8 Things You Should Do If You Have Tinnitus

by Ben Thompson, AuD

Since the brain perceives tinnitus in the same manner as all other sounds, it’s possible to reach a point where your brain habituates to tinnitus and effectively filters it out, allowing you to focus on the things you want to do. In the same way that people who live by airports, highways, or busy establishments learn to habituate and tune out certain parts of their environment, the brain is capable of habituating to tinnitus and avoiding reactive emotional responses in the limbic system. 

It is absolutely possible to be successful with tinnitus, and to continue to live as you once did and do well across all areas of life. While tinnitus has the potential to be annoying, troublesome, and stressful, it ultimately doesn’t need to inhibit you. If you think you have tinnitus, there are many things you should do to begin the habituation process.

 

Is There a Cure For Tinnitus?

 

There are a few main avenues of research being done towards finding a tinnitus cure and new treatments. The first research topic is wearable devices that use bimodal stimulation, which is activating multiple senses at once. The Michigan Tinnitus Device uses sound tuned to your tinnitus frequency at the same time as a small, painless electrical pulse. Their study showed the device lowered the loudness of tinnitus for patients–for some by half.

The second focuses around injections into the ear. Our ears have tiny hair cells that help allow us to hear. The MIT-related Frequency Therapeutics hopes to find a cure for a common type of hearing loss with their FX-322 injection. This can then help with tinnitus since the two are often related. More studies need to be done to see how well, and if, this works. A company called Otonomy has great hopes in the multiple drug injections they’re working on. 

Other forms of research include genetic research and ear electric/magnetic stimulations. Tinnitus research will take time to find an effective option. Many groups are working on it. There is no cure for tinnitus yet, but there are some currently helpful treatments you can start today.

 

Is Tinnitus Linked To Covid?

 

Tinnitus has been linked to Covid. It can occur with or without Covid-caused hearing loss. Tinnitus and Covid is a real thing, although it doesn’t affect most of the people who get Covid.

A study of 279 people showed that 78 of them, 28%, got tinnitus after Covid. Age also helped decide how severe symptoms were. Those 31-40 had a higher rating in severity, frequency, and duration of their tinnitus. It also showed that being hospitalized meant you were more likely to have severe tinnitus symptoms than those who remained out of the hospital for Covid treatment.  
There is also a smaller link between the Covid vaccine and tinnitus. The Vaccine Adverse Event Reporting System, VAERS, has over 15,000 cases of tinnitus after the Covid vaccine. Out of 11 billion Covid vaccine shots given, however, this is a small number of cases. Other popular vaccines such as the flu and pneumonia vaccines have a higher rate of tinnitus.  

 

1. Consult a Licensed Audiologist

If you believe you are suffering from tinnitus, it’s important to visit an audiology clinic for an in-person consultation. Consulting an audiologist and receiving a hearing test (also known as an audiogram) will help determine if you are suffering from hearing loss-tinnitus and the treatment options that are available to you. An audiologist can also provide guidance on purchasing hearing aids and sound therapy devices.

 

2. Consider Trying Hearing Aids or Tinnitus Sound Therapy

Hearing aids can benefit those tinnitus patients who have documented hearing loss. With the help of a tinnitus-specialized audiologist, consider the online service by Treble Health for the best hearing aids for tinnitus. These hearing devices can be programmed to promote habituation and retrain the brain so that it no longer focuses on the tinnitus sound. We highly recommend getting fitted for hearing aids if you have hearing loss in addition to tinnitus.

Patients without hearing loss who still suffer from tinnitus can benefit from devices called tinnitus maskers. These are similar to hearing aids, except for the fact that they are programmed with sound therapy. They can produce a wide variety of low-level sounds like white noise or pink noise which, over the course of a few months, can greatly support the habituation process.

 

3. Use Sound Therapy

Sound therapy is a crucial tool for achieving tinnitus habituation, and can help to vastly improve quality of life. Many individuals ultimately find that after a robust sound therapy protocol, tinnitus volume will decrease. When discussing sound therapy, it’s important to consider both the technology (the device, instrument, or speaker creating the sound) as well as the actual sound output (white noise, pink noise, water sounds, etc.).

There are many modes of sound therapy available to patients. One of the simplest and cheapest is a basic speaker (running as little as $50 from manufacturers like Sound Oasis) programmed with white noise, pink noise, and natural sounds. Slightly more expensive alternatives include bone conduction headphones and tinnitus maskers. 

And beyond that, the widely agreed-upon gold standard for sound therapy are hearing aids programmed for tinnitus. These typically require calibration from an audiologist, and are beneficial in affording patients the flexibility to move between different sound environments without having to adjust their sound therapy.

 

4. Limit Daily Stressors

Any stimulus or activity that activates the stress response or prompts anxiety in the body can make tinnitus worse. Since the brain is designed to focus on threatening stimuli, whenever it’s presented with outside stressors it will feel compelled to categorize tinnitus as a negative stimulus and maintain its intensity.

You may notice that your tinnitus is typically less noticeable during periods of mental and physical calm and relaxation. It’s no surprise then that tinnitus can mirror our mental and physical state, and that periods of stress and anxiety can cause a concurrent spike.

 

5. Limit Loud Noise Exposure

Loud noise exposure can cause temporary threshold shifts in hearing, which can then result in increases in tinnitus volume. Loud noise exposure typically occurs in environments like loud bars or concert venues, and may create a temporary change in tinnitus. These temporary changes in tinnitus volume can even affect those with long-standing tinnitus who have otherwise habituated.

 

6. Improve Sleep Quality

Tinnitus habituation requires a foundation of healthy sleeping patterns. If your sleeping patterns are out of balance it will be very hard to make any progress with your tinnitus. Lack of sleep can impair our emotional, physical, and mental well-being, thereby laying the groundwork for a possible increase in tinnitus. For example, lack of sleep may make you more emotionally reactive to your tinnitus, causing you to notice it more and making it difficult to productively habituate to it. Sound sleep affords us a mental and physical reset, which is crucial for those committed to achieving habituation.

If you are struggling with sleep, there are a few things you can do. First, try performing a sleep audit. This involves inspecting your pre-sleep rituals and routines and improving them where possible—for instance, are you stimulating your brain right before sleep (like by watching TV) or trying to sleep in a room with a lot of unnecessary light?

Another thing you can do, especially if you struggle with insomnia, is to try implementing cognitive behavioral therapy. Science has shown that medications for insomnia are not entirely effective, and that the best path forward involves changing and reworking certain behaviors associated with sleep. For example, if you’re finding yourself waking up in the middle of the night and struggling to fall asleep, you might want to experiment with walking to another room, sitting down in a chair, and observing your breathing until you start to get tired again. Research has shown that this is one of the most effective tools for helping you to fall back asleep. There are also a variety of wearable tech options (such as sleep headbands and “sleepbuds”) available to help with achieving sound sleep for those dealing with tinnitus.

 

7. Practice Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) refers to a set of targeted practices that allow the brain to rewire and restructure itself. There is a large body of psychological research supporting the efficacy of these practices, as they allow individuals to eliminate certain negative thought patterns and emotional associations and thereby habituate to tinnitus.

The limbic system in the brain is one of the “older” parts of our brain responsible for keeping us alive and alerting us to potential threats through anxiety and fear responses. However, brain imaging scans have shown tinnitus patients to have a more activated limbic system than the average person, which explains why tinnitus can become so bothersome and triggering for certain patients. By committing to CBT techniques through one-on-one counseling with a psychotherapist or audiologist, tinnitus patients can work to unlearn some of these emotional patterns and achieve the degree of neuroplasticity needed for habituation.

 

8. Experiment with Mindfulness

Mindfulness is a type of meditation that involves observing one’s thoughts—both positive and negative—with equanimity, and thus working to create a sense of space in one’s mind so as to not become a victim to negative thought patterns. Mindfulness frequently takes the form of structured breathing, and there are a variety of research-backed apps available to help beginners develop a sustainable mindfulness habit.

Mindfulness meditation, as well as other holistic health habits, are crucial for tinnitus patients because they work to reduce limbic system activity and therefore diminish the strength of one’s tinnitus. And while there are a host of holistic health habits that one may feel compelled to adopt, the best path forward is to first focus on steps outlined above. If a possible technique or treatment is not evidence-based or audiologist-approved, that should be a red flag to tread carefully and to possibly invest more time and effort into your current treatment protocol.

 

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About the Author

Dr. Ben Thompson is an audiologist and tinnitus expert. He completed his residency at University of California at San Francisco (UCSF) and is a past board member of the California Academy of Audiology (CAA). Dr. Thompson is the founder of Treble Health, a nationwide telehealth company that provides tinnitus treatment. He has a popular YouTube channel with over three million views.