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Tinnitus – Losing the Sound of Silence

According to the Mayo Clinic, tinnitus is a chronic condition whereby a person experiences ringing or other noises in one or both ears. Tinnitus is a common problem that affects approximately15% to 20% of people, and is especially common in older adults.

How does it work? Under normal conditions, when a person hears a noise, sound waves connect with various areas of their ear, creating vibrations. These vibrations then displace fluid inside of the ear that elicits a chemical response that turns them into bioelectrical signals. The nerve impulses are then relayed to the brain, which interprets them as sound. In the case of tinnitus, these nerve impulses do not travel through the ear but are instead created internally by the nervous system.

While internally generated signals are part of normal hearing, most are able to establish a baseline that is perceived as silence. Conversely, people with tinnitus lack this baseline, and some level of noise, such as buzzing or ringing, is chronically heard.

What causes tinnitus? Tinnitus may be caused by illness, loud noises, infections, or even natural aging. Over time cells become damaged, and if enough cells die, the auditory system becomes less sensitive. Because there are now fewer cells relaying information to the brain, the brain compensates by modifying neural activity by “turning up the volume.” A side-effect of this adjustment is a modified baseline for silence which creates the constant background noise. This condition is known more specifically as subjective tinnitus and accounts for the majority of tinnitus cases.

There is no known cure for subjective tinnitus though it is important to have a discussion with your health care team as well as consider seeing an audiologist. In addition, certain treatments may help ease the symptoms of subjective tinnitus. White noise machines may help to suppress symptoms by producing a sound similar to static or by creating environmental sounds. This may help a person get a higher quality of sleep. Also, keeping a fan or humidifier in the bedroom may help. Another device that is sometimes used is a masking device that is worn in the ear, which is similar in size to a hearing aid. This device produces a low-level noise that may help suppress tinnitus symptoms.

Behavioral treatment options may also help with tinnitus. Tinnitus retraining therapy is a program that is usually administered by an audiologist and combines sound masking and counseling from a trained professional. Cognitive behavioral therapy may be another option for people suffering from tinnitus. It is conducted by a licensed mental health professional such as a psychologist and may teach you how to better cope with bothersome background noise. It may also help with other tinnitus-related problems, such as anxiety and depression.

Last, medications may also be an additional option. While no medication can cure tinnitus, some may help reduce the severity of the symptoms. Medication for anxiety and depression may also be prescribed if these conditions accompany tinnitus.

A few simple steps can be taken to help prevent tinnitus or to keep symptoms from worsening. First, use hearing protection whenever you are operating loud equipment such as a lawn mower, leaf blower, or some other machinery. Over-the-ear protection is best. Also, turn down the volume when listening to music, especially when using headphones or earbuds. Last, limit alcohol, caffeine, and nicotine as these substances can affect blood flow and contribute to tinnitus. Consult your primary care physician or audiologist for more information about tinnitus.