Hearing Loss Help  

by Neil Bauman, Ph.D.

Researchers are busy looking for ways to reduce tinnitus. A recent study (1) that caught my eye, and one that shows promise, consists of listening to your favorite music for about 2 hours a day for a year. How hard can that be when one of the benefits is reducing the volume of your tinnitus?

In order for this to work, there are two conditions you must meet. First, your tinnitus must be a tonal kind of tinnitus that stays at a constant frequency. Second, the music you listen to must be digitally modified to take out the frequency of your tinnitus—hence the term “notched music”—as you have a notch where there is no sound at your tinnitus frequency.

(The way the researchers created this “notch” was to filter out a whole octave of sound centered around the frequency of the person’s tinnitus.)

Then, you just listen to your music for about 2 hours a day for the next year. By the end of 6 months, you’ll notice that the volume of your tinnitus is dropping significantly.

After 12 months, the people in this study found their tinnitus had dropped in volume by about 28%, and their annoyance at their tinnitus had dropped around 22%. In contrast, those in the placebo group (who listened to their favorite music without the notch) actually had their tinnitus increase about 9% and their annoyance at their tinnitus increase about 7%. (There was no indication as to what kind of music people listened to, nor at what volume.)

The reason this notched music therapy appears to work is that our brains are “plastic”. That means they can adapt and change their responses over time. Apparently our brains are more amenable to changing based on listening to sounds we like rather than to ones we dislike—hence the need to choose music you particularly like.

Researchers are beginning to understand that tinnitus arises when the auditory cortex in our brains inadvertently changes in inappropriate ways.

Researchers feel that tinnitus is “associated with a relative excitatory-inhibitory cortical neural network dysbalance, at the expense of the inhibitory system.” Say what? In plain English, what this means is that when everything is functioning properly, some auditory neurons in our brains may get too excited and “talk” out of turn so to speak. When they do this, the surrounding neurons tell them to “shut up”. This maintains order in the auditory cortex.

However, when too many begin to talk out of turn and not enough tell them to “shut up”, things get a bit wild and the result is tinnitus. If this situation is allowed to continue, it becomes the new norm and you end up with constant tinnitus.

Furthermore, if you have a hearing loss, some neurons in your auditory cortex are deprived of normal sound signals. Since neurons are not happy doing nothing, they “rewire” themselves so that they are no longer excited by the frequencies they were originally tuned to. Instead, they tune in to the frequency of their neighboring neurons. When a bunch of them do this, the resulting synchronized spontaneous neural activity apparently results in what we call tinnitus.

The good news is that previous research has shown that this “rowdy” behavior can be modified by behavioral training. The way the researchers did this in this study was to eliminate sounds at the frequency of the person’s tinnitus. Now, since there was no “sound stimulus” at the frequency of the “tinnitus neurons”, but at all other frequencies, the “neurons that weren’t stimulated were suppressed via lateral inhibitory inputs originating from surrounding neurons.” In other words, enough of the surrounding neurons told the “tinnitus neurons” to “shut up” and thus the volume of their tinnitus went down, and things became more normal once again.

It appears that notched-music therapy may prove to be an enjoyable, low-cost and casual (relaxed) treatment for reducing tinnitus a significant amount.

If you want to learn more about tinnitus and some of the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

(1) “Customized notch music training reduces tinnitus loudness” by Henning Stracke, et. al. Communicative & Integrative Biology 3:3 pp. 1-4, May/June 2010.

by Neil Bauman, Ph.D.

In a previous article “Nodding Chime Tinnitus“, a woman explained that she heard chiming tinnitus whenever she nodded or shook her head.

I asked anyone reading that article if they had ever had somewhat similar experiences. Here are five responses I received.

One lady reported:

I also have the same type of thing when I shake my head. At the same time, I have a constant sound in one of my ears regardless of what I am doing.

A man explained:

This is one of my symptoms. The note is slightly different for yes and no—yes is higher-pitched. I think I’ve experienced this for many years, but only started to notice continuous tinnitus at the age of 50, about 8 years ago. I have been wearing higher-frequency hearing aids since then, have had tests for acoustic neuromas, and have undergone tinnitus retraining therapy with some success.

In addition to the nodding/shaking symptoms, I get similar chimes when I jog. I can also reduce or increase my steady- state tinnitus by pressing quite hard on various parts of my jaw. Pressing the jaw into the joint tends to decrease the tinnitus, pushing my chin to one side tends to increase it. The effect is quite dramatic.

A lady wrote:

I also have a type of tinnitus that happens when I shake my head up and down or side to side. It’s not chimes to me but more like a static or buzzing. I can’t remember when it started, but I have a progressive hearing loss that resulted in my surgery one year ago for a cochlear implant. I can provoke it at will—pretty much all the time.

Another phenomena I’ve had for a few years—worse before the CI—has what I’ve found on the web as an “audible wakening”. Basically when changing consciousness stages I sometimes hear a “wraaanggg” type of almost screaming “sound”. Can’t explain it much better—sorry. I wonder whether others have reported this to you.

Another lady reported:

I’m writing regarding the woman who hears a chime sound when she nods or shakes her head.

In addition to ongoing mild tinnitus, I experience movement-induced sound as well. Unfortunately, the sound is not a pleasant chime tone, but a very startling loud buzz—like a noisy fly or bee right inside my ear! The first time I heard it I was terrified that an insect had flown into my ear and would sting me or get stuck and have to be removed surgically. The sound (so far) only happens when I shake my head from side to side to signify “no”.

I hear a variety of other tinnitus sounds intermittently that don’t seem to be related to any particular activity or situation—loud squeals, clicks, and the occasional whooshing noise. They are irritating when they happen, but aren’t terribly disruptive.

Still another lady explained:

I identify with the “chime” tinnitus report—I just tested myself by nodding my head vigorously. I confirmed that indeed, the movement changed the volume of my tinnitus, especially on the head upward movement of a “yes” head nod, and a leftward head movement in a “no” nod. (The ‘yes’ movement yields more dramatic results.) I have unilateral sensorineural loss in my right ear, with tinnitus that is not bothersome—it’s simply “there”.

When I wear my hearing aid, it plugs that ear with the ear mold, and this somehow calls attention to my tinnitus—when I walk, I get a modulation of the tinnitus that reflects the rhythm of my footsteps. That’s annoying. This is akin to my ability to “ding” my head—if I plug my right ear, and flick my finger just so around my cheekbone, I can produce a “ding” sound in my head. (Fun, huh?)

Interesting, isn’t it? Thank you all for sharing some of the weird tinnitus sounds you experience. This once again proves the enormous variety of tinnitus sounds we hard of hearing people experience.

by Neil Bauman, Ph.D.

A lady wrote:

I was diagnosed with Meniere’s disease. I have horrible tinnitus and can tell my hearing has gone horribly downhill. My question is, can a hearing aid help with the tinnitus to shut it out or anything? When I’m in a room with stuff going on I don’t usually hear it AS well as I do in a quiet room, but it’s still enough to really bug me.

Excellent question. Hearing aids in and of themselves do not affect the loudness of your tinnitus as such. Rather, they amplify sounds so you hear more (and louder) sounds. The good news is that this partially masks your tinnitus so you don’t notice it as much.

It is basically the same effect as you have already found when in a noisy room—your tinnitus doesn’t appear to be as loud because your brain has lots of real sounds on which to concentrate. Furthermore, in a noisy situation, the contrast between the background sound level and your tinnitus is much less than if you were in a quiet room.

However, when you are in a quiet location there is nothing to mask your tinnitus sounds. Thus, you perceive them as louder and more intrusive. Wearing a hearing aid in a quiet room will pick up the softer sounds you can no longer hear and thus help mask your tinnitus.

When your tinnitus is bothering you and you are in a quiet place, you need to enrich your environment with real sounds—turn on the TV, listen to a radio, stereo, iPod or MP3 player, and/or wear hearing aids.

This is especially important at night when the room is quiet. Some people find that just having a fan running, or a clock radio playing music really helps take their focus off their tinnitus. Use whatever works to give your brain real sounds to listen to so you don’t focus on your tinnitus.

You see, if you focus on your tinnitus, you will perceive your tinnitus as becoming louder and louder and more and more intrusive as the days go by. Therefore, you want to focus on the loves of your life, and the things you are doing, rather than on your tinnitus. When you do this, you’ll notice, if you stop at that point and think about it, that your tinnitus now appears softer and much less intrusive. This should be your goal.

If you want to learn more about tinnitus and the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A woman explained:

When I nod my head, or shake it from side to side (yes-ing or no-ing), I hear chimes. Kind of like those chime toys that babies have, that when they are touched sway side to side and there’s a little chime inside. Do you know of anyone else that experiences this?

Hearing chimes when you nod or shake your head is not particularly common to be sure, but it is not unknown either. I knew a lady that every time she shook her head she heard the pure tone “F”. You have some thing like she has.

There are all sorts of strange kinds of tinnitus. For example, some people hear a special tinnitus sound when they turn their head all the way right or left, or bend over (somatic tinnitus). Others hear their tinnitus when they move their eyes (gaze-evoked tinnitus). Your tinnitus chimes when you nod or shake your head.

I’m curious how common this kind of tinnitus is. If any of you reading this have a similar kind of tinnitus, I’d love to hear of your experiences.

by Neil Bauman, Ph.D.

Here’s a shocking statistic—75% of 18 to 30 year-olds who go to nightclubs and concerts may experience tinnitus, according to an article published in a recent edition of the Journal of Clinical Nursing.

That’s a lot of people flirting with disaster to their ears. You see, in such situations tinnitus is your ears’ warning that you are damaging your ears by exposing them to sounds that are much too loud. When this happens, pay attention. Protect your ears, or get out of the noisy environment if you value your ears.

Fortunately, for most people this resulting tinnitus is temporary and disappears in hours or a few days. However, be warned, typically the more you listen to loud sounds, the louder your tinnitus becomes, and the longer it lasts, until finally it never goes away. You don’t want that to happen to you!

In addition to being a real “pain” in and of itself, tinnitus is also often a warning of impending or actual hearing loss. Studies reveal that 85% of people with hearing loss also have tinnitus.

Incidentally, some people are more susceptible to tinnitus than others. For example, some studies show that depression and bothersome tinnitus go hand in hand. If fact, 62% of tinnitus sufferers have a “lifetime prevalence of major depression” according to the above article. In addition, tinnitus causes things such as tension, frustration, anger, loss of concentration and sleep disturbance.

If you want to learn more about tinnitus and the things you can do to help bring it under control, see the book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How“.

by Neil Bauman, Ph.D.

A man wrote:

I have tinnitus. Tonight I was surfing the web and found a site that played pure tones at various frequencies when you clicked on the corresponding buttons. To my surprise, most of my high-pitched tinnitus went away for a while after listening to the higher-frequency sounds! Does this make sense to you? Might this sort of thing be a treatment for people?

Cool, huh? What you have discovered for yourself is a phenomenon called “residual inhibition”. Residual inhibition occurs when you mask your tinnitus with a frequency of sound that closely matches the pitch of your tinnitus and then turn the sound off. At that point, for numbers of people such as yourself, your tinnitus either disappears, or is greatly reduced in volume. This effect typically only lasts a few seconds, but in some people it can last for several minutes, hours, days or rarely, even permanently eliminate their tinnitus. (Such blessed relief!)

The closer you match the pitch of the sound to your tinnitus, typically the more your tinnitus is reduced, and the longer the residual inhibition lasts. Obviously, this works best for people whose tinnitus consists of a single, constant frequency of sound.

Thus, if your tinnitus is a constant tone, and you listen to a pure tone sound of the same frequency for 30 seconds or a minute, often you will find that your tinnitus disappears (or is greatly reduced) for several seconds (typically 30 to 60) immediately after you turn the tone off.

There have been several commercial attempts to use residual inhibition to help people that suffer from their tinnitus. One product that showed early initial promise was the Quiescence tinnitus management software, but unfortunately, it seems to have fallen by the wayside. Even so, researchers are still studying residual inhibition, trying to understand more of how it works. Perhaps, in the future, they will discover a way to make the effect last long enough that it becomes a useful treatment for tinnitus.

by Neil Bauman, Ph.D.

A lady asked:

Can HCTZ cause the constant roar I now hear in my ears?

Hydrochlorothiazide (HCTZ) is about the least ototoxic of all the diuretics. It is listed as sometimes causing dizziness or vertigo, but is not listed (as far as I have ever seen) as causing tinnitus.

However, one lady told me that whenever she takes HCTZ, her tinnitus gets louder. Thus, it could be the cause your constant roar (tinnitus) too.

Think back to when you started taking HCTZ. If you didn’t have the loud roar before you began this drug, and your tinnitus started soon after (in the following 14 days or so), then this is strong circumstantial evidence that Hydrochlorothiazide is indeed causing your tinnitus.

To learn which drugs are (or can be) ototoxic, see “Ototoxic Drugs Exposed“. This book contains information on the ototoxicity of 763 drugs, 30 herbs and 148 chemicals.

by Neil Bauman, Ph.D.

A man wrote:

I have mild to moderate hearing loss, bilateral tinnitus and some hyperacusis. There’s no rhyme or reason to the hyperacusis. Some days it’s stable and other days it gets worse. Likewise with my hearing loss—it fluctuates—sometimes in the morning I feel I can hear fine and after a busy day at work or home life, I feel cotton got into my ears and my hearing is worse at night as well as the tinnitus—like I used my ears to much during the day. That type of feeling.

My problem is what can I do about telephone use. It seems that whenever I talk on the phone my tinnitus gets worse after I hang up. I started using my cell phone with the speaker, so my ear is not against the phone itself. But it still increases the level of my tinnitus after the phone call.

This is baffling me because I really enjoy speaking with people, but now I cut my calls short for fear of the intensity of the tinnitus later on. I wish there was some solution for phone use. I think that my response is hyperacusis after using the phone.

Is there any solution to this, or do I just suffer with it? I am trying to protect my hearing. I have nerve damage and this close noise bothers it. Recovery usually takes a few hours back to the same level.

You are not alone in this. My tinnitus gets worse from using the phone too. I wonder if your problem is the same as mine.

Incidentally, I think you have recruitment rather than hyperacusis.

For me, the louder parts (spikes) of each syllable are too loud and cause my recruitment to kick in, which aggravates my tinnitus. However, if I turn down the volume so these spikes do not recruit (and aggravate my tinnitus), then I can’t hear the softer parts of the syllables and thus don’t understand what the person on the other end is saying. It’s sort of a Catch-22 situation.

That is part of the problem. In addition, I need enormous amplification in order to hear the other person (I have an 80 dB loss right where our voices are pitched). Since the phone’s side tone amplifies my own voice even more than the other person’s voice, my voice in the handset is then much too loud for me. However, if I turn down the volume, then I can’t hear the other person, and if I speak softer, the other person can’t hear me. The result is that after talking on the phone for a while (and I often am on the phone for an hour or more at a time), my tinnitus is louder for 10 or 15 minutes after I hang up.

The obvious solution to this problem is to wear hearing aids that have their compression set such that no louder sounds can reach your recruitment threshold. Then, since no sounds will recruit, it won’t aggravate your tinnitus. (At least, that’s my theory.) The compression not only keeps the lid on the louder sounds, but at the same time, it increases the volume of the softer parts of speech so you can hear and understand the other person.

Since I don’t like wearing my hearing aids for phone use (never have, but that’s me), part of my solution was to get a binaural headset so both ears can hear at once. The advantage of hearing with both ears at the same time is that you can cut the volume in half and still understand the other person as well as before with one ear and twice the volume. By cutting down the volume, my own voice isn’t as loud and thus much easier on my ears (which is a blessing). It’s not the perfect answer, but is much, much better than before.

You can get this binaural advantage by wearing two hearing aids in t-coil mode and plug a neckloop (amplified or bluetooth) or T-links into your cell or landline phone. Then you can turn the volume down and yet still hear clearly since both ears are working together now. If you have the Oticon Epoq or Phonak Exelia (or equivalent) hearing aids with their remotes, you can use bluetooth phones and the sound will be piped into both your hearing aids automatically.

In summary, wearing two hearing aids with sufficient compression to control your recruitment would be the best solution to prevent your recruitment from kicking in and aggravating your tinnitus while on the phone (or anywhere else for that matter). Second best is to do what I do and wear a binaural headset. The wonderful binaural headset I use (for landline phones only) is found here.

Sudden Hearing Loss—What Happens Next?

by Neil Bauman, Ph.D.

A man explained:

I am a 37 year old male who has experienced sudden hearing loss in my right ear. Unfortunately, the problem was not treated right away. Prednisone therapy, which didn’t help, was initiated 13 days after the loss. In hearing tests I could not understand any speech, though I hear tones and some low register sounds. I’m curious to know the possibility, if any, of the hearing returning. My MRI came out negative and I experienced very little, if any, vertigo. It has now been four weeks since the loss. If my hearing does not recover, does the ringing, at least, eventually die down? Do hearing aids assist in reducing the ringing?

Sudden hearing loss typically strikes without warning. The standard treatment is Prednisone. Beginning it as soon as possible after the sudden hearing loss gives the best chances of recovery. Just remember that sometimes Prednisone works and sometimes it doesn’t. Also, sometimes hearing comes back on its own without, or in spite of, any treatment.

In your case, it seems the Prednisone didn’t work. Even though you began it after 13 days, that is not necessarily too late—but the sooner you begin, typically the better results you have.

Unfortunately, it seems that neither the Prednisone, nor time, has restored your hearing. Typically, the worse the sudden loss, the less chance there is of full, or even any, recovery.

The way it usually works is that the hearing you have at the end of 30 days or so is what you will be left with—unless your hearing has been returning a bit at a time all along, in which case it could continue to improve after the 30 days. Since you haven’t had any significant hearing returning during this time, I think the chances that more will return are slim.

You ask, “If my hearing does not recover, does the ringing, at least, eventually die down?”

It may, or may not. In any case, you can learn to habituate to your tinnitus so it no longer bothers you—no matter how loud or soft it is. The thing to do is not dwell on, or focus on, your tinnitus. Totally ignore it, and act like it isn’t there. When you do this, you will notice that your tinnitus tends to fade into the background and not be so intrusive. Not easy to do, I know, but it does work for many people. I’ve had tinnitus for 40 plus years now, and although my ears are ringing away as I write this, I do not let my tinnitus bother me. It is just “there”. (Of course, if I had by “druthers”, I’d rather it wasn’t there at all!)

Conversely, if you dwell on your tinnitus, it will get even worse. That is why it is so important, right from the start, to learn to focus on other things and thus ignore your tinnitus.

Since people typically perceive their tinnitus as louder when there is no sound around, enriching your sound environment helps mask your tinnitus. That is why wearing hearing aids help a lot of people cope with their tinnitus. Hearing aids bring in lots of real sounds for your brain to process so it doesn’t concentrate on your tinnitus as much. Thus, your tinnitus seems to fade into the background to some degree. However, when you take your hearing aids off at night, the lack of real sounds allows your tinnitus to come back until the next morning when you put your aids in again.

One trick to help you manage your tinnitus during the night is to set your clock radio to stay on for an hour or so, so your brain has real sounds to listen to while you fall asleep. Other people find that having a fan running in their bedroom does the same thing. Still others listen to CDs of environmental sounds—rain, waves on the seashore, birds, etc. and have good results with that. Do what works best for you. Hopefully your tinnitus will only be a minor annoyance in your life, not a major problem.

If this doesn’t work, my book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How” teaches you a number of things you can do to help yourself successfully live with your tinnitus.

by Neil Bauman, Ph.D.

A lady explained:

I find that my tinnitus is worse if I am stressed about something. Sometimes the pitch changes and sometimes I can hear more than one sound at a time. My tinnitus is always worse when I’m trying to get to sleep and that’s when I get anxious. I can hear it in the day too, so it’s there all the time. When I wake up in the morning it can be very loud and I have to get up straight away or I can become panicky. I have always been noise phobic from when I was a small child. I just can’t handle fireworks or loud noises. When I was very young I became very upset by the scratching of the needle on a record. Is this part of the profile of someone with tinnitus?

Very much so. Stress and anxiety are two triggers of tinnitus. If you are a high-strung, anxious type of person, often you will find that not only do you hear tinnitus, but you also may have hyperacusis—where you hear some/all sounds louder and more intrusive than normal.

I was helping a lady recently that had much the same experiences as you—she was high-strung, anxious and had just gone through a very stressful situation. Her tinnitus was now much louder than normal, and she was worried that it would stay that way. In the past when she would stress over something, her tinnitus would get louder, but subside in a day or two. This time it wasn’t—hence her call to me for help.

I explained to her that when we are anxious, this puts our bodies in the “fight or flight” mode. Extra adrenaline surges through our arteries giving us more strength to fight or flee. At the same time, our senses become more acute. Thus we actually hear better than normal during such events—especially fainter sounds.

When you are anxious all the time, your body becomes stuck in this fight or flight mode, which includes the increased acute hearing. The result is that you perceive certain sounds to be annoyingly loud such as your phonograph needle. At the same time, loud sounds are then much too loud (such as fireworks).

The usual reaction to this increased sensitivity to sound is to avoid all noisy places and wear ear protectors most of the time. This actually proves counterproductive because when you wear ear protectors all the time, you brain becomes “starved” for normal sounds. As a result, it cranks up its internal volume control. This just makes the situation even worse—because when you take the noise protectors off, sounds are louder and even more annoying than before.

On top of this, your tinnitus is also louder because, with the increased internal volume, your brain is now hearing more of the random firings of the neurons in your auditory system—which some researchers think we hear as tinnitus.

The way to resolve this problem is not to overprotect your ears. Yes, clap your hands to your ears if there is a sudden loud sound around you (a siren going past you, or a truck blasting his air horn), but otherwise do not overprotect your ears so your auditory system will always have adequate stimulation. This will cause your brain to turn down the internal volume.

At the same time, you need to learn how not to be so anxious. You need to learn to be calm and “hang loose”. That will get you out of the “fight or flight” mode. This alone will let your brain turn down its internal volume.

When you do this, you will find that your tinnitus often becomes less intrusive and fades into the background. You will also find hat those sounds you found annoying before now don’t bother you much, or at all.

I’m not saying this is easy to accomplish, but it is necessary. There are a number of books available that teach you how to relax and calm down. If you need further help, see a therapist that specializes in helping people work through their anxiety problems without using drugs.

The end result will be reduced tinnitus, reduced hyperacusis and more enjoyment in your life. That makes it all worthwhile, doesn’t it?

If you have tinnitus, my book, “When Your Ears Ring—Cope with Your Tinnitus—Here’s How” teaches you a number of things you can do to help yourself successfully live with your tinnitus.