by Neil Bauman, Ph.D.
A man asked,
Does listening to music at low volume levels, but for 5-6 hours or more every day, make tinnitus worse? Is it better to listen via speakers or headphones?
Listening to music at low volume levels should not bother your tinnitus (or make it worse). That’s a general rule of thumb.
However, you need to define what you consider “low volume levels”. In a society addicted to loud music, your definition of “low” volume may be much higher than the commonly-accepted “safe” levels promulgated today. To me, “low levels” of sound would mean that all sounds (including all peaks in the music you are listening to) would measure less than 80 dB. The average sound level should be no more than the same level as people talking—namely in the range of 50 to 70 dB or so.
If you keep what you are listening to in that range, I doubt that it will negatively affect your tinnitus.
However, some people have “weird” hearing/tinnitus and their tinnitus is sensitive to lower-level sounds. If this is your situation, turn the volume down until it doesn’t bother your tinnitus.
Other people have “reactive” tinnitus. Reactive tinnitus reacts or responds to louder sounds. Thus, your tinnitus continues to get louder and louder as the volume of sound around you goes up. If this is your case, you need to keep turning the music down until you find a “safe” level that does not cause your tinnitus to react.
Thus, depending on your tinnitus, the above rule of thumb may not apply to you. The best way to know what is right for you is to monitor your own tinnitus. If low-level music makes your tinnitus worse, either turn the volume down more until it doesn’t, or don’t listen so long that it bothers your tinnitus. In addition, your ears need some “down time” too—so give them breaks from time to time.
Theoretically, whether you wear earbuds/earphones or listen via loudspeakers shouldn’t make any difference if you keep the volume to a low level as defined above.
A problem could arise if you were listening to music that is generally softer, but at points has crashing cymbals, loud drums or other suddenly-crescendoing sounds. If you are wearing earbuds/headphones, there is less physical space for those extra-loud sounds to dissipate before they hit your eardrums than if you were listening via loudspeakers.
In my case, since I have a severe hearing loss, as well as discrimination problems, I need to have the average volume very loud in order for me to hear and understand anything. In other words, the average level is much louder than 50 to 70 dB—more like 95+ dB—and this is already over the hearing-damaging level. Thus, any increase in volume (music peaks) can hurt my ears. As a result, for this kind of music I typically opt for listening via loudspeakers so the peaks have a chance to dissipate in the air before they hit my eardrums.
In such cases choose loudspeakers over earbuds/earphones. Even so, if you keep the peaks below 80 dB, it shouldn’t really matter. However, if your tinnitus is louder after listening to your music, then you know it is still too loud for your ears, and you have to turn the volume down more.
Listening to low-level music (just loud enough to hear) may also have a beneficial effect on your tinnitus. You may find that the music masks your tinnitus so it doesn’t bother you while you are listening to it. And if you are really lucky, you may find that residual inhibition kicks in, such that after you stop listening to the music, you discover to your joy that your tinnitus is now at a much lower level, or even disappears for awhile.
If you want to learn more about noise and tinnitus, the many things that can trigger tinnitus, or more about a number of things you can do to help bring your tinnitus under control, check out my book, Take Control of Your Tinnitus.
Is it good to listen to mellow soft music for tinnitus?
Hi Ruben:
For most people that is an excellent way of coping with tinnitus. If it helps you, go for it.
Cordially,
Neil
I am deaf and had tinnitus for 30 years and it drives me crazy so how do I deal with it as my guess is most research are based on hearing people.
P.S. listening to music doesn’t matter how low or loud doesn’t for me whatsoever
Hi George:
When it comes to tinnitus and using music to mask it, I’m with you. Most research is done on people with reasonable hearing. If you have a severe or profound loss, then what they say about listening to music probably doesn’t apply too well. Thus, you have to use other techniques in order to successfully deal with your tinnitus.
One that I find particularly useful is explained in detail in Chapter 16 of my book, “Take Control of Your Tinnitus”. You can get this book at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
I am having Tinnitus from last 11 years, sometimes it attacks like anything else I am becoming habitual of this. What to do? I am not able to understand. Someone is saying cupping therapy and someone are saying some other machine to be used. Please tell me.
Hi Roopak:
I’m not sure what you are really saying, but I think you have a hearing loss that is accompanied by tinnitus. You should have your hearing checked and if necessary, get hearing aids. Your tinnitus may be the result of your hearing loss since tinnitus very often accompanies hearing loss.
Cordially,
Neil
Hi Doctor.
I got tinnitus for about 1 year now (I’m 30). I might have had it before but wasn’t aware of it. I think I got it from listening to loud music through my headset. My tinnitus doesn’t really bother me at night unless I think about it.
The problem is I have loud neighbors and I tried talking to them but no good. I use the Flent Quiet Time earplugs and it does well it masking sound, except for furniture pushing and knocks on the wall. I came across the Boose Sound Mask. You can Google it. It is an earplug that plays relaxing ocean/wind/campfire sound for bed. I am thinking about buying one but I am not sure if it will worsen my tinnitus. I don’t use headset anymore and having the idea of using Boose scares me. However, If I use the Boose earplug at a low volume (low enough to mask my tinnitus and keeps my mind off my noisy neighbors) and set the times for the headset to stop playing after a hour, will this still damage my ears?
Your advise will mean a lot to me.
Thank you in advance.
Hi Majd:
Loud music through headphones can certainly cause tinnitus over time. And you are right–for most people it doesn’t bother them unless they think of it. I know, I’m not even aware of my tinnitus unless I am thinking about it–like right now as I write this. Now my tinnitus is ringing away. But as soon as I go on to something else, within 5 minutes I won’t be aware of my tinnitus again. This is called being habituated to your tinnitus.
There is nothing wrong with wearing headsets/earphones/ear buds. All you have to do is keep the sound level down to a reasonable level. A reasonable level is the level you’d listen to a person talking, or listening to a lecture. Music listened to at speech levels won’t be loud enough to hurt your ears. So that’s a good rule of thumb for listening to any music.
I think you have a good plan. Keep the volume down–you don’t have to completely mask your tinnitus. Just partially masking it is all you need. Also, don’t wear the headset once the music turns off–you don’t want to block sound, you need to let the sounds through so you don’t develop hyperacusis where your brain turns the internal volume up so it can hear through the blocked earphones.
Cordially,
Neil
Ive suffered with tinnitus for 3 years. I’m ok with dealing with it now. If I have to listen to music in the background of a shop not loud just normal for 4 hours would this make my tinnitus worse. While I’m in the shop is it best to take my hearing aids out. The music isn’t loud just in the back ground
Hi Jackie:
If the music is just background music and is not loud, and is not bothering you, and is not making your tinnitus worse, that should be fine. No need to take your hearing aids out. Enjoy the music.
Cordially,
Neil
I have had tinnitus for 5 months, and I have found that the only way to get to sleep is by wearing my earphones whilst I sleep. This has really helped my tinnitus as I play relaxing tones all night long at really low volumes. However, I am worried that listening to music all night long in my earphones despite the low volume could cause hearing loss ?
Hi Kieran:
You are doing the right thing–playing relaxing music to let you get to sleep. Some people use a fan, but I think music is nicer. Do what works for you.
If the sound volume is really low–softer than you would normally hear people talking–you won’t hurt your hearing, even though it is all night long.
Personally, I wouldn’t wear earphones/headphones/earbuds as they can be very uncomfortable to lay on. It would be better to listen via a loudspeaker set on the bedtable or headboard if you are alone. If you have a roommate, then perhaps a pillow speaker would be better.
Cordially,
Neil
Im new to tinnitus
Ive only got it for 3 days
I played a rain sound on my earphones and slept on it for hours and i woke up to the constant ringing i cant shake off im scared
Hi Yoohan:
What caused your tinnitus, do you know? Let’s see if I undestand–you wore earphones playing rain sounds and woke up with tinnitus? Why would you do that if you didn’t have tinnitus already?
Cordially,
Neil
Hello Dr.
I’ve had tinnitus for about 2 years now. I’ve probably had it a little longer, and didnt realize it. It’s really loud in my right ear and manageable in my left. Sometimes when I turn my head a certain way my tinnitus gets worse until I look forward again. It doesnt sound like the super loud ring from temporary tinnitus, it almost sounds like blood rushing through my ears. Although in my right ear I can hear the “bad ring” very faintly. If I listen to music in my earbuds will the “bad ring” get worse? Sorry if that is a weird way to explain it, I call the “bad ring” the type of ringing you hear when you get temporary tinnitus from a concert.
Hi Tori:
Tinnitus typically gets worse when you listen to sound at levels too loud for your ears. Typically you are damaging your inner ears and tinnitus is one way your body tells you that you are doing that.
Wearing earphones/earbuds does not of itself cause tinnitus or make it worse. It is the volume that is the culprit. If you listen to music at the same level you hear people talking, you should never damage your ears from listening to music. But today, most people seem to think you have to listen to music very loudly–and this just leads to more ear damage and more tinnitus. Tone it down and you should be ok. If your tinnitus gets louder, then you know you still have the volume much too high.
Cordially,
Nei
Hello Dr Bauman – wondering if you could help here – – for a week now i have had a high pitched tone in one ear. i am a musician and have been listening to my headphones more than usual – 2 – 3 hours a day – while quarantined in Berlin – – although it is just piano music and at low volume (i know that ‘low’ is subjective but it is my estimation that it is low volume!). I do need to finish a music project but am wondering if this is the cause. Am ‘hoping’ the Corona and my general a-socialness is the cause due to stress… thanks for taking the time to read this. keith
Hi Keith:
To me low volume would be a bit softer than the level at which you hear people talking. Is that what you call “low”?
Is there any other reason for the tinnitus, such as drugs/medications, hearing loss, etc.?
Does your tinnitus vary at all, or is it the same volume and pitch 24/7?
Cordially,
Neil
Hey doctor thank you for your all answers to people that are even not your patients.
I am suffering from tinni. for 7 months and today I am at a vacation which has “loud noised- places” in it. I almost everytime closed my ears with my hands/with a naphkin/ with earplugs and almost everytime stayed away from the music source. I rarely closed to them but I closed my ears ext. carefully in those moments. I still had seconds that I exposed to quiet high noises. Does this behaviour will worsen my tinnitus or my acts were enough to protect my ear? Thank you so much.
Hi Bahadir:
I don’t have ANY patients. Remember, I’m not a medical doctor.
You get tinnitus in one of two ways due to noise exposure. First, is exposing your ears to a very loud sound–even if it only lasts a few milliseconds–such as an explosion or gunshot or equivalent. Second, from loud noise exposure over time.
Thus, the longer you expose your ears to loud sounds, the greater the risk of developing tinnitus. This means that unless the music is dangerously loud, and you only expose your ears for a second or two at a time while you try to plug your ears, it is unlikely to cause permanent tinnitus.
You always want to either keep a good distance from loud music, or wear properly-fitted ear protectors.
Cordially,
Neil
Hi Neil!!!
6 months ago I was diagnosed with moderate hearing loss on my left ear. On my right ear no loss but 20db at 6khz tinnitus. I got it or realized I have it when my dog kept barking very loud and very close to me at a neighbor. I was in a house corner and the sound kind of echoed giving me the tinnitus that’s here to stay, had it on both ears the left one disappeared before I went to an audiologist. Anyway, I love music and been hearing it at lower volumes 50-65 tops for not more than an hour then I take a break not shorter than 10 min. And sometimes keep listening since it’s difficult in this quarantine/lockdown….. I’ve been hearing speakers and headphones… I even think it helps and doesn’t hurt. Just wanted to see if this doesn’t harm me more or it’s going to be dangerous for my ears in the future.
Thanks for answering to all of us!!!! =)
Hi to everyone that is also suffering with this….
Hi Eugenio:
Listening to music at a low level for extended times should be perfectly ok if you keep the music to the level you normally hear people talking or less. I’d say what you are doing now shouldn’t cause you any hearing problems in the future.
Cordially,
Neil
Thank you very much!!!! This help means a lot to me and I know also to a lot of people that reads it while still afraid of tinnitus. Thanks again
Hello Neil. I have a strange story to tell. My tinnitus spikes even at 40dbA while using headphones/headsets when there is a sudden shift in tonality. For example 1) when starting up a conversation using headset 2) beginning of a new song with a trumpet-like instrument 3) activating a EQ setting which changes tonality suddenly (with no change in volume – no preamp or anything). In all cases, the volume was low but there was this sudden shift in tonality. Have you ever heard a case like mine, and do you have any theory as to which part of my inner ear is broken ? (Hair cells vs glutamate receptors?) I developed tinnitus after listening to 12+ hours daily of quiet music (60dbA) for 3 months, so my damage area might be different, I am not sure. But ever since I had tinnitus, this strange trigger pattern of spikes confounds me. I never get spikes from loudspeakers at moderate volume or my baby son screaming next to me (although it annoys me – I have a mild/moderate H). All these data points taken together, would you have any thoughts as to what is going on with my inner ear , or what makes headphones so unique ? Thanks!
Hi Dazed:
I think that along with your tinnitus, you have a bit of loudness hyperacusis. One of the characteristics of hyperacusis is that you cannot stand sudden shifts in volume (or in your case tone) like you can with normal ears. Furthermore, loudness hyperacusis can cause distorted hearing which is another way of describing your strange hearing phenomenon.
Typically loudness hyperacusis develops from exposing your ears to excessively loud sounds–like your son screaming in your ear for example. When you wear earphones/ear buds, the sound is trapped in your ear canals so can produce a stronger sound signal than otherwise.
Cordially,
Neil
Thank you so much Neal for your reply ! Everything you said makes sense to me. After posting my question to you above, I kept digging into this further. It turns out that I also have “reactive” tinnitus whose description really matches my experience. During a listening session with headphones, my tinnitus gets louder gradually (regardless of spikes occurring or not). Same happens while I am shopping at crowded Costco. When I am in a quiet place, the elevated tinnitus calms down to baseline within an hour or two. And I learned that this reactive tinnitus goes hand in hand with hyperacusis. Well, all these make sense in hindsight! 🙂
Hi Dazed:
As you now know, reactive tinnitus is a combination of tinnitus and hyperacusis.
And as you also probably now know, you have the “winding up” form of reactive tinnitus.
Cordially,
Neil
Hello Neil, I hope you are doing well!
I am a music lover. In an effort to minimize tinnitus, would it be helpful to boost bass and reduce treble, while keeping the volume the same (at low volume)? There is a group of people who say treble is more damaging to ears, and then there is another group who says opposite – that bass carries more energy, thus more harmful. After all, bass DOES boost sound pressure quite a lot when Z weighting is used to measure the sound. Since hearing loss seems greatest at 4khz, no matter what kind of noise caused it, it makes me wonder if the bass energy would still bend and destroy high frequency cells just as much as (or more than) high frequency noise would, without realizing it (since we are not bothered by bass as much)?
Hi Music Lover:
You raise some interesting points.
It is true that lower frequency sounds carry more sound energy than do higher frequency sounds. However, your ears do not hear all frequencies of sound at the same level. For example, your ears do not hear very low frequencies as well as they do higher frequencies. Your ears are actually tuned to hear the voice frequencies the best.
Thus you would not hear a low frequency tone at a given low volume, yet you would hear a higher-frequency tone at that same volume.
It is also true that loud noise seems to cause a hearing loss at 4 kHz–the so-called “noise notch”. This is true for noise damage, but not for other causes of hearing loss. For example, hearing loss from taking drugs typically begins at the highest frequency you can hear and progressively works its way down the frequency spectrum so ultimately you only hear low-frequency sounds.
Also, be aware that your cochlea is set up such that the hair cells for decoding the high frequency sounds are at the base and the low frequency sounds are decoded at the apex. Thus, since the oval window, upon which the stirrup bone “raps”, delivers all the energy to these high-frequency-responding hair cells first–you might say that the absorb the brunt of the sound energy and thus may be damaged first.
Now to put this in practical terms for your tinnitus. Typically tinnitus is just above or below the frequency of your greatest hearing loss. So if you have a high-frequency loss, you’d expect to have high-frequency tinnitus, and vice versa. (Note, this is just a rule of thumb, but it is not always the case. For example, my tinnitus is a very high pitch, yet I have my greatest loss down around 500 to 2000 Hz, so I don’t fit the pattern.
I don’t think it matters a whole lot whether your tinnitus is low, medium or high frequency sounds, if you are listening to your music at a low level so no peaks exceed 70 dB or so, no frequency of sound should bother your tinnitus.
However, if you also have loudness hyperacusis, then that’s an entirely different story.
Cordially,
Neil
Dear Mr. Bauman, thank you for having this website and for replying to all these comments from readers.
I got tinnitus after a performance where the monitor volume (I play guitar) was way too loud. At that time I never heard of tinnitus and wasn’t using hearing protection. That was about 2 years ago and it hasn’t gotten better or much worse since then. What I “hear” is a pretty high pitched sound; not exactly sure what the frequency would be. My ears were measured and I have this “notch” of a few dB at around 4k.
Anyway, I experience that my tinnitus gets worse for some time (several minutes to several hours) if I’ve been wearing headphones (in-ears to be precise) or used my headset for work. To my ears the volume is safe, but of course I don’t know the exact loudness level.
For music I listen using in-ears again at (what I think is) a low level; when performing I use custom made earplugs now…. if only I knew 2 years ago what I know now.
Anyway, question is if there’s a way to tell if my headset/ in-ears are playing too loud? Any thoughts on that? I don’t want any further damage to my ears and manage to live with the tinnitus as I have it right now; but I don’t want it to get worse of course.
Hi GuitarPlayer:
Your tinnitus is a high-pitched sound because you have damaged your high-frequency hearing.
You have the classic “noise notch” at 4 kHz which indicates that you have exposed your ears to excessive volumes of sound in the past.
Safe volumes are the same volumes at which you hear people speaking. So if your music is louder than that, turn the volume down until it matches the average speech volume. That’s a good rule of thumb to follow.
If you are used to loud music, turning it down to what you think is safe is very subjective–and is probably still too high. It’s much the same as flying down the freeway at 70 mph for awhile, then I tell you WITHOUT looking at your speedometer, to slow down to 30 mph and tell me when you think you are doing 30. I’ll bet you’re doing 45 or more. It just seems so slow.
That’s why you need an objective way of measuring the sound your ears are absorbing–and comparing the music level to normal unamplified speech is a good way without needing any equipment.
When your tinnitus gets louder when you listen to your music via headphones/earbuds, you know you are listening to it too loud. Turn the level down until it doesn’t affect your tinnitus.
You may also have some degree of loudness hyperacusis, and thus may have reactive tinnitus from what you say.
Cordially,
Neil
Thank you very much for your detailed reply !!
And indeed, if our drummer starts while I’m still setting up my gear not yet wearing my plugs then it hurts and I instinctively cover my ears with my hands and get out of the room.
I’ll focus more on the volume thing; “problem” is that the Tinnitus is almost inaudible when listening to music; It comes back when turning of the sound…… anyway, good advice, very very much appreciated !!
Hi Neil,
This page has been a brilliant source of information for me, where many questions I thought to scour the internet for were all answered in one place – many thanks.
Just wanted to get your opinion on my situation, if you have the time; I’m 22 with constant Tinnitus (it’s louder in my left ear but present in both) which doesn’t change much aside from spikes. Although you’ve mentioned that we shouldn’t experience loud spikes at low listening levels [I stick to around 50db] mine will happen quite quickly (within 30 minutes) when I listen to/produce music at these volumes without earplug protection. I also experience some sensitivity when my T gets worse, with even typing this out on my keyboard causing my ears to rumble and the “spike” to persist.
Do you know why these low volumes bother my Tinnitus? I saw you mention Loudness Hypercausis but Dazed above seems unfazed by constant loud noises – where my T can be triggered by any loud sound. I was also wondering whether you know if any further damage will be done to my ears by continuing to work on my music at low db despite the spike and accompanying sensitivity?
Thank you for this great content,
Quinn
Hi Quinn:
I’d say you have significant loudness hyperacusis and that is what is causing your tinnitus to get louder with louder sounds. When your tinnitus interacts with your hyperacusis, that is called reactive tinnitus.
Typically, you initially get loudness hyperacusis in the first place by exposing your ears to excessively loud sounds. And then any negative emotions towards it make things worse.
You can also get it from wearing ear protectors when you don’t really need them. So you can get it both ways–too loud of sounds, or not enough softer sounds. Thus, you have to walk a fine line between the two.
In order to get things back to normal, you need to treat the hyperacusis as the primary condition and the tinnitus secondarily. This means that when using any kind of sound therapy, you need to set the volume low enough that it does not bother your hyperacusis, or make your tinnitus react. Then over time you slowly increase the background broadband sound just a smidgen and let your ears/brain get used to it. Then slowly increase it.
You treat tinnitus the same, but typically you’d use louder broadband sound–which would be too loud for your hyperacusis at the beginning. That is why you start with softer sounds for your hyperacusis, and later when your ears can stand it, then the sounds become loud enough to also treat your tinnitus.
You need to protect your ears from louder sounds for a couple of months or more until your hyperacusis is under control.
Cordially,
Neil
Evening Neil,
Thank you very much for your response, I hadn’t expected a reply so quickly.
I immediately went to research reactive tinnitus and it took me a moment to realise that the article I was reading was also by yourself! I hadn’t even considered that constantly-fluctuating tinnitus wasn’t the usual experience, and so understanding that very likely have reactive tinnitus has shifted my thought process entirely. From what I’ve read in your article, my experience is very similar to many of those comments/excerpts you’d included – though perhaps to a lesser intensity than many are going through. I’ll certainly start on the Sound Therapy from now!
So as not to cause any further damage, do you have a moment to give a quick response on the below couple questions?
1) In the case that my tinnitus spikes, should I take a complete break from listening to sounds that trigger the reaction or am I able to continue in a low-noise environment without causing further, lasting, damage?
2) Is it okay to compose music at louder decibel levels but with earplugs, dampening the sound – leaving it still audible enough to compose by (say, listening to a piano through earplugs.) In theory, it shouldn’t really help all that much but I believe the hi-fi earplugs block out some of the higher “resonant” frequencies that the instruments produce. Do you think this approach will have the same negative effect as isolating environmental sound?
3) Unfortunately my voice actually triggers my tinnitus as well! Do you know of anything that can attenuate the sound of my voice/perhaps a different speaking technique?
One final question, does your book now contain some content surrounding reactive tinnitus? I’d read that there was an update coming soon, but I’ll pick it up regardless.
Thank you Neil
Hi Quinn:
To answer your questions.
1. Some people find that a complete rest from the trigger sounds is the way to go while their ears “heal”. But it may not be practical or necessary. Keeping these sounds below the level where they trigger your reactive tinnitus is not going to damage your ears.
Actually, there is not “physical” damage. Think of it more as the auditory processing mechanism is out of balance. Once you brain rebalances things, then you get back to normal.
2. The key to understanding this is that it is the sounds reaching your inner ears that is the limiting factor. So if musicians ear plugs (or any ear plugs for that matter) keep the volume of the offending sounds below your trigger point, then all should be well.
3. Your voice reaches your ears by both air conduction and bone conduction. So the only way I see it is to speak softer. You have to talk, so don’t cut out talking–just keep the volume down–but yet loud enough others can hear you.
4. Depends which book you are talking about. If you are meaning my book “Hypersensitive to Sound”, yes, that book is available now and explains all 7 kinds of hyperacusis and their interactions and what you can do about them. There is a chapter on reactive tinnitus too–much the same as the article you have read as I used it as the basis for that chapter.
I’m also working on the next edition (8th) of my tinnitus book which will also have that chapter on reactive tinnitus, plus a lot of new information on tinnitus. I’m hoping to have that book out by the end of the year.
Cordially,
Neil
Hi Neil,
Fantastic – thank you very much for your help, I have already found that the sensitivity has decreased somewhat. I had been overprotective and assumed consistent earplug use was the best way forward, but reducing the time wearing them has made me realise how sensitive my hearing was becoming.
I’ve just picked up the “Hypersensitivity to Sound” book to gain a deeper understanding of how it all works & will carefully consider your above response in how I go about treating it.
Thanks again!
Quinn
Hi, Dr. Bauman.
Apologies for the long note.
In your Blog ‘Low-Level Music and Tinnitus’ you stated,
“…The average [music] sound level should be no more than the same level as people talking—namely in the range of 50 to 70 dB or so. If you keep what you are listening to in that range, I doubt that it will negatively affect your tinnitus. However, some people have “weird” hearing/tinnitus, and their tinnitus is sensitive to lower-level sounds. If this is your situation, turn the volume down until it doesn’t bother your tinnitus.
I believe I have “‘weird’ hearing/tinnitus” that rapidly developed in mid-October 2021, but I would like your opinion on that, please. I am also interested to know whether any of your books address this condition.
My hearing is ‘OK’ for my age (61). I tested late end of October 2021)–I have moderate to normal sensorineural hearing loss (rolls off above 2-3K), excellent word recognition, and normal tympanometry.
I’ve had tinnitus in my right ear for 15 years (since age 45, or so). Until 2 months ago, I was able to ignore it because the ‘ringing’ was almost imperceptible to me (i.e., 0.5/10 or 1/10). In mid-October 2021, I noticed that when listening to my stereo via speakers at moderate volume, e.g., 50-60db (measured via a sound level meter from my sitting position across my living room) for a period of 30 minutes or so, my tinnitus began to ring more loudly than ever (2/10 to 3/10). Then I noticed the TV did the same thing at similar volumes (via TV speakers or surround sound). In fact, all stereos and TVs had the same effect. When I first noticed this, if I turned off the stereo or TV, the ringing would subside to my original ‘baseline’ level in a few hours. At first, it was difficult for me to believe that such moderate level sounds could exacerbate my tinnitus. So, I experimented, e.g., changing speakers, amplifiers, etc., thinking that it was something about the equipment or maybe room acoustics. All configurations had the same effect. And, after a week or so, it seemed that a 2/10 level was about a low as my ringing would go.
At the end of October, I attended a weekend getaway with several friends, and the conversation was very loud. Even though I was wearing noise canceling headphones (Sony XM4) set at full noise cancellation, the ringing in my ears became ‘louder’ than I had ever experienced, e.g., 6/10–I left the gathering early, after 24 hours. The ‘louder’ ringing did not subside for days, but since then it ranges from 2/10 to 6/10.
Currently, with stereo (speakers or headphones) or TV, I can turn the volume down very low (below the detection limit of my sound level meter: <45db), e.g., where I can just fully understand the TV dialog, and my tinnitus will become exacerbated after 10-15 minutes of exposure. In the old days, I would set TV volume between 50-60 dB. Now, I can set it to where my wife can just hear it (45dB), *and* at the same time I wear Sony XM4 or Bose NC 700 headphones with the full noise cancellation setting, and that TV soundtrack will exacerbate my tinnitus. If I am alone and the room is very quiet, I can set the TV volume to where I can mostly make out the speech, but still need to rely on subtitles (e.g., TV volume setting 8 out of 100, not sure of dB, but very low) and that *may not* exacerbate my tinnitus. For music, a volume level that may not exacerbate my tinnitus would be so low that I would not be able to hear the content sufficiently to enjoy it. Once my tinnitus is exacerbated, the ringing in my ears does not subside for several days if it subsides at all. I.e., 10-15 minutes of exposure to sub-50db sound can result in an exacerbation that last for days (or is permanent; this still is all somewhat new to me).
Other notes.
. my right ear was exposed (unprotected) to the sound of a single gunshot in my 20s. I never did listen to a lot of loud music, go to a lot of concerts, or go clubbing. Some, but not a lot. Occupationally, I mostly had office jobs.
. I had a tooth extraction of #3 (upper right molar) in late August 2021 that resulted in a perforation between my oral and nasal cavities. The perforation seemed fully healed within 3 weeks, or so. I am noting this because of possible associated head trauma.
. I used to wonder whether I had tinnitus in my left ear. Now I know that I do although my right ear is much louder. Volume and tone do change. Right ear tinnitus can be monotone or polytone.
. Car noise as the driver or passenger is a problem for me, even on surface streets. I need to wear ear protection.
. Forced air heater system in my home is a problem. Noise level is 55dB in the room with the air intake. I can't sit in that room while furnace is blowing, even when wearing noise canceling headphones.
. If I speak a little louder than a soft voice, my own voice can vibrate my right ear canal, eardrum, and/or internal mechanisms (I'm not sure, but I physically feel the vibration), which can exacerbate my tinnitus. I am not sure whether the vibration phenomenon is new to me, but the fact that my tinnitus is exacerbated by it is new.
. Conversations at 50-60dB are no problem for me indoors or out (whereas TV or stereo, earbuds at the same level, or even lower, are a problem). Louder conversations (60+ can be a problem). Of course, louder people in enclosed spaces is especially a problem.
. I fare better outside than indoors. Hiking in nature or talking with a neighbor on mostly a quiet sidewalk is no problem.
. Clangy and crunchy sounds are subjectively more annoying to me than they used to be, but those sounds tend to be very short lived and (perhaps for that reason) don't seem to exacerbate my tinnitus. E.g., I go to the grocery store without wearing ear protection (unless piped music is obtrusive)–any louder noises there tend not to be extremely loud and are short lived.
. Tinnitus masking will not work for me because the required volume levels would exacerbate my tinnitus. I wonder whether sound therapy, etc., is an option for the same reason.
. I am struggling to find an audio-rich environment that will not exacerbate my tinnitus.
Thanks in advance for any feedback you might have.
Steve
Hi Steve:
I can tell you what you have. You have loudness hyperacusis in addition to your tinnitus. It sounds like the hyperacusis causes your tinnitus to get louder. This is called reactive tinnitus. In addition, the fluttering feeling you have in your ears is called tonic tensor tympani syndrome (TTTS).
I explain all these conditions and solutions in my book, “Hypersensitive to Sound” which you can get at https://hearinglosshelp.com/shop/hypersensitive-to-sound/
I’m curious how all this began. You mention wearing noise-cancelling headphones. Wearing such headphones when not really needed can cause what you are experiencing. Some people wear ear protectors so they can get a good night’s sleep and over time develop tinnitus and hyperacusis as a result. You never want to unnecessarily wear ear protectors.
Are you on any medications and did you begin one or change a dose on one back when you first noticed these problems?
Tell me more about how you began wearing ear protectors and why, etc.
Also, are you particularly anxious or stressed? Again, very often either of these two conditions often go together with loudness hyperacusis. The more you tell me about how it all began can help me help you successfully deal with this.
Note that when you have both tinnitus and hyperacusis, you have to treat the hyperacusis first, NOT the tinnitus or you just make things worse.
Cordially,
Neil
Thank you, Niel for helping so many people to understand their tinnitus.
I have had tinnitus for some years. A general hissing constantly, and on and off ringing that lasts hours or even days.
Now I am dreaming of taking up flute after many years break.
Is this unnadvicable?
Can I play with earplugs?
Thank you again for your enormous help!
Hi Flutist:
I don’t see any reason not to pursue your dreams of playing the flute again. It’s not the sound itself that bothers tinnitus, but the volume of the sound.
You don’t say whether you are going to be playing in an orchestra or going solo or with a piano accompanying you.
In an orchestra type of setting, you need to protect your ears from the sounds of the other instruments. Therefore, you should wear ear protectors. You wan to get the special “musicians ear protectors” as they let you hear all pitches normally, whereas typical ear protectors cut out the low sounds more than the higher sounds so music doesn’t sound natural.
If you age going solo (or with a piano), whether you need musician’s ear protectors or not is up to your ears. If playing makes your tinnitus worse, get and wear musician’s ear protectors. But if not, and as long as your ears are “happy”, you probably don’t need to wear ear protectors. (It never hurts to err or the side of caution if you are unsure whether you should be wearing ear protectors in any given situation.)
Cordially,
Neil
Hi Neil,
If I read correctly I mave ended up with reactive tinnitus and loudness hyperacusis. I have lived with tinnitus since 2016 and got used it. It was so low that I went days without noticing it.
I am an avid music-listener and also play in a couple of bands. After a period a to much loud music and one unfortunate event my tinnitus and ears has started to act i new ways.
My tinnitus has become louder and react to music with high tones. My ears has started to become warm when i listen to music – and cold if I listen a bit longer. It is mostly my right ear which is also the one with tinnitus.
I wondering what my options are. Even if I play music that is so low that I cant hear when i do everyday activities my ears seem to react. Even if I turn volume down so that I can not hear the music in a sensibe way. How is possible to move forward/treat this?
Music has been important sinse childhood and I am quite worried that I might have lost something that is very dear to me.
Thank your for your help
Best regards
Claus
Hi Claus:
Your ears can only accept so much abuse with loud sounds before they “retaliate” and you end up with tinnitus and possibly hyperacusis of some sort.
It is common for loudness hyperacusis to kick in with higher frequency sounds as that is where you dynamic range is mostly affected.
I’ve heard of warm/hot ears before, but not them switching then to cold ears. That’s a new one on me.
Now, what can you do? First, you need to protect your ears from loud sounds. Don’t expose them to loud sounds, period.
For some people, a few months of quiet does the trick and lets their ears return to normal or near normal. For other people, they need constant background sound such as pink noise or fractal music or water sounds. What you do is set the sound level to just below where your hyperacusis begins to kick in and leave it there day and night. Then slowly begin to push the envelope–increase the sound in tiny increments every two weeks or a month or so as your ears are able to handle it. You keep on doing this and eventually–a few months to a couple of years–your ears will be able to tolerate normal sounds again. But be aware that they may never be able to tolerate loud sounds.
Thus, in noisy environments such as bars, discos, concerts, you’ll need to wear ear plugs.
Be aware that you’ll almost certainly experience setbacks from unexpected loud sounds. If this occurs, just start over again an the level where your hyperacusis begins to kick in and continue on from there.
Cordially,
Neil
Hi Neil, enjoy your book. Do you think listening to music on my ear buds on one side could heighten my tinnitus. I like to have one ear open so I can do other things and listen to music at the same time. I listen to music most of the day. I switch ears every few hours. Thanks Mike
Hi Mike:
Listening to music at a reasonable level (the same level as you hear people talking should not exacerbate your tinnitus any more than listening to a lecture via earbuds would. There should not be a problem. Now listening to louder music is another story. Is that how you developed tinnitus in the first place?
Normally you want to keep your ears balanced in what they hear–so changing side frequently would be a good idea. I’d change side every hour or less rather than going a few hours per side.
Cordially,
Neil
Is it physically possible that listening to music at low levels can cause permanent damage to the ears?
Personally I find it to be the case that I have the ‘weird’ tinnitus that gets worse when watching shows on my phone or computer speakers even at a truly low level. But then I can’t tell if the spike wears off or if just my anxiety decreases but the louder ringing remains onwards.
I want to know because if I can rest assured no permanent damage is caused it will decrease stress when this happens
Thank you
Hi Murray:
If by low levels of sound you mean sounds that never exceed 70 dB, then the answer is no. Such sounds do not cause physical damage to our ears, although it can feel like it could.
When your tinnitus acts up in unison with background sounds, you have a condition called reactive tinnitus which is basically tinnitus married to loudness hyperacusis. This is what I think you almost certainly have.
Also, note that reactive tinnitus, like both tinnitus and loudness hyperacusis, is a psychosomatic condition that gets worse when you are stressed and anxious about it. So calming down and getting your anxiety under control goes a long ways to eliminating these conditions.
Typically reactive tinnitus and loudness hyperacusis are the result of damaging your ears by exposing your ears to excessively loud sounds in the past.
Cordially,
Neil
Hi, Neil. As well as the others, I appreciate that you take the time to answer the doubt of your lectures. I must point out that I have been searching for days for information about what is happening to me, without having an appropriate answer. Because of your good knowledge, I trust that you can provide me with better guidance.
I must first say that I wish October last year I started with tinnitus in my left ear. Until today, I am not sure how it started, because I was not exposed to loud noises and I always listen to music at rational volumes. As the months passed, I began to notice that a sound was also emerging in my right ear, although of a different tonality.
So far, everything was fine. I mean, I had the “typical” tinnitus. During the day I did not perceive it and it was only present in silent environments or when night fell. However, since August 25th, I am dealing with something different, which I do not know if it is tinnitus, and I must admit that it is playing with my emotions.
You see, Neil, I think that now all things (even the most everyday ones, such as the shower, the television, the squeaking of chairs, even my own voice), produce a high-pitched sound like a beep, which makes me despair. Initially I thought it was the sound of the navera, the birds or the insects in my garden, but nothing like that. I soon discovered that it was my ears that for some reason are not processing things well.
I can affirm that I listen to everything “naturally”, because in the sites I have read it is said that hearing loss of high-pitched sounds causes the person to be unable to hear female and girls’ voices, which does not happen to me; or that I cannot perceive high-pitched sounds, and that is not my case either, since I not only listen to them, but it plays with my anxiety.
This is especially painful since that damn beep is present in everything. I can no longer listen or watch TV with peace of mind and this affects me quite a lot, because I was used to listening to music to mask the tinnitus. I do not know if what I am suffering from is tinnitus with hyperacusis, as you have said in other answers. I don’t have that certainty, because I dare say that the beep is parallel to the sound that accompanies it, so if for the sensory source, also for the beep.
To be honest, this is killing me. I sit in a ring, because I hear the beeping from when I get up to when I go to bed, and I can’t escape from it. I should also tell you that I feel a feeling of fullness in my ears, so I will go to the doctor to rule out some internal ear condition. In any case, what do you think might be happening to me?
Thank you very much in advance. Greetings from Colombia.
Hi Edward:
Back in October before your tinnitus began were you taking any drugs or medications? Many of them can cause tinnitus. Also, what was your emotional status back then? Tinnitus can also arise when you are particularly anxious or stressed. Those are two common causes of tinnitus that are not related to exposing your ears to loud sounds.
I think what has been happening, is that you are focusing on your faint tinnitus and the more you do that, the louder and more intrusive it becomes, so you focus on it even more. This becomes a vicious circle–you focus more on it, and it becomes worse and harder not to focus on, etc. Am I on target?
Now it has progressed to such an extent that it involves loudness hyperacusis as well. When the two “marry” you end up with reactive tinnitus. I’ve had people have “beeps” piggybacked onto the sounds they hear–much like you are experiencing.
Since both loudness hyperacusis and tinnitus are psychosomatic conditions–meaning they have both a physical component and a psychological component. Of the two, I consider the psychological component the more important one.
Thus you need to work on getting your anxiety levels down and as you do this, you will find the “beeps” should fade away. So you need to quit focusing on your ear problems and focus on the loves of your life and in the process ignore your ear problems. It is hard to do at first, but it really works. You can get rid of the “beeps”, but be aware that they can come back during times of greater stress and when you become more anxious. That is why it is so important to get your anxiety under control.
The above conditions are not necessarily related to any noticeable hearing loss.
The feeling of fullness can also be part of the above. I doubt your doctor will find anything wrong. This feeling of fullness should go away as you get your anxiety under control.
Cordially,
Neil