Audiology Information Series

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Audiology Information Series


 ASHA  2015     10802


Information Series

Tinnitus (“TIN-a-tus” or “Tin-EYE-tus”) refers to 

“ringing in the ears” when no other sound is present. 

Besides ringing, tinnitus can sound like hissing, roaring, 

pulsing, whooshing, chirping, whistling, or clicking.

Tinnitus can occur in one ear or both ears. Below are 

some commonly asked questions about tinnitus:

Is tinnitus a common problem?

Yes. Almost everyone at one time or another has 

experienced periods of mild ringing or other sounds in 

the ear. Some people have more annoying and constant 

types of tinnitus. One third of all adults experience 

tinnitus at some time in their lives. About 10%–15% 

of adults have prolonged tinnitus requiring medical 

evaluation. The exact cause of tinnitus is often not 

known. One thing is certain: Tinnitus is not imaginary.

Is tinnitus a disease?

No. Just as fever or headache go together with many 

different illnesses, tinnitus is a symptom common to 

many problems. If you have tinnitus, chances are the 

cause will remain a mystery.

What causes tinnitus?

Conditions that might cause tinnitus include:

•  Hearing loss

•  Ménière’s disease

•  Loud noise exposure

•  Migraine headaches

•  Head injury

• Drugs or medicines that are toxic to hearing



•  Anemia

•  Hypertension

•  Stress

•  Too much wax in the ear

•  Certain types of tumors

•  Too much coffee

•  Smoking cigarettes

Why is my tinnitus worse at night?

During the day, the distractions of activities and the 

sounds around you make your tinnitus less noticeable. 

When your surroundings are quiet, your tinnitus can seem 

louder and more bothersome. Fatigue and stress may also 

make your tinnitus worse. 

How is the cause of tinnitus diagnosed?

Tinnitus is a symptom of a problem. The first thing you 

should do is to try to find out the underlying cause. You 

should have a medical examination with special attention 

given to conditions associated with tinnitus. You should 

also receive a full hearing evaluation by an audiologist to 

see if hearing loss may be causing your tinnitus.

Should I see an audiologist?

Your hearing should be tested by an audiologist certified 

by the American Speech-Language-Hearing Association 

(ASHA) to see if hearing loss is present. Since tinnitus can 

be associated with a number of hearing-related conditions, 

the hearing (audiologic) evaluation can help provide 

information about the cause and treatment options for 


Can tinnitus actually be measured?

Tinnitus cannot be measured directly. The audiologist 

relies on information you provide in describing your  

tinnitus. The audiologist will ask you questions such as:

•  Which ear is involved? Right … left … both? 

•  Is the ringing constant? 

•  Do you notice it more at certain times of the day or 


•  Can you describe the sound or the ringing? 

•  Does the sound have a pitch to it? High pitch … low 



Audiology Information Series


 ASHA  2015     10802

•  How loud does it seem? Does it seem loud or soft? 

•  Does the sound change in volume or pitch over time? 

•  Do you notice conditions that make the tinnitus worse—

such as when drinking caffeinated beverages, when 

taking particular medicines, or after exposure to noise? 

•  Does the tinnitus affect your sleep … your work … your 

ability to concentrate? 

•  How annoying is it? Extremely so or not terribly  


In discussing your answers to these questions, the  

audiologist can give you information that will increase 

your understanding of your tinnitus. 

Knowing more about the cause of your tinnitus can be a 

great relief. When the possible cause of your tinnitus is 

understood, your stress level (which can make tinnitus 

worse) is frequently reduced. You can “take charge” by  

anticipating, preventing, and changing situations that 

make your tinnitus worse.

How is tinnitus treated?

The most effective treatment for tinnitus is to eliminate 

the underlying cause. Tinnitus, in some cases, can be a 

symptom of a treatable medical condition. Unfortunately, 

in many cases, the cause of tinnitus cannot be identified, 

or medical or surgical treatment is not an option. In these 

cases, the tinnitus can still be managed using a variety of 

other methods. Be sure to discuss with your doctor any 

medical treatment options before considering tinnitus 


Tinnitus management can include:

•  Hearing aids

•  Biofeedback

•  Hypnosis

•  Electrical stimulation

•  Relaxation therapy

•  Counseling

•  Habituation therapies

•  Tinnitus maskers

•  Sound machines 

Audiologists and otolaryngologists (ear, nose, and throat 

doctors, or ENTs) routinely collaborate in identifying 

the cause of tinnitus and providing treatment and 

management. A treatment that is useful and successful for 

one person may not be appropriate for another.

The American Tinnitus Association ( has 

information on various treatment options.

Will a hearing aid help my tinnitus?

If you have a hearing loss, there is a good chance that a 

hearing aid will both relieve your tinnitus and help you 

hear. Your ASHA-certified audiologist can assist with the 

selection, fitting, and purchase of the most appropriate 

hearing aids for you. Your audiologist will also help you 

learn how to get the best use out of your hearing aids.

What is a tinnitus masker?

Tinnitus maskers look like hearing aids and produce 

sounds that “mask,” or cover up, the tinnitus. The masking 

sound acts as a distracter and is usually more tolerable 

than the tinnitus. 

The characteristics of the tinnitus (pitch, loudness,  

location, etc.) that you describe for the audiologist 

determine what kind of masking noise might bring 

relief. If you have a hearing loss as well as tinnitus, the 

masker and the hearing aid may operate together as one 


Like all other treatments for tinnitus, maskers are useful 

for some but not all people. As with a hearing aid, a careful 

evaluation by an audiologist will help decide whether a 

tinnitus masker will help you.

Are there other devices that can help me?

Sound machines that provide a steady background of  

comforting noise can be useful at night or in a quiet  

environment. Fish tanks, fans, low-volume music, and 

indoor waterfalls can also be helpful. There are even  

applications for portable media players (iPod and MP3 

players) that offer a variety of masking sounds that may 

reduce the annoyance of tinnitus. 

Audiology Information Series


 ASHA  2015     10802

Compliments of 

American Speech-Language-Hearing Association 

2200 Research Boulevard, Rockville, MD 20850 • 800-638-8255

For more information about hearing loss, hearing aids,  

or referral to an ASHA-certified audiologist, contact:

2200 Research Boulevard

Rockville, MD 20850





For more information and 

to view the entire Audiology 

Information Series library, scan 

with your mobile device.

Should I join a self-help group?

Tinnitus can be stressful because it can be difficult to  

describe, predict, and manage. Self-help groups are  

available in many communities for sharing information 

and coping strategies for living with tinnitus. 

Often a self-help group promotes feelings of hope and 

control. Members of the group share strategies that they 

have found successful in dealing with their tinnitus. It can 

help to be reassured that you do not have a rare disease or 

serious brain disorder, or are not going deaf. With support, 

people with tinnitus usually find that they can cope with 

their tinnitus. 

Your audiologist can connect you with a self-help group in 

your area. For additional information or help in finding a 

group near you, contact the American Tinnitus  

Association ( 

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