Have you ever experienced ringing, buzzing, hissing or other noises that no one else around you seems to hear — and you wonder whether you’re making it up in your mind? The truth is, you’re probably not imagining things. But you might have tinnitus, which is when you hear noises or sensations in your ears even though no outside noise is actually present.
Tinnitus is a fairly common phenomenon, affecting around 50 million Americans, which equates to about 15% of the country’s population. It’s defined as “the perception of a sound that’s not objectively measurable,” according to Dr. Douglas Hildrew, an otolaryngologist at Yale Medicine.
To some degree, it’s perfectly normal to hear noises that others do not.
“A certain level of sound inside the ears or head is actually normal — and frequently detectable if a person is placed in a quiet enough environment,” said Dr. William Reisacher, an otolaryngologist at NewYork-Presbyterian Hospital and Weill Cornell Medicine. “In general, the mind does not perceive these sounds because it is much more interested in the sounds coming from outside.”
The problem comes when you hear these noises in an environment that’s not completely quiet and they start to interfere with your day-to-day life. For some, the noises can be tied with anxiety and depression, Hildrew said.
How To Tell If You’re Experiencing Tinnitus
If you’re experiencing tinnitus, you might hear ringing noises, high-pitched tones, whistling, hissing, buzzing, pulsing or other sounds, but the specific experience varies from person to person. The noise may come and go or be constant, and it can either be temporary or permanent. Some people even hear music even when nothing is being played, Hildrew said.
For some, these sounds can be heard in loud environments ― a restaurant, for example ― whereas others may get tinnitus at any time, regardless of whether it’s quiet or noisy. To determine if you have tinnitus, a doctor or audiologist will typically conduct a comprehensive hearing exam. Sometimes doctors also do imaging tests such as a CT scan, movement tests and questionnaires to see how the tinnitus is affecting your life.
Tinnitus isn’t a condition ― instead, physicians refer to it as a symptom that signals a problem with your body’s auditory system. Typically, tinnitus arises because of damage to the ear.
“The way your brain basically makes sense of that is fabricating a noise that’s not objectively real, but subjectively is quite real,” Hildrew said.
While tinnitus may be short-lived or harmless for some people, it may be life-altering for others due to the mental, physical and cognitive toll it can take. Just think for a moment how distracting, frustrating and potentially isolating it would be to constantly hear a high-pitched tone or buzzing noise and not be able to do anything about it.
“The most common cause of tinnitus is hearing loss,” Reisacher said, whether it lasts in the short or long term. Other conditions that can also cause tinnitus include migraine headaches, trauma and muscle tightness.
Some people experience tinnitus related to sensorineural hearing loss, which occurs when there’s damage to the inner ear. This more permanent form of hearing loss is often age-related, but it can also result from trauma or exposure to loud noises. Tinnitus is actually the top service-related disability among veterans. Hearing aids are one way to address this form of hearing loss and any related tinnitus, but they aren’t always effective.
Other people may experience tinnitus as a result of conductive hearing loss, or when sounds can’t get through your outer and middle ear to your inner ear. Potential causes can include infections, fluid in the ears or earwax that’s stuck in the ear canal. Typically, this form of hearing loss and any related tinnitus can be treated with medication, hearing aids, surgery or other medical procedures, such as an earwax extraction.
What Can Be Done To Treat Tinnitus
“Tinnitus is best treated by determining the underlying cause, such as obtaining hearing aids for hearing loss,” Reisacher said. Medication, surgery or other procedures can also be used to address infections or trapped earwax.
“But if no treatment is available, using another sound in the environment, such as natural sounds or white noise, known as ‘masking,’ can help distract a person from listening to their tinnitus in quiet settings,” Reisacher added.
Some hearing aids now include these tinnitus masking features.
“It’s a program that provides a background noise that allows their brain to not focus on the tinnitus,” Hildrew said. “So it doesn’t take it away, but it helps a great deal.”
There are ways to manage and reduce the condition’s perceived intensity, according to the American Tinnitus Association. One commonly recommended treatment is cognitive behavioral therapy, which has been shown to improve a patient’s overall quality of life.
Other treatments include sound therapy, hypnotherapy, biofeedback and maintaining activities that you enjoy. Medications are also sometimes prescribed to treat associated anxiety and depression.
Reisacher recommended seeing an otolaryngologist if your tinnitus becomes constant, doesn’t resolve within two weeks, or is accompanied by additional symptoms, such as hearing loss.
What you don’t want to do is ignore tinnitus in hopes that it will go away, because this is a situation where time is of the essence. The month or even the first few days after experiencing a sudden change in your hearing is a crucial window where doctors can often make a meaningful intervention, Hildrew said.
“Oftentimes, that doesn’t happen because people try and [stay] tough through it,” he said.
There’s no way to ensure you’ll never experience tinnitus, but staying on top of your ear health is a good idea. That can be as simple as seeing a local audiologist each year for a hearing test. These tests are important for two reasons: to detect any problems you’re experiencing, and to establish baseline hearing data that may be useful in the future. Without this baseline data, “it’s a real challenge to know how much is the recent hearing change and how much is historical,” Hildrew said.
Additionally, going to concerts and listening to music through headphones are fine, but there’s a safe way to do it as well as an unsafe way, he added.
One clear sign you’re causing damage, Hildrew said, is if your ears feel full and are ringing a bit after exposure to loud noises. Reisacher also advised avoiding exposure to sustained loud noises, using hearing protection when needed and keeping fingers and Q-tips away from your ears.