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| Although tinnitus can start at any age, it becomes more common as people get older. |
That Ringing
in Your Ears
Alarmed by That Ringing in
Your Ears?
What you need to know if it's tinnitus
by Stacey Colino
It
began one night with a high-pitched squeal, one annoying and persistent enough
to prevent me from sleeping.
When
I asked my husband where he thought it was coming from, he said he didn't hear
it, which made sense once I realized the sound was coming from my left ear.
Instantly,
I guessed what it was: tinnitus.
Commonly
referred to as ringing in the ears, tinnitus involves the perception of sound
when there isn’t an external source and can include a buzzing, hissing,
whistling, whooshing or clicking tone.
It
can be temporary (after attending a loud concert, for example) or chronic.
And
it's a surprisingly common affliction. More than 50 million people in the U.S.
have experienced tinnitus, and about 20 percent of those who have it report
that it negatively affects their quality of life, according to the American
Academy of Otolaryngology-Head and Neck Surgery.
Indeed,
tinnitus can have substantial ripple effects on how a person feels and
functions.
During
the day the condition can cause sufferers to have trouble focusing or thinking
clearly; at night, it can lead to trouble sleeping, notes Quinton Gopen, an
otolaryngologist at UCLA Medical Center.
But
a ringing or buzzing in your ear can also be a sign of problems you shouldn't
try to ignore.
If
you have the sensation in one ear, as I did, such unilateral tinnitus could
signal a (usually benign) tumor on the acoustic nerve.
If
you hear a noise that pulses like a heartbeat (what’s called pulsatile
tinnitus) in one or both ears, the pattern could stem from blood vessel
abnormalities or vascular malformations.
In
either case, see an ear, nose, throat (ENT) doctor (aka an otolaryngologist)
who may order imaging tests, such as an MRI or CT scan, to suss out these
problems, Gopen says.
Although
tinnitus can start at any age, it becomes more common as people get older.
That’s
because as the decades pass, the hair cells in the inner ear tend to
degenerate, which in turn makes auditory neurons hyperactive, explains Michael
Benninger, an otolaryngologist and chairman of the Head and Neck Institute at
the Cleveland Clinic.
"This hyperactivity causes them to respond as if
they're being stimulated by sound even when they aren’t,” he says.
Exposure
to loud noises (say, from listening to music at too high a volume with earbuds
or enduring on-the-job exposure to roaring machinery) or having a strong family
history of hearing loss increases your risk of developing tinnitus at a younger
age, Benninger adds.
What's
more, having a severe ear infection, a disorder of the temporomandibular (jaw)
joint, Ménière’s disease (a disorder of the inner ear) or an earwax blockage
can increase your risk of developing the condition.
Some
medications can contribute to tinnitus, including high doses of aspirin and
regular use of other nonsteroidal anti-inflammatory drugs (such as ibuprofen),
as well as certain antibiotics, chemotherapy drugs, diuretics and
antidepressants.
Once
you have ringing in the ears, lifestyle factors such as stress and sleep
deprivation can make it worse.
Sometimes,
though, there isn’t a clear cause, as I discovered for myself. Because I had
tinnitus in only one ear, I scheduled an appointment with an otolaryngologist,
who turned out to be not too concerned about it, partly because he was my age
(45) and had tinnitus in both ears.
He
examined my ears, sent me for a hearing test and ordered an MRI, to look for a
structural cause.
The
results: My ears looked fine, my hearing turned out to be normal for my age,
and the MRI showed nothing unusual in my head.
All
good news, except it didn’t explain why high-pitched sounds continued to recur
in my left ear. I decided I’d have to learn to live with it, because there
isn’t a cure for tinnitus.
Still,
it’s worth seeing a doctor because if there is a physiological cause (such as a
severe ear infection, a jaw joint disorder or excessive earwax), it’s often
treatable.
And
even if there isn’t, a doctor can help you find ways to ease your symptoms.
Some people experience a reduction in their tinnitus while taking supplements
of lipoflavonoids or ginkgo biloba, for instance, though the research on their
effectiveness is mixed, Gopen says.
Others
get relief from medications such as a tricyclic antidepressant (such as
amitriptyline) or a benzodiazepine (such as Klonopin).
If
you have hearing loss as well as tinnitus, wearing a hearing aid can help
restore a more normal input of sounds, says Daniel Jethanamest, M.D., of the
department of otolaryngology, head and neck surgery at New York University
Langone Health, who explains that these devices can include features such as
"habituation" sounds, which help the brain learn to ignore tinnitus's
ringing or buzzing, or "notch therapy," which filters out the pitch
of a person's tinnitus, to enhance external sounds and inhibit internal ones.
Hearing
aids for tinnitus aren't recommended, however, if you don't already have
hearing loss.
In
that case, you can turn to sound-masking devices or other sound therapies to
distract you from the internal noise.
A
relatively new device called Desyncra uses an iPod to deliver four tones,
customized to match the individual’s tinnitus.
Instead
of relying on habituation, the goal is to reset modulation of the neuronal
networks that are involved in tinnitus, Jethanamest explains.
Doctors
also recommend cognitive behavioral therapy to help patients cope with the
condition.
Luckily
for me, my tinnitus is fairly mild, and, eight years on, it comes and goes — in
both ears now and at a lower volume.
It
flares up mostly at night, particularly when I’m under a lot of stress or when
I get wax buildup in my ears, so I make an effort to keep my ears clean and to
relax before going to bed.
If
the tones arrive despite these precautions, I practice mindfulness meditation:
I acknowledge their presence without reacting to them and focus on the pattern
and sensation of my breathing; as I do this, the sounds seem to gradually fade,
and I fall asleep.
It’s
not a fluke that this technique helps me. In a recent study, researchers in the
United Kingdom found that practicing mindfulness meditation helped improve
tinnitus more than relaxation therapy did.
If
my tinnitus worsens down the road, I’m counting on the possibility that new
treatments will be available.
Already,
more aggressive treatments — such as repetitive transcranial magnetic
stimulation and deep brain stimulation, which use either magnetic pulses or
electromagnetic energy to stimulate the brain — are being investigated for
beneficial effects for those with unrelenting tinnitus that severely
compromises their quality of life.
One
way or another, my hope is that a cure will be found for those who are truly
bothered by the noises in their head.
STACEY COLINO is an award-winning writer specializing in health and
psychology. Her work appears in US News & World Report, Prevention, Family
Circle, Parade, and Parents. She lives in Chevy Chase, MD.
https://www.aarp.org/health/conditions-treatments/info-2017/tinnitus-ringing-in-ears-treatments.html
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