can trigger short term tinnitus, but when it lasts for more than 6 months it is considered chronic. Unfortunately, chronic tinnitus can be very unpredictable, and one size does not fit all.  In about 10% of cases, tinnitus symptoms can become so debilitating and intrusive to daily life that medical help needs to be sought.

Many people suffer from some form of tinnitus. Data collected by the American Tinnitus Association (ATA) suggests that around 50 million Americans, or 17% of the U.S. population, suffers from tinnitus. It is safe to say, then, that someone you know has experienced tinnitus, and if so, they understand the frustration and anxiety that come along with this problem. 

Tinnitus - ringing in ear

So where does it come from and what are the causes? There are several factors that can cause tinnitus, whether in the short term or the long term. These include the following:

- Ototoxic drugs that can damage ear nerves
- Aspirin or other pain relieving medication
- Loud noises
- Impacted earwax
- Middle ear problems, such as infections
- Meniere’s disease, a disorder of the balance mechanism in the inner ear
- Aging

        A common cause of tinnitus is damage to the hair cells in the cochlea, which help transform sound waves into signals for your nerves. If the brain doesn’t receive the proper signals from the cochlea, the brain will turn up the signals just like you turn up the volume on the car radio. This extra electrical noise will be heard as tinnitus. Your brain thinks it is doing the right thing by pumping up the volume, but the constant buzzing or ringing will wreak havoc with your nerves. 

        Tinnitus - damaged hair cells cochlea

        Sound Therapy

        Although it is clear that tinnitus is a difficult ailment to deal with, there are several sound therapies that can help you reduce the effects of tinnitus in your life. The loudness of tinnitus can be debilitating, and sound therapy can help. Sound-based therapies work in different ways to eradicate the sound of tinnitus or the perception of tinnitus in people who suffer from this. There are five basic therapies:

        1. Masking: This approach integrates outside noise into a patient’s auditory system, at a loud enough volume that it will partially or completely eradicate the noise of the tinnitus itself.

        2. Habituation: This technique seeks to help a patient reclassify tinnitus as an unimportant sound that they can ignore. Through time and habit, they can end up less affected by the distraction of tinnitus. 

        3. Distraction: Speaking of distraction, this idea offers external sounds to move a patient’s attention to something besides the tinnitus. Whether music, nature sounds, or television programs, these all try to help the patient forget about the internal buzzing and chirping. 

        4. Neuromodulation: This approach uses specialized sound to mitigate a patient’s neural hyperactivity, which many think is the underlying cause of tinnitus.

        5. Cochlear implants: These surgically implanted devices can increase the stimulation from outside sounds, which will distract a patient’s brain from the inner sounds of tinnitus. 

              Using a Tinnitus Masker 

              In addition to sound therapy, a tinnitus masker can be a key to ridding yourself of many aspects of tinnitus that can seem overwhelming. A tinnitus masker is an electronic hearing aid device that can lower a patient’s perception of tinnitus. It works by generating and pulsing out broad-band or narrow-band noise at low levels, in order to mask the sound of your tinnitus. 

              This is considered white noise. If you are suffering from both tinnitus and hearing loss, the hearing aid you utilize and the masker would be combined into one instrument. If you would like to know if a masker would be good for you, you can easily test this theory by standing next to a faucet of running water. If you hear the water and not the ringing in your ears, it is likely that a masker will help you. 

              If you think a hearing aid is the best solution for your tinnitus, consider that hearing aids work best when they are used consistently day after day during your waking hours. And often, hearing aids are better for younger patients who have not been suffering from tinnitus for very long. Some drawbacks of a hearing aid are that if you are extremely sensitive to sound, then a sound amplifying device could cause you discomfort. Also, hearing aids can sometimes be cost-prohibitive and unfortunately are not covered under insurance plans for the most part. 

              It is important to think about the whole picture when considering a hearing aid and tinnitus masker. The American Tinnitus Association said, “The efficacy of these combination devices varies, depending on the device, the integrated sound feature, and the particular patient. And, although research data is not definitive, the professional consensus seems to be that hearing aids with integrated sound generators benefit a significant number of patients.”

              For people suffering from tinnitus, a tinnitus masker is certainly a viable solution in their quest for quiet. Even more so, many aspects of tinnitus will be relieved if a tinnitus masker is used in conjunction with other therapies. 

              Tinnitus Masking vs. Retraining Therapy

              So which type of therapy is right for you? In the case of tinnitus, each case is highly individualized and each patient needs to find out what works best for him or her. Many studies have been done about the efficacy of therapies, maskers, hearing aids, and the like, and there does not seem to be a definitive answer.  In most cases it seems like a combination of treatments will be best in order to assuage the constant ringing or humming that individuals experience.

              According to the National Library of Medicine: “The limited data from the studies included in the review failed to show strong evidence of the efficacy of sound therapy in tinnitus management, however the absence of conclusive evidence should not be interpreted as evidence of lack of effectiveness. There is a lack of quality research in this area and also combined approaches (hearing therapy plus counselling) are commonly used in the management of tinnitus. Optimal management of tinnitus may involve multiple strategies.”

              When patients aggressively confront their tinnitus with a variety of treatments, they will tend to have more success in eradicating it. Tinnitus masking on its own may not be wholly effective, but in combination with other therapies and treatments, it can offer some assistance. 

              One such treatment is tinnitus retraining therapy. Tinnitus retraining therapy (TRT) is a holistic process that aims to retrain one's auditory system to relieve the constant chirping, ringing, or buzzing. This process generally takes about 12-18 months to complete, with many people enjoying improvements after 3 months. “More than 100 studies have examined the effectiveness of TRT, and most have found significant improvements in about 80 percent of patients."

              The field of retraining therapy continues to grow and change, with many modifications improving the effectiveness of retraining therapy as new techniques are discovered. Tinnitus retraining therapy is a combination of physical therapies, counselling, and mindset. The physical conditions must be met, of course, such as masking, habituation, and distraction. More than that, however, patients have had good luck working with a counsellor, who was able to keep them motivated and teach them the tricks they needed to assuage the effects of the tinnitus. A listening ear and regular encouragement go a long way toward helping a patient live with tinnitus. Since there really isn't a cure, trying to relieve the constancy of the problem and find out what works for each personal patient is very important to the overall success of the patient. When a patient implements the physical remediations, along with working with a counsellor, success is more likely.  

              Life Hacks: Living With It

              Although tinnitus is not a life-threatening or dangerous condition, it is certainly annoying, anxiety-provoking, and problematic. If you are interested in mitigating the negative effects that tinnitus can have on your life, consider the following life hacks to get rid of the annoying buzzing and ringing and get you back to your regularly scheduled peaceful hearing. Not everyone has the time or money needed for therapy or other expensive cures, but suppression of tinnitus is possible when following a few specific rules. 

              People enjoying a conversation

              High-fidelity Ear Plugs

              Take a page out of countless musicians' song books and try out some high-fidelity earplugs, also known as musician’s earplugs. Not only do these absorb and block out sound like you would expect ear plugs to do, but they also have special filters to mitigate the decibel level of your surroundings. High-fidelity ear plugs are able to even out the sounds around you so you can enjoy talking to music, listening to music, and other important sound moments. With these earplugs to regulate sound, you will get more of the sounds that you desire and less buzzing, ringing, and trouble. 

              White Noise

              If you have an annoying, constant noise that only you can hear, your first goal would be to get rid of it. White noise will often do the trick. For this, there are many opportunities to cover up the sounds in your own head, with sound machines, white noise machines, fans, and other options. Unfortunately most of these can be very repetitive and the cure can end up worse than the disease in many cases! 

              But never underestimate your Smartphone. At your fingertips you have an endless supply of apps that provide sound therapy, and if you use a Bluetooth speaker you also have high quality sound output. If you keep the sound of the audio lower than the volume of your tinnitus, this creates habituation. You can actually “trick” your brain into thinking your tinnitus is at a lower volume, and your nervous system will eventually stop reacting so negatively. 

              Distraction

              Believe it or not, distraction is another technique for suppression of tinnitus. This, of course, would be a very individualized plan, based on your own personal likes and dislikes. Sound is very important to our survival, as we as humans have trained ourselves to listen intently to discern if something is going to harm us. But with the constant ringing or buzzing in our ear, our fight or flight response can go crazy trying to keep up with the constant sounds. 

              If you can distract yourself with a game, a playlist, or a walk in the woods listening to nature sounds, you can snap out of the endless cycle of trying to discern if a sound is coming from a friend or foe. The constant monitoring of our environment that humans do makes tinnitus a real problem. 

              Appreciation of Small Victories

              As in most things, the little things matter. You might not be able to gain perfect quiet if you are suffering from tinnitus, but you need to be willing to celebrate small victories at the end of the day. When the variety of therapies is used in conjunction with your own tricks for combating tinnitus, you can forget about it for stretches of time and make the most of your day. 

              In conclusion, tinnitus can be a stressful, worrisome problem for those who suffer from it. The ringing, buzzing, and chirping can seem endless and all-encompassing for those who have developed this condition. But with dedication to a slow, steady process, many who suffer can find some relief for their tinnitus problems. Using sound therapy such as habituation and distraction, as well as a variety of masking tools, will alleviate chronic tinnitus, even if a cure for tinnitus is not wholly possible. The addition of a counsellor’s input is also a component of therapy that will likely improve tinnitus over time. With patience and persistence, you can train yourself to forget the noise. 

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