CBT could potentially help people with tinnitus deal with fears that their tinnitus might be caused by brain damage or might lead to deafness. During CBT, they might learn that the condition is common and that it is not associated with brain damage or deafness. They might also be exposed to the sound in a safe environment, so that it has less of an impact on their daily life. CBT also involves techniques such as applied relaxation and mindfulness training.
Overdosing on certain prescription drugs, recreational drugs or alcohol. This can sometimes cause permanent damage to nerves that affect hearing. In some cases when a pregnant women uses drugs during pregnancy, this can cause tinnitus to develop in her child. Common drugs that might contribute to tinnitus include ototoxics, psychotropic drugs, aminoglycosides, certain antibiotics and vancomycin.

Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[100] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[101] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media.[102] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[103]
Vascular issues. Some people have blood vessels near their ears that are capable of causing tinnitus. I have found that if the blood pressure is elevated, this increased pressure can cause that dreaded ringing in your ears or even a whooshing sound. Because pregnant women often have elevated blood pressure, they are easily susceptible to tinnitus. Tinnitus caused by pregnancy should go away with an over the counter tinnitus treatment and once the baby is born. An overactive thyroid has also been shown to causes vascular issues that bring on tinnitus.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:

Hearing loss: Probably the most common cause for tinnitus is hearing loss. As we age, or because of trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, becomes damaged. Current theories suggest that because the cochlea is no longer sending the normal signals to the brain, the brain becomes confused and essentially develops its own noise to make up for the lack of normal sound signals. This then is interpreted as a sound, tinnitus. This tinnitus can be made worse by anything that makes our hearing worse, such as ear infections or excess wax in the ear.


^ Jump up to: a b c Han BI, Lee HW, Kim TY, Lim JS, Shin KS (March 2009). "Tinnitus: characteristics, causes, mechanisms, and treatments". Journal of Clinical Neurology. 5 (1): 11–19. doi:10.3988/jcn.2009.5.1.11. PMC 2686891. PMID 19513328. About 75% of new cases are related to emotional stress as the trigger factor rather than to precipitants involving cochlear lesions.
^ McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle-Taylor P (2001). "Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999". Clinical Otolaryngology and Allied Sciences. 26 (5): 388–93. doi:10.1046/j.1365-2273.2001.00490.x. PMID 11678946. Archived (PDF) from the original on 2017-09-24.
Microvascular compression may sometimes cause tinnitus. According to Levine (2006) the quality is similar to a "typewriter", and it is fully suppressed by carbamazepine. It seems to us that response to carbamazepine is not a reliable indicator of microvascular compression as this drug stabilizes nerves and lowers serum sodium. Nevertheless, this quality of tinnitus probably justifies a trial of oxcarbamazine (a less toxic version of carbamazepine).

Tinnitus is not a disease but a symptom that can result from a number of underlying causes.[2] One of the most common causes is noise-induced hearing loss.[2] Other causes include ear infections, disease of the heart or blood vessels, Ménière's disease, brain tumors, emotional stress, exposure to certain medications, a previous head injury, and earwax.[2][4] It is more common in those with depression.[3]
If you experience tinnitus, don’t suffer in silence. The ringing, roaring, buzzing, or hissing in your ears may be interfering with your sleep, your relaxation, and your enjoyment of life. Why let tinnitus control your life? Many effective treatments for tinnitus exist these days – treatments based on solid research that have proven effective and benefited many people. With help from a tinnitus treatment expert, you could finally silence the tinnitus that has perturbed you for years.

But one of the awesome powers of the human brain is its adaptability. “It can learn and reorganize itself every time you practice something new,” Kilgard says. His research, including a study published in February 2014 in the journal Neuromodulation, has shown this adaptability may be key to helping the brain “turn down” the hyperactivity that can lead to tinnitus, he says. (4)
Widex employs fractal tone technology, so that the sounds you hear are predictable but not repeating. Your audiologist can choose between an assortment of “musical tones” known as “Zen styles,” which are random and chime-like. Your audiologist can adjust the tones’ pitch, tempo, and volume. If employed correctly, Widex Zen Therapy can help re-wire your brain and make your tinnitus less noticeable.
Your doctor will try to determine what is causing the condition. If it is not due to a medication side effect or a general medical condition (such as high blood pressure), he or she may refer you to an otolaryngologist (an ear, nose, and throat doctor) or an audiologist (hearing specialist). It is especially important to see an otolaryngologist if you experience tinnitus in only one ear, tinnitus that sounds like your heartbeat or pulse (pulsatile tinnitus), tinnitus with sudden or fluctuating hearing loss, pressure or fullness in one or both ears, and/or dizziness or balance problems. Unless the cause of the tinnitus is obvious on physical examination, a hearing test is usually required.
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Earwax (ear wax) is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
Earwax (ear wax) is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.

An assessment of hyperacusis, a frequent accompaniment of tinnitus,[56] may also be made.[57] The measured parameter is Loudness Discomfort Level (LDL) in dB, the subjective level of acute discomfort at specified frequencies over the frequency range of hearing. This defines a dynamic range between the hearing threshold at that frequency and the loudnes discomfort level. A compressed dynamic range over a particular frequency range is associated with subjectve hyperacusis. Normal hearing threshold is generally defined as 0–20 decibels (dB). Normal loudness discomfort levels are 85–90+ dB, with some authorities citing 100 dB. A dynamic range of 55 dB or less is indicative of hyperacusis.[58][59]
Experts believe that tinnitus is associated with neural (brain and nerve) injuries that affect the auditory pathway and therefore someone’s ability to hear sounds. (10) Most of the time, tinnitus is a result of a disorder that affects parts of either the outer, inner or middle ear. The good news is that the majority of cases are not linked to any serious illness, although some cases are.
The researchers next tested whether tinnitus could be reversed in noise-exposed rats. The animals received VNS paired with various tones other than the tinnitus frequency 300 times a day for about 3 weeks. Rats that received the treatment showed behavioral changes indicating that the ringing had stopped. Neural responses in the brain's auditory cortex returned to their normal levels as well, indicating that the tinnitus had disappeared.

We provide here a list of known ototoxic drugs and herbs that have been known to cause or exacerbate tinnitus. This list is for educational purposes only and is available as a resource to you to use in your discussions with your health care professional. We thank doctor Neil Bauman, Ph.D., for his expertise in this area and for compiling this list for us.

If you develop tinnitus, it's important to see your clinician. She or he will take a medical history, give you a physical examination, and do a series of tests to try to find the source of the problem. She or he will also ask you to describe the noise you're hearing (including its pitch and sound quality, and whether it's constant or periodic, steady or pulsatile) and the times and places in which you hear it. Your clinician will review your medical history, your current and past exposure to noise, and any medications or supplements you're taking. Tinnitus can be a side effect of many medications, especially when taken at higher doses (see "Some drugs that can cause or worsen tinnitus").


A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:
One group of 247 patients received standard (usual) care for tinnitus. This included audiological checks, counselling, prescription of a hearing aid if indicated, prescription of a “masker” if requested by the patient (a device that generates neutral sounds to distract from the noise of the tinnitus), and counselling from social workers when required.
Tinnitus is usually described as a ringing in the ears, but it can also sound like clicking, hissing, roaring, or buzzing. Tinnitus involves perceiving sound when no external noise is present. The sound can be very soft or very loud, and high-pitched or low-pitched. Some people hear it in one ear and others hear it in both. People with severe tinnitus may have problems hearing, working, or sleeping.
Don’t ignore ear pain. Pain or discomfort in your ear can be a sign of conditions associated with tinnitus, including ear infections and earwax buildup. These conditions, and the discomfort they cause, can also interfere with sleep. Whether your ear pain is sharp or dull, constant or intermittent, accompanied by itching or not, take these symptoms to your doctor.
There are, however, excellent tools to help patients manage their condition; treatments that reduce the perceived intensity, omnipresence, and burden of tinnitus. These currently available treatments are not “cures” — they neither repair the underlying causes of tinnitus, nor eliminate the tinnitus signal in the brain. Instead, they address the attentional, emotional, and cognitive impact of tinnitus. They help patients live better, more fulfilling, and more productive lives, even if the perception of tinnitus remains.
However, the multidisciplinary approach based on CBT is not a “cure for tinnitus”, as implied in some papers, but rather a system for managing its symptoms and effects on people’s lives. The differences in outcomes between the treatment and usual care groups were quite small, with the multidisciplinary approach giving a small improvement in quality of life compared with usual care, and moderate improvements in tinnitus severity and impairment. Also, less than 70% of participants completed the trial to 12 months, and this could have affected the reliability of the study’s overall results. Furthermore, as the patients in the study were only followed for 12 months, it is uncertain whether this approach can help in the longer term.
 Sound therapy can be effective in treating tinnitus because it may make the tinnitus less noticeable or mask the tinnitus or fade tinnitus. Hearing aids are included as a critical component of a sound therapy program. Modern hearing aids come with a special tinnitus managing sounds along with digital amplification. They are much evolved over the older technology. Different products work in different ways, although most hearing aids can alleviate tinnitus, certain hearing aids have built-in technology specifically for tinnitus relief. At amplifon, we have a clearly defined way to measure and quantify chronic tinnitus. As per the severity of the problem, an appropriate combination of treatment methods is selected to deal with your tinnitus. Amplifon audiologists are specially trained in counselling procedures as well which is another critical element of sound therapy. Consult your Amplifon audiologist to find more details about what suits you to deal with your tinnitus problem.
Psychological research has looked at the tinnitus distress reaction (TDR) to account for differences in tinnitus severity.[18][21][22][23] These findings suggest that at the initial perception of tinnitus, conditioning links tinnitus with negative emotions, such as fear and anxiety from unpleasant stimuli at the time. This enhances activity in the limbic system and autonomic nervous system, thus increasing tinnitus awareness and annoyance.[24]
Tinnitus is commonly thought of as a symptom of adulthood, and is often overlooked in children. Children with hearing loss have a high incidence of tinnitus, even though they do not express the condition or its effect on their lives.[100] Children do not generally report tinnitus spontaneously and their complaints may not be taken seriously.[101] Among those children who do complain of tinnitus, there is an increased likelihood of associated otological or neurological pathology such as migraine, juvenile Meniere’s disease or chronic suppurative otitis media.[102] Its reported prevalence varies from 12% to 36% in children with normal hearing thresholds and up to 66% in children with a hearing loss and approximately 3–10% of children have been reported to be troubled by tinnitus.[103]
When there does not seem to be a connection with a disorder of the inner ear or auditory nerve, the tinnitus is called nonotic (i.e. not otic). In some 30% of tinnitus cases, the tinnitus is influenced by the somatosensory system, for instance people can increase or decrease their tinnitus by moving their face, head, or neck.[27] This type is called somatic or craniocervical tinnitus, since it is only head or neck movements that have an effect.[25]
Michael Chrostowski, PhD is the founder of Sound Options Tinnitus Treatments Inc. His dedication to improving the lives of tinnitus sufferers drives his vision of providing effective, affordable and accessible treatments for the many tinnitus sufferers he has met throughout his research career. With over 8 years of research in the field of tinnitus and collaborations with leaders in the field, Dr. Chrostowski was able to make use of cutting-edge research to develop software that can customize an effective and personal treatment for tinnitus. Dr. Chrostowski received a BASc in electrical and computer engineering at the University of Toronto and a PhD in neuroscience at McMaster University.
Every person living with tinnitus hears a unique sound. The sound can be a low or high frequency, and its volume and pitch may change over time, with the severity varying from person to person. Those with acute tinnitus may struggle to sleep, focus at work, or communicate with others. In such cases, treatment plays a crucial role in helping an individual regain control of his or her life.
Tinnitus is usually described as a ringing in the ears, but it can also sound like clicking, hissing, roaring, or buzzing. Tinnitus involves perceiving sound when no external noise is present. The sound can be very soft or very loud, and high-pitched or low-pitched. Some people hear it in one ear and others hear it in both. People with severe tinnitus may have problems hearing, working, or sleeping.
Paquette et al (2017) reported a prospective study of 166 patients who had brain surgery involving removal of the medial temporal lobe. The prevalence of tinnitus increased from approximately from 10 to 20% post surgery. This study did not include a control -- a natural question would be -- suppose a different part of the brain were removed. One would also think that drilling of the skull from any source might increase tinnitus. We are presently dubious that the medial temporal lobe suppresses tinnitus.
Treatment of the underlying primary disorder may help to improve or cure rhythmic tinnitus. For example, the treatment of blood vessel disorders (e.g. dural arteriovenous shunts) can include certain medications or surgery. A surgical procedure known as sinus wall reconstruction can successfully treat pulsatile tinnitus due to sigmoid sinus diverticulum and dehiscence. In fact, most individuals have experienced complete resolution of their tinnitus following this surgery. Surgery may also be necessary for rare cases of pulsatile tinnitus caused by a tumor.
Microvascular compression may sometimes cause tinnitus. According to Levine (2006) the quality is similar to a "typewriter", and it is fully suppressed by carbamazepine. It seems to us that response to carbamazepine is not a reliable indicator of microvascular compression as this drug stabilizes nerves and lowers serum sodium. Nevertheless, this quality of tinnitus probably justifies a trial of oxcarbamazine (a less toxic version of carbamazepine).
Currently there is no cure for most cases of tinnitus. Depending on the type of tinnitus, symptoms will tend to come and go over time. Stress level, diet, and exposure to noise can worsen tinnitus. Many people find their tinnitus annoying but can learn to adapt without difficulty. It is likely that if you have had tinnitus, you will have it again in the future.
Hearing (audiological) exam. As part of the test, you'll sit in a soundproof room wearing earphones through which will be played specific sounds into one ear at a time. You'll indicate when you can hear the sound, and your results are compared with results considered normal for your age. This can help rule out or identify possible causes of tinnitus.
Tinnitus (pronounced ti-ni-tis), or ringing in the ears, is the sensation of hearing ringing, buzzing, hissing, chirping, whistling, or other sounds. The noise can be intermittent or continuous, and can vary in loudness. It is often worse when background noise is low, so you may be most aware of it at night when you're trying to fall asleep in a quiet room. In rare cases, the sound beats in sync with your heart (pulsatile tinnitus).
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