TINNITUS ti-NIGHT-us or
In almost all cases, tinnitus is a subjective noise, meaning that only the
person who has tinnitus can hear it. Someone with tinnitus often describes it
as "ringing in the ears," but people report hearing all kinds of
sounds: crickets, whooshing, pulsing, ocean waves, buzzing, even music.
Many people will experience it temporarily or intermittently. Most of the
people we help here at the American Tinnitus Association experience this
"ringing in the ears" 24 hours a day, seven days a week.
What is Tinnitus?
Tinnitus is the medical term
for the perception of sound in one or both ears or in the head when no external
sound is present. It is often referred to as "ringing in the ears,"
although some people hear hissing, roaring, whistling, chirping, or clicking.
Tinnitus can be intermittent or constant-with single or multiple tones-and its
perceived volume can range from subtle to shattering.
How many
people have tinnitus?
The ATA estimates that over
50 million Americans experience tinnitus to some degree. Of these, about 12
million have severe enough tinnitus to seek medical attention. And about two
million patients are so seriously debilitated that they cannot function on a
"normal," day-to-day basis.
I have heard
two different pronunciations. Which is correct?
Tinnitus has two
pronunciations: tin-NIGHT-us or
What causes
tinnitus?
The exact physiological cause
or causes of tinnitus are not known. There are, however, several likely
sources, all of which are known to trigger or worsen tinnitus.
My neighbor has tinnitus but says it
doesn't bother her. Mine drives me nuts. Why the difference?
Approximately 50 million
Americans experience tinnitus, but not everyone experiences it to the same
degree. Some people hear ringing or other noises in their ears immediately
following exposure to excessive noise, like right after a concert, but the
sound is temporary. Other people report hearing a slight noise all the time if
they listen for it, but most of the time cannot distinguish the noise over all
the other sounds in their environment. Other factors can affect the severity of
the condition from patient to patient, such as different degrees of hearing
loss and different kinds of noises heard. Interestingly, the loudness of the
tinnitus, when measured in a laboratory setting, did not correlate to the
severity of the tinnitus as rated by the patients themselves. Every person has
his or her own level of tolerance to the tinnitus sounds. It is a very personal
and individual experience.
Is tinnitus
hereditary?
There appears to be a predisposition based on heredity for some people when
they are exposed to loud sounds, but whether or not tinnitus is genetically
indicated is not certain. Scientists working on the Human Genome Project, for
example, have not discovered a "tinnitus gene," but they have
identified genes that are responsible for a few rare varieties of hearing loss,
temporomandibular joint (TMJ) dysfunction, Ménière's Disease, and acoustic Neuroma.
These conditions frequently include tinnitus as a side effect, which suggests
that there might be a connection. For now, however, a connection between your
mother's tinnitus and your tinnitus is still unknown.
We have recently funded a three-year study that is attempting to improve our
understanding of a genetic component, if any. In 2002, Avril
Holt, Ph.D., from the
ABSTRACT: Tinnitus, the perception of sound in the absence of an acoustic
stimulus, is a significant problem in the
Can a one-time exposure to loud noise cause tinnitus?
Many people write to the
American Tinnitus Association asking if a one-time exposure to loud noise
experienced many years ago can cause tinnitus. Noise is damaging if you must
shout to be heard, if your ears hurt, or if your hearing is lessened
immediately following noise exposure. The noise exposure could occur just one
time or over months or years. The level of noise can affect the degree of
hearing loss. For example, sounds of 100 decibels experienced for more than 15
minutes can cause hearing loss. Sounds of 110 decibels experiences for more
than a minute can cause hearing loss.
A one-time exposure to loud noise is not guaranteed to cause tinnitus or
permanent hearing loss, since people's ears vary in sensitivity. It is also
possible that the damage from noise exposure might not be noticeable for many
years.
Does tinnitus cause
depression?
In some
cases, yes. The
chronic sound of tinnitus can cause difficulty with sleep, concentration,
reading, interpersonal relationships, and other everyday activities – all of
which can lead a person, especially one who is predisposed to it, towards a
state of depression.
In a 2003 study on depression and tinnitus, researchers found that most people
with tinnitus were neither depressed nor seriously bothered by their tinnitus.
But the patients who were depressed were far more disabled by their tinnitus
than the non-depressed patients. If depression is a problem for you, it would
be wise to seek help from a mental health professional.
What is pulsatile
tinnitus?
Pulsatile tinnitus is a rhythmic, pulsing sound
most often in time with the heartbeat. It can usually -– but not always -- be
heard objectively through a stethoscope on the patient's neck or through a
microphone placed inside the ear canal. While it is not a common form of
tinnitus, it has some well-known causes: hypertension, a heart murmur,
Eustachian tube disorder, a glomus tumor, an
abnormality of a vein or artery, and others. Very often, this kind of tinnitus
can be treated.
If you are experiencing pulsatile tinnitus, it is
always a good idea have a medical examination.
Can you tell me more about
other kinds of hearing disorders?
Other hearing disorders are
associated with tinnitus, including hearing loss, Ménière's
disease, and hyperacusis.
Is there anything I can do
to protect myself from tinnitus?
First, protect your hearing.
At work, make sure Occupational Safety & Health Administration (OSHA)
regulations are met: hearing protection is required under OSHA for any job in
which noise levels exceed 90 decibels over the course of an eight-hour workday.
Many hearing specialists counsel that this sound level is too high, and for
some people, 90 decibels is still too loud. Further, as noise levels increase,
the recommended time of exposure decreases. OSHA mandates that workplaces with
excessive noise levels must protect workers by implementing a continuing,
effective hearing conservation program. In other words, wear your earplugs or
earmuffs, limit the amount of time you spend in noisy environments, and follow
hearing conservation guidelines established by your employer.
Recreational noise also has an impact on your hearing. The next time you are
around a noise that bothers your ears—for example, a sporting event, concert,
or while hunting—wear hearing protection, which can reduce noise levels 15 to
20 decibels. For extremely loud situations, earmuffs over earplugs might be
necessary. Be aware of other activities or situations that include loud noises,
like hair drying or lawn-mowing. Make it easy for yourself to protect your ears
by hanging earmuffs over the lawn mower handle, or keeping ear plugs in the
bathroom next to your hair dryer. Repeated exposure to loud noises can have a
cumulative, damaging effect on your hearing.
If your physician prescribes you medications, be sure to ask if the prescribed
medications are ototoxic, or harmful to the ears, or
if the drugs are associated with tinnitus as a side effect. This information is
easily obtained in the Physicians Desk Reference.
Can anything make tinnitus
worse?
Exposure to loud noises, as
mentioned earlier, can have a negative effect on your hearing and exacerbate
tinnitus. Be sure to protect yourself with earplugs, earmuffs, or by simply not
taking part in noisy events.
Some medications can make tinnitus worse. Tell all of your physicians—not just
your ear, nose, and throat doctor—about all prescription and over the counter
medications you are currently taking or have recently taken.
Many people find that alcohol, nicotine, and caffeine can worsen their
tinnitus, as can eating certain foods. Some people find that foods with a high sugar content or any amount of quinine (tonic water)
make their tinnitus seem louder. Monitor how you respond to different stimuli,
and find a healthy balance where you do not eliminate all the foods that you
love, but also where you do not unnecessarily exacerbate your tinnitus.
Finally, stress and fatigue can affect your tinnitus. Make time to relax, and
understand that life events can manifest themselves in your body in the form of
increased tinnitus. Of course, this is easier said than done. Finding a good
support network can help.
What kind of tinnitus
research is being done?
Research funded by the
American Tinnitus Association focuses on two main areas: mechanisms and
management. "Tinnitus mechanisms" research explores what the
condition is about, where it occurs, how it occurs—the who,
what, where, when, and why questions. "Tinnitus management" research
looks into treatments available, how well those treatments work, and how they
compare to one another. The ATA attempts to find a balance between the two
types of research.
What is the
role of the ATA Scientific Advisory Committee?
The ATA Scientific
Advisory Committee is a group of volunteer researchers and clinicians who
review grant applications for tinnitus research funding. After their review,
SAC members make recommendations to the ATA Board of Directors on which studies
should be funded. Many SAC members are researchers, and several have applied
for and received ATA grants, but they must excuse themselves from deliberations
on their own submitted grants or on grants from their affiliated hospitals or
universities because of conflict of interest.
Where can I
find a health care professional to help me figure out the best treatment?
ATA maintains a listing
of health care professionals who self-report their interest in treating
tinnitus patients. This listing is available online in our Members section. Or
you can call or write to ATA headquarters for a copy. The listing is not
exhaustive: there are no doubt many other physicians, audiologists, hearing
instrument specialists, and other providers with an active interest in and
awareness of tinnitus. If you know of a health professional not included in the
listing who would be a good addition to this resource, please let an ATA staff
member know. Staff members can also help you track down professionals in your
area using other resources; please let us know how we can assist you.
Tinnitus
Health Care for Veterans
The American Tinnitus Association supports legislation that improves
recognition of and compensation for tinnitus experienced by Veterans. Back in
2002, the American Tinnitus Association strongly supported legislation that
would require the Department of Veterans Affairs (VA) to contract with the
National Academy of Sciences to assess noise-induced hearing loss and tinnitus
associated with military service from World War II to the present. Congress
passed this law in December of that year.
The study is now underway, as mandated by Congress, by the
The expert committee is charged with providing recommendations to the VA on the
assessment of noise-induced hearing loss and tinnitus associated with service
in the Armed Forces—that includes Army, Navy, Air Force, Marine Corps, and
Coast Guard. The committee will also review data on compliance with hearing testing
regulations, review and assess available data on hearing loss, identify sources
of potentially damaging noise during active duty, and identify risk factors for
noise-induced hearing loss.
Additionally, and perhaps most interesting to ATA members, the
A final report is expected in August 2005.
The American Tinnitus Association has collected a wealth of information about
applying for a VA service connected claim. Call 800-634-8978 for more details.
Tinnitus
Advocacy Tools: How to Apply for VA Disability Claim
The American Tinnitus Association receives dozens of phone calls
each month related to veterans seeking service connection for their tinnitus.
By establishing this connection, veterans can receive compensation for their
tinnitus, with a maximum 10 percent disability rating, as well as healthcare
services and tinnitus devices. The following information is provided as a
service to veterans who believe their tinnitus is related to their time in the
military, and who seek appropriate compensation for their tinnitus.
http://www.ata.org/programs/va_disab_claim.html
American
Tinnitus Association