Tinnitus is a ‘phantom’ auditory sensation heard when there is no such external stimulus.
Tinnitus can be subjective or objective. Subjective tinnitus means only an affected person can hear a sound. However, with objective tinnitus, the sound can also be heard by someone else. Your doctor or audiologist will be able to let you know which category your tinnitus falls in when he or she does an examination.
The central auditory system identifies and prioritizes information, and makes decisions on which sounds must be attended to and which sounds must be ignored.
This ability has a crucial role in understanding tinnitus.
There is a close relationship between tinnitus and psychological distress
Tinnitus sufferers might experience many problems such as depression, anxiety, insomnia and other sleep problems. Ironically, your reaction to tinnitus determines how prominent the sensation is.
Here’s why.
It is assumed that tinnitus is the result of increased spontaneous activity in auditory nerve fibers.
When your brain receives a tinnitus sensation it checks it and tries to categories it and assign it meaning. But when your brain does not find any meaning for tinnitus, the sound becomes focused and amplified – especially when someone has a negative thought and is worried about it.
Tinnitus becomes louder and more persistent by focusing, worrying, and thinking about it.
Conversely, once your brain recognises tinnitus as non-threatening, the amplification goes away.
Keys to successful tinnitus management
- Retraining your brain to ignore tinnitus: requires a combination of sound enrichment and counselling to help people change their negative reactions to their tinnitus
- Avoiding extreme silence: to provide a sense of relief from tinnitus
- Overcoming any fear and worries: to reduce negative emotional response to tinnitus
- Habituation: to believe that tinnitus is not important and ignore it
- Sound therapy: to distract yourself from listening to tinnitus
- Listening to relaxation CDs or DVDs or doing relaxation exercises
Apart from the above ways to manage your tinnitus, the use of some medication and hearing aids with tinnitus masker are also considered helpful for tinnitus treatment.
Hearing aids and tinnitus
Tinnitus is usually localised towards the affected ear which has a hearing loss. Hearing aids are usually offered to a person with tinnitus who has associated hearing loss. The aim is to increase the stimulation of the auditory system by external sound so the brain will pay less attention to tinnitus, essentially ‘hearing around’ the tinnitus.
Modern hearing aids such as the Blamey Saunders hearing aids can be set to meet your own hearing needs. Most clients will not hear their tinnitus while they are using a hearing aid.
If your hearing aids is not set properly it can make you more aware of your tinnitus. If so, consult your audiologist to help you adjust your hearing aid.
Better hearing can lead to reducing awareness of tinnitus.
Hedyeh is an audiologist at Blamey Saunders hears, and is their resident tinnitus specialist.
For more information regarding tinnitus treatment, email her at info@blameysaunders.com.au.
The second question is why tinnitus is usually a pure tone. For a intriguing clue, search for ‘synchronised metronome’ videos.
I have both pulsitile and head shake tinnitus which indicates that it relates to blood pressure. I can easily count my pulse through my tinnitus. ENT advises this relates to the increased sensitivity as you describe.
For really weird variations, read Oliver Sacks’ book Musicophilia which describes how some people hear music. Sometimes the same refrain, sometimes longer pieces, invented or real. I know an implant recipient who hears trumpets.
There is also a strange parallel in visual hallucinations called ‘Charles Bonnet syndrome’.
Hi Rod, thanks for your response. There is lots we don’t know about tinnitus. Some people report low pitched buzzing to high pitched whistles. As you probably know, stress and noise damage are the primary risk factors for tinnitus. In fact, we have seen university students with no hearing loss reporting tinnitus due to the stress of exams! If you’re interested, Better Hearing Australia run fantastic tinnitus management sessions. Thanks again for your interesting comment!
I believe I have had tinnitus for 60 years. Let’s go back to the 1950s when TV came to Australia. There was a transformer in the TVs that emitted a tone of 16 kilohertz. I think it was the electrical impulse that drove the cathode ray tube dot back and forth across the screen.
When we got our TV I found the sound annoyingly loud. My brother did also. The rest of the family could not hear it at all. My father grew annoyed about this because he couldn’t hear it and the TV was a wonder. I remember that when I got home from school, I could hear it from the footpath, about 15 metres away.
I found some other kids of my age (12) could hear it but most could not. (It was emitted from all TVs operating with valves).
At this time I also noticed I could hear a high pitched sound all the time. A friend could also hear this, and guessed it was some sort of random noise from air. The sound never bothered me, and I didn’t think about it much. It is the same sound I now know as tinnitus.
When I was in my early thirties, I discovered on a few occasions that I could hear “ultrasonic” burglar alarms, which had been accidentally left on. They were piercing! And very high pitched, possibly faulty. I would guess at over 20 Khz.
But then I experienced some particularly loud noises, including explosive tools, plus long periods of constant random noise, like hail on a tin roof. In my 40s I had hearing loss, but found this hard to believe because my hearing had always been so acute.
I met a couple of men who told me they had tinnitus and what a problem it was, one could not sleep. I expressed my concern and felt sorry for them. It never occurred to me that I had tinnitus, because it was something that was always there. It was something I ignored. It didn’t bother me much, until my hearing started to deteriorate and then I felt it was interfering with my hearing.
When I was finally tested, I had the cookie bite problem, down about 60 db at speech, but picking up after 4 khz.
The tinnitus is constant, but has some mixed tones. At times I hear a sort of morse code, like the intro to Inspector Morse but not as pleasant, which is layered over the usual sound.
I thought I would tell this little story because the usual pattern seems quite different. I’ve never heard any other reports like this.