Tinnitus: What is it, and why do I hear it?

Tinnitus (“TIN-ah-tus” or “Tin-EYE-tus”) refers to “ringing in the ears” when no other sound is present. Not everyone experiences a ‘ringing’ sound–tinnitus can also sound like hissing, roaring, pulsing, whooshing, chirping, whistling, or clicking.  Tinnitus can occur in one ear or both ears.  It can be a constant presence, or it can come and go. Below are some commonly asked questions about tinnitus:

Is tinnitus a common problem?

Yes. Almost everyone at one time or another has experienced periods of mild ringing or other sounds in the ear. One third of all adults in the United States experience persistent tinnitus.   Tinnitus is most common in people who have a history of noise exposure, whether through military service, working around loud equipment, or being a musician or music lover.

Is tinnitus a disease?

No. Tinnitus is more similar to a fever or a headache–it is a symptom, not a disease or illness.  If you experience tinnitus, it is helpful to try to determine the underlying cause.

What causes tinnitus?

Tinnitus is a common symptom of many conditions.  The most common of these conditions is a change in hearing.  Tinnitus can also be caused by noise exposure, migraine headaches, head injury, medication use, high blood pressure, certain types of tumors, stress, caffeine, or cigarette smoking, among other things. 

How is the cause of tinnitus diagnosed?

Since tinnitus is a symptom of an underlying condition, the first step should be to determine the underlying cause.  A complete physical with a primary care doctor will help to determine if any medical conditions or medications could be contributing to the tinnitus.  A comprehensive hearing evaluation by an audiologist to see if hearing loss may be causing your tinnitus.

Can tinnitus actually be measured?

Tinnitus cannot be measured directly.  A doctor can listen to your heart or lungs with a stethoscope, but you are the only one who can hear the ringing or hissing in your ears.  An audiologist will ask you to describe your tinnitus:  Is it present in one or both ears?  Is it constant, or does it come and go?  Can you describe the sound of the tinnitus (ringing, buzzing, hissing, etc.)  Is it high pitch or low pitch?  Do you notice anything in your everyday life that makes it better or worse (stress, sleep deprivation, caffeine, noise, etc.)  The audiologist may also ask you if your tinnitus interferes with your daily activities.

Why is my tinnitus worse at night?

During the day, activities and sounds in your environment make tinnitus seem quieter. When your environment is quiet, such as at bedtime, your tinnitus can seem

louder because it is the only noise present.  Think about tinnitus like a single birthday candle lit in a dark room–it will seem quite bright for such a small object.  Now imagine you turn on the lights in the room and the partygoers are mingling. . .the birthday candle is still there, but faint.  Chances are it is no longer the center of attention.

How is tinnitus treated?

The first step to treatment of tinnitus is to eliminate the underlying medical condition, if one exists.  Sometimes something as simple as changing the dose of a medication (or adding a medication to treat a previously-undiagnosed health issue) can lead to a reduction in tinnitus.  Always seek the advice of the doctor who prescribed a medication before you start or stop taking it.  If medical or surgical treatment of an underlying cause is not an option, tinnitus can still be managed.  Since hearing loss is one of the most common conditions associated with tinnitus, hearing aids can be a very effective treatment.

Have more questions?  Check back in August for next month’s blog post. We will discuss why your tinnitus seems worse in a quiet room, and what can be done to reduce the ringing.