Tinnitus – a sound in the head with no external source – is not a disease; it is a symptom that can be triggered by a variety of different health conditions. So what causes tinnitus? Common sources include hearing loss, ear wax buildup, ototoxic medications, and ear bone changes. No matter what the cause, the condition interrupts the transmission of sound from the ear to the brain. Some part of the hearing system is involved as well, whether the outer, middle, or inner ear.
Most people develop tinnitus as a symptom of hearing loss. When you lose hearing, your brain undergoes changes in the way it processes sound frequencies. A hearing aid is a small electronic device that uses a microphone, amplifier, and speaker to increase the volume of external noises. This can mollify neuroplastic changes in the brain’s ability to process sound.
Imagine you’re settling in for a night’s rest. In your quiet bedroom, you’re tune right into those tinnitus noises—and you can’t shake your focus on them. You start to wonder about how you’ll ever fall asleep with these sounds in your ears. You think about the rest you’re missing out on because you’re not already asleep, and you wonder how you’ll have the energy to make it through your day.

A large, 2014 study of almost 14,000 people found obstructive sleep apnea was linked to significantly higher rates of hearing impairment and hearing loss. Scientists think one reason for this is changes to blood flow to the ear that result in inflammation. (We know that sleep apnea causes changes to circulation and weakens blood flow to some areas of the body, including the brain.) A related factor? People with sleep apnea are at greater risk for high blood pressure, and high blood pressure can exacerbate hearing loss, according to research.


Tinnitus is a ringing, buzzing, hissing, swishing, clicking, or other type of noise that seems to originate in the ear or head. Most of us will experience tinnitus or sounds in the ears at some time or another. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), about 10% of adults in the U.S. - nearly 25 million Americans - have experienced tinnitus lasting at least five minutes in the past year. Tinnitus is identified more frequently in white individuals, and the prevalence of tinnitus in the U.S. is almost twice as frequent in the South as in the Northeast.
Note however that tinnitus nearly always consists of fairly simple sounds -- for example, hearing someone talking that no one else can hear would not ordinarily be called tinnitus -- this would be called an auditory hallucination. Musical hallucinations in patients without psychiatric disturbance is most often described in older persons, years after hearing loss.
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Copyright ©2019 NORD - National Organization for Rare Disorders, Inc. All rights reserved. NORD is a registered 501(c)(3) charity organization. Please note that NORD provides this information for the benefit of the rare disease community. NORD is not a medical provider or health care facility and thus can neither diagnose any disease or disorder nor endorse or recommend any specific medical treatments. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder.
When tinnitus is unexpected and unwelcomed, it can lead to a negative reaction to the tinnitus. This can create a vicious cycle. When tinnitus is perceived, it can prompt emotions, including frustration, fear, unhappiness, etc.  These can, in turn, cause physical reactions such as anxiety and stress.  This reinforces the tinnitus and perpetuates the cycle. 

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.
Research shows a frequent correlation between tinnitus and hearing loss. Because tinnitus is perceived differently by each sufferer, an exact diagnosis is essential. A doctor may conduct ENT, dental, orthodontic, and orthopedic examinations in order to establish whether a case can be medically treated or not. The pitch and volume of tinnitus can be determined by special diagnostic test, and a hearing test can reveal whether hearing loss is also involved. Treatment with hearing aids is often the first step to relief from tinnitus. Hearing aids compensate for hearing loss, which enables concentration on external sounds instead of internal noises.
High-pitched ringing. Exposure to a very loud noise or a blow to the ear can cause a high-pitched ringing or buzzing that usually goes away after a few hours. However, if there's hearing loss as well, tinnitus may be permanent. Long-term noise exposure, age-related hearing loss or medications can cause a continuous, high-pitched ringing in both ears. Acoustic neuroma can cause continuous, high-pitched ringing in one ear.
The researchers point out that up to one in five adults will develop tinnitus, a distressing disorder in which people hear buzzing, ringing and other sounds from no external source. Tinnitus can occur in one or both ears, and is usually continuous but can fluctuate. A randomised controlled trial is the best way of assessing the effectiveness of an intervention.
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The results were calculated using a measure called “effect size”, which is a way of quantifying the size of the difference between the two groups. For the difference in quality of life scores between groups, the effect size was calculated to be 0.24. This can be interpreted as a “small” effect. In other words, treatment including CBT gave a small improvement in quality of life compared with usual care.
Almost every ENT, audiology practice, and hearing aid dispenser who claims to offer tinnitus treatment only offers one solution: hearing aids. While amplification may help some, only 50% of people living with tinnitus experience hearing loss that affects their understanding of speech, which means hearing aids are ineffective. At Sound Relief, we offer only evidence-based options like sound therapy and have seen countless patients experience life-changing results.
Tinnitus can be extremely disturbing to people who have it. In many cases it is not a serious health problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment. Sixteen million Americans seek medical treatment each year for tinnitus, and about one-quarter of those experience it so severely it interferes with their daily activities.
Acoustic qualification of tinnitus will include measurement of several acoustic parameters like frequency in cases of monotone tinnitus or frequency range and bandwidth in cases of narrow band noise tinnitus, loudness in dB above hearing threshold at the indicated frequency, mixing-point, and minimum masking level.[51] In most cases, tinnitus pitch or frequency range is between 5 kHz and 10 kHz,[52] and loudness between 5 and 15 dB above the hearing threshold.[53]
This study has several strengths. It included a relatively large number of patients, reducing the possibility of bias by “masking” which treatment patients received, classifying participants according to the severity of their tinnitus and using highly standardised interventions. Also, the researchers used established scales to measure the severity of tinnitus and its impact on quality of life.
At Sound Relief Hearing Center, we utilize a variety of evidence-based tinnitus treatment options. Most audiologists only offer one solution, hearing aids, which are ineffective in many cases. To treat each unique case of tinnitus, we utilize a variety of innovative technologies and therapies, including Tinnitus Retraining Therapy (TRT). For more information about your tinnitus treatment options, visit our page Tinnitus Treatment. If you’re worried that you won’t ever escape the ringing in your ears, check out our page Tinnitus Success Stories. Finally, follow our Tips from Tinnitus Experts to avoid exacerbating the problem.
Acoustic Neural Stimulation. This relatively new treatment has shown to be effective in reducing, and in some cases eliminating, symptoms in patients whose tinnitus just won’t go away or is very loud. The treatment utilizes a device small enough to fit into the palm of your hand that delivers a broadband acoustical signal embedded in special music you can listen to via headphones. The treatment eventually desensitizes you to the ringing in your ears by stimulating changes in the neural circuits in your brain.
If cerumen (more commonly known as ear wax) accumulates in your ear canal, it can diminish your ability to hear. Your auditory system may overcompensate for the loss, fabricating noises that do not exist. Your audiologist can safely remove the buildup, and in most cases, this will immediately alleviate your tinnitus. However, sometimes ear wax buildup causes permanent damage, resulting in chronic tinnitus.
Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.

FACT: Many people with tinnitus will also have a hearing loss. In fact, a recent French study showed that of 123 people with tinnitus surveyed only one did not have hearing loss.  The British Tinnitus Association estimates that 90 percent of people with tinnitus also have a hearing loss. Moreover, research says that those who don’t may have a “hidden hearing loss.”
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
About six percent of the general population has what they consider to be "severe" tinnitus. That is a gigantic number of people ! Tinnitus is more common with advancing age. In a large study of more than 2000 adults aged 50 and above, 30.3% reported having experienced tinnitus, with 48% reporting symptoms in both ears. Tinnitus had been present for at least 6 years in 50% of cases, and most (55%) reported a gradual onset. Tinnitus was described as mildly to extremely annoying by 67%.(Sindhusake et al. 2003)
Resetting the tonotopic map. Researchers are exploring how to take advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. Previous research has shown a change in the organization of the tonotopic map after exposing the ear to intense noise. By understanding how these changes happen, researchers could develop techniques to bring the map back to normal and relieve tinnitus.

Ringing in your ears, hissing, buzzing, roaring - tinnitus can take many forms. The bothersome and uncomfortable noise in your ear varies from one tinnitus sufferer to another. So does the impact of tinnitus on people's lives. Some get used to the never-ending noise in the ear with relative ease, while others are driven to despair. Many ask can tinnitus be cured? Is there a tinnitus remedy?


No matter what the cause, the condition interrupts the transmission of sound from the ear to the brain. Some of the neural circuits no longer receive signals. Strangely, this does not cause hearing loss. Instead, when neural circuits don’t receive stimulation, they react by chattering together, alone at first and then synchronous with each other. Once the nerve cells become hyperactive and occur at the same time, they simulate a tone the brain “hears” as tinnitus. Analogous to a piano, the broken “keys” create a permanent tone without a pianist playing the keys.
Tinnitus can be triggered by a variety of different causes, and it varies dramatically from person to person. Some of the causes result in permanent tinnitus that may require treatment, while others result in temporary tinnitus that disappears on its own. Common causes of tinnitus include hearing loss, wax buildup, stress, exposure to loud noises, certain disorders, and certain medications. To learn more about the various causes of tinnitus, check out our page What Causes Tinnitus?
Individuals were recruited from within and around Hamilton, Ontario via online announcements and audiology clinics. Applicants were initially interviewed via telephone to screen for all inclusion and exclusion criteria for the study in order to determine whether they qualified for on-site screening. The on-site screening, and characterization of participants’ hearing thresholds and tinnitus profiles were conducted in a lab at McMaster University using a computer-based tinnitus assessment tool. Participants were randomly allocated to the treatment or placebo-control group. The assignment of the treatment or placebo music package was completed by a distributor site independent of the research study site. Participants and research personnel were blinded to which music package the participants received.
In this exercise you are going to imagine yourself in another place – as if you’re actually there. What it looks like, the smells, the sounds… You can make this exercise as long as you want to and you can take your time to visualise a number of different places, such as a forest, a garden or a beach. Here is a short example of how you can do this (remember not to rush through it).
Repeated loud noise exposure can be a cause of tinnitus as well as hearing loss. Loud music may cause short term symptoms, but repeated occupational exposure (for example, musicians, factory and construction workers) requires less intense sound levels to cause potential hearing damage leading to tinnitus. Minimizing sound exposure, therefore, decreases the risk of developing tinnitus. Sound protection equipment, like acoustic ear-muffs, may be appropriate at work and at home when exposed to loud noises.
About six percent of the general population has what they consider to be "severe" tinnitus. That is a gigantic number of people ! Tinnitus is more common with advancing age. In a large study of more than 2000 adults aged 50 and above, 30.3% reported having experienced tinnitus, with 48% reporting symptoms in both ears. Tinnitus had been present for at least 6 years in 50% of cases, and most (55%) reported a gradual onset. Tinnitus was described as mildly to extremely annoying by 67%.(Sindhusake et al. 2003)

Tinnitus (pronounced "tin-it-tus") is an abnormal noise in the ear (note that it is not an "itis" -- which means inflammation). Tinnitus is common -- nearly 36 million Americans have constant tinnitus and more than half of the normal population has intermittent tinnitus.   Another way to summarize this is that about 10-15% of the entire population has some type of constant tinnitus, and about 20% of these people (i.e. about 1% of the population) seek medical attention (Adjamian et al, 2009). Similar statistics are found in England (Dawes et al, 2014) and Korea (Park and Moon, 2014).
Removing Excess Earwax. There is a small chance that your tinnitus is being caused by an excess build up of ear wax that is blocking the ear canal. This is especially common in older patients who have a lot of ear hair that ear wax has been building up on over the years. By removing both the excess hair and ear wax, especially if it’s in contact with your ear drum, your tinnitus can improve.
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.

The multidisciplinary approach required input from many different professionals including audiologists, psychologists, speech therapists and physical therapists. Which particular care elements of the intervention had the greatest effect is unknown. A multidisciplinary approach such as the intervention trialled here may have resource implications if it were introduced into standard clinical practice.


Most cases of tinnitus are unfortunately thought to be difficult to treat, and sometimes severe tinnitus cannot be treated at all when permanent and irreversible damage to the ears or nerves has occurred. That being said, many patients find natural tinnitus treatment methods and coping strategies to be very helpful in allowing them to adjust to the changes that tinnitus brings. Here are six of those tinnitus treatment options:

Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.


Tinnitus is the hearing of sound when no external sound is present.[1] While often described as a ringing, it may also sound like a clicking, hiss or roaring.[2] Rarely, unclear voices or music are heard.[3] The sound may be soft or loud, low pitched or high pitched and appear to be coming from one ear or both.[2] Most of the time, it comes on gradually.[3] In some people, the sound causes depression or anxiety and can interfere with concentration.[2]

Patients with head or neck injury may have particularly loud and disturbing tinnitus (Folmer and Griest, 2003). Tinnitus due to neck injury is the most common type of "somatic tinnitus". Somatic tinnitus means that the tinnitus is coming from something other than the inner ear. Tinnitus from a clear cut inner ear disorder frequently changes loudness or pitch when one simply touches the area around the ear. This is thought to be due to somatic modulation of tinnitus. We have encountered patients who have excellent responses to cervical epidural steroids, and in persons who have both severe tinnitus and significant cervical nerve root compression, we think this is worth trying as treatment.

^ Langguth B, Goodey R, Azevedo A, et al. (2007). "Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006". Tinnitus: Pathophysiology and Treatment. Progress in Brain Research. 166. pp. 525–36. doi:10.1016/S0079-6123(07)66050-6. ISBN 978-0444531674. PMC 4283806. PMID 17956816.


Often people bring in very long lists of medications that have been reported, once or twice, to be associated with tinnitus. This unfortunate behavior makes it very hard to care for these patients -- as it puts one into an impossible situation where the patient is in great distress but is also unwilling to attempt any treatment. Specialists who care for patients with ear disease, usually know very well which drugs are problems (such as those noted above), and which ones are nearly always safe.
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^ Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Dauman N, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC (2014). "A review of hyperacusis and future directions: part I. Definitions and manifestations" (PDF). American Journal of Audiology. 23 (4): 402–19. doi:10.1044/2014_AJA-14-0010. PMID 25104073. Archived (PDF) from the original on May 9, 2018. Retrieved September 23, 2017.
The cause of tinnitus may be difficult to determine. Your doctor will ask if you have been exposed to loud noise at work or home and will ask about medications you take, including all herbs and supplements. He or she may look in your ears to see if you have wax blockage or if the eardrum appears abnormal. If your hearing is affected, then your doctor may have you undergo a hearing test called an audiogram to measure your hearing ability in each ear.
Avoid a too-quiet bedroom. People with tinnitus may find it easier to sleep in a less quiet bedroom, and may benefit from white noise or other sleep-friendly sounds that help mask and minimize their tinnitus. To my patients who are looking to introduce soothing sounds to their sleep environment, I recommend the iHome Zenergy Sleep System, which combines relaxing sounds with aromatherapy and sleep-promoting light therapy.

In persons with pulsatile tinnitus, additional tests maybe proposed to study the blood vessels and to check the pressure inside the head. Gentle pressure on the neck can be performed to block the jugular vein but not the carotid artery. The Valsalva maneuver reduces venous return by increasing intrathoracic pressure. If there is a venous hum, this usually abates or improves markedly. If the pulsation is arterial, these tests have no effect.
Another thing that tinnitus and sleep problems share? A tendency among people to brush them off, and try to “tough it out,” rather than addressing their conditions. It’s not worth it, to your health or your quality of life. If you’re having trouble sleeping and you have symptoms that sound like tinnitus, talk with your doctor about both, so you can sleep better—and feel better— soon.

^ Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Dauman N, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BC (2014). "A review of hyperacusis and future directions: part I. Definitions and manifestations" (PDF). American Journal of Audiology. 23 (4): 402–19. doi:10.1044/2014_AJA-14-0010. PMID 25104073. Archived (PDF) from the original on May 9, 2018. Retrieved September 23, 2017.
We conducted a randomized, double-blind, placebo-controlled trial investigating the effects of the customized music-based sound therapy for reducing tinnitus. Participants (N = 50) who suffered from tinnitus were randomly allocated (with 1:1 ratio) to the treatment and placebo groups with assessments at baseline, 3, 6, and 12 months. The primary outcome was the differences in mean scores of the THI compared at four time intervals. Independent and paired samples t-tests were conducted to compare THI scores between and within groups, respectively.
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.
Millions of Americans experience tinnitus, often to a debilitating degree, making it one of the most common health conditions in the country. The U.S. Centers for Disease Control estimates that nearly 15% of the general public — over 50 million Americans — experience some form of tinnitus. Roughly 20 million people struggle with burdensome chronic tinnitus, while 2 million have extreme and debilitating cases.1
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