Tinnitus: what can help when it never gets quiet

The bass booms powerfully from the loudspeakers, the rock band’s screaming vocals are shrill, and if it weren’t for the rousing energy of the people around you, you’d almost be inclined to say it’s too loud. But you can’t say that at a concert, club or night at the bar.

The noisy building site might be annoying during the day and distract you from your work but you pay for it in the evening. It’s only when you’re lying in bed that you realise the buzzing and humming is still there and it almost hurts. Is that tinnitus?

Tinnitus: noises within come to stay

If you look it up the old-school way, the Cambridge Dictionary explains tinnitus as «a condition of the ear in which the person suffering from it hears noises such as ringing». But what actually is it?

Unlike after a concert, where the noises from your surroundings reverberate for a long time before disappearing again, the noises come from within with tinnitus. And they stay. If it’s only for a few weeks, then it’s referred to as acute tinnitus. However, it’s chronic if the tinnitus lasts longer than three months. And it’s not that rare: according to a report by the National Institute of Deafness and other Communication Disorders from May 2023, around 10 to 25 per cent of adults suffer from such symptoms. It becomes particularly problematic when the noise is so strong that the person affected is no longer able to concentrate on anything else.

What happens when you have tinnitus

From a purely auditory perspective, this is what happens in your ear when you have tinnitus; when sound waves hit the auricle, they travel from there through the ear canal to the middle and inner ear and cause the eardrum to vibrate. From there, the vibration continues via the ossicular chain into the cochlea where the fine hair cells are stimulated. These move and convert the sound waves into electrical signals – i.e. music, speech, sounds which are ultimately transmitted via the auditory cortex to the auditory nerve of the brain, where they’re interpreted. Make sense?

With tinnitus, loud noises or medication (more on this later) have damaged these fine hair cells in the cochlea. As a result, the circuits in the brain receive the electrical signals unexpectedly. The neurons are literally upside down, and by processing the incorrect information, give the illusion of sound or the sounds that occur with tinnitus: clicking, buzzing, humming, whistling, etc. Tinnitus therefore not only affects the ear, but the entire auditory pathway, including the brain.

Cause not entirely clear: what research says about volume and tinnitus

According to the WHO, continuous noise exposure of more than 65 dB during the day and 55 dB at night is harmful to human ears. The effects can be quite drastic and include sleep disorders and cardiovascular complaints to an increased risk of a heart attack up to 20 per cent.

In Switzerland, the Federal Office for the Environment FOEN (link in German) has therefore also put planning values (for the development of new buildings and noise-generating installations) of 50 dB (day) and 40 dB (night) in place for purely residential and respite areas. The alarm values are roughly at the same level as those of the WHO.

Excessively loud ambient noise from aeroplanes, trains, cars, construction sites or industrial plants is therefore a huge problem for our health, to say the least. Data from 2017 shows that within Europe, around 14 million people have suffered from permanent noise pollution from car traffic alone. This has resulted in around 3.7 million people with sleep problems and 33,600 with detectable cardiovascular disorders.

This much on noise pollution as the cause behind tinnitus. In addition to noise pollution, there are other causes for noises in your ears. Hearing loss or impaired hearing in old age, due to chronic illnesses, smoking and the normal decline in sensory abilities to name a few.

«Somatic sounds» are another possible cause. This is when the body’s own sounds can come to the fore. You probably know the feeling; when you cover your ears with earplugs and everything sounds muffled and suddenly you can hear your heartbeat.

Wrong medication or too high a dosage

Medication is also an area to consider. The perceived «wonder drugs» aspirin or ibuprofen can sometimes pose a risk of causing tinnitus. The same applies to antibiotics, cancer medication and antidepressants. Findings from Harvard show that tinnitus can disappear again when the drug is discontinued or the dose is reduced.

In rarer cases, however, a tumour, low blood pressure or chronic diseases such as diabetes, migraines or autoimmune diseases can also lead to tinnitus. If the noise persists and doesn’t improve over a longer period of time, you should definitely consult a doctor. CT scans or an MRI can help rule out whether there’s a tumour or blood vessel problems.

Effective and non-effective methods to alleviate symptoms

First and foremost, tinnitus can be very stressful for those affected. If the noise robs you of sleep and gets on your nerves, you can feel assured it’s not actually harmful to your ears. Although a chronic illness is currently incurable, there are methods and approaches that can help you deal with it better:

Counselling and cognitive behavioural therapy (CBT) for tinnitus

In the form of psychotherapy and counselling, many sufferers will initially try and manage chronic tinnitus by looking at it more positively. For example, by writing down their daily symptoms in a diary and talking through them. Cognitive behavioural therapy aims to improve quality of life by supporting patients towards a stronger mental health and changing their behaviours.

Sound therapy and hearing aids

A simple form of therapy with headphones and other devices (such as apps for smartphones) sounds promising. But studies currently suggest that music and sound therapies achieve little for tinnitus. On the other hand, the effectiveness of hearing aids is clear, especially for people with age-related tinnitus. People with hearing loss can wear hearing aids to help drown out the tinnitus or even mentally block it out.

• ###Mechanical therapy There are also manufacturers now who have come up with special devices to eliminate the noise and whistling caused by tinnitus. The ForgTin ear hook by the Austrian company Pansatori is one of them. As a CE-certified medical device, it’s designed to reduce disturbing noises by simulating pressure around the ear. It can be worn during the day and is also compatible with glasses and hearing aids. You can use the accompanying app to keep a tinnitus diary and document your progress, etc. So far, however, only limited study data available shows the positive efficacy, but it can vary greatly from person to person. At around 450 euros each, the price of such devices isn’t extremely high.

What you can do at home for acute tinnitus

Reduce stress: whether it’s yoga, relaxation, breathing exercises or a fundamentally calmer lifestyle. Reduce your workload if necessary too.

Be active: if the buzzing and whirring in your head doesn’t stop, one thing that helps – which seems obvious at first – is silence. That’s why it’s important to get outside when you have acute tinnitus, meet up with friends, go on walks and listen to the nature.

Concentration: learn to overhear. All you have to do is listen to classical music for 10 minutes a day. Turn the volume down to a minimum and focus on just one instrument. This will improve your ability to block out other noises.