ASHA 2015 10802
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:
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
• 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.
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
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
• Does the sound have a pitch to it? High pitch … low
• 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.
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
• Electrical stimulation
• Relaxation therapy
• 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 (www.ata.org) 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.
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
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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
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