Expert advice: Top tips for coping with tinnitus

Tinnitus, or ringing in the ears, is a frustrating problem that affects one in seven Australians. In most cases tinnitus is temporary and occurs after being exposed to loud noise. But for others, the ringing noise is constant and long-running.

While you can do a lot to protect your ears, once the damage is done, there is no way to reverse it. However, tinnitus can be managed with the help of technology and lifestyle changes.

Hearing Australia audiologist Catherine Hart explains what tinnitus actually is, what causes ringing in the ears and tips for dealing with tinnitus.

Tinnitus explained

Tinnitus usually manifests as noises in your ears when no external sound is present. The sound is often described as a ringing or buzzing noise, Hart tells Starts at 60, although people report hearing other sounds too, including whooshing, whistling, humming, cicada sounds or pounding. “Occasionally tinnitus can even have a musical quality to it,” she adds.

The phantom noises caused by tinnitus can range from low to high and vary in frequency, and range from causing mild annoyance to making day-to-day life unbearable.

Hart says that tinnitus can come and go or may be present all the time, “especially when it’s quiet and other everyday sounds aren’t drowning out the tinnitus and making the tinnitus less noticeable”.

The causes and risk factors of tinnitus

Tinnitus mostly occurs when our brain is trying to compensate for some type of hearing loss and is usually a symptom of problems with the auditory system (your outer, middle and inner ears and the small, complex parts inside your head, including the cochlear), such as those caused by exposure to loud noises or middle-ear conditions.

Meanwhile, people who are exposed to loud sounds and noises, such as habitually listening to blaring music or working in a job that involves regular exposure to noisy equipment, may be at greater risk of tinnitus. Hart says sounds any louder than 85 decibels have the potential to damage our hearing. “A handy rule of thumb is that if you have to raise your voice to be heard, it’s time to use hearing protection,” she says.

Tinnitus can also be caused by something as simple as an excess of earwax, while some medical conditions and medications, such as high doses of aspirin or antibiotics, can trigger tinnitus. Significant stress can also make tinnitus worse for people who already have it, Hart adds.

Age is another tinnitus risk factor. Age-related hearing loss (ARHL), otherwise known as presbycusis, is the gradual deterioration of hearing due to age and initially affects the ability to hear high-pitched sounds, such as a phone ringing or a beeping microwave, and can progress to the inability to hear lower pitches as well.

“Our hearing starts to decline in the higher pitches as we age, so hearing loss and potentially tinnitus can become more of an issue for this reason,” Hart says. “Medications may also come into play here too as we age.”

Tinnitus is often associated with hearing problems but the condition does not cause hearing loss. “The hearing loss usually appears first, and of course not all people with hearing loss suffer from tinnitus,” she adds.

How to prevent tinnitus

If you don’t have tinnitus, there are measures you can take to try to prevent it developing. The most obvious way to prevent tinnitus is by avoiding exposure to loud noises.

Hart recommends wearing earplugs in noisy environments and playing personal listening devices at a safe volume. For example, setting the volume at below 50 per cent of the maximum on your device is safe for an unlimited amount of time, but if the volume is set at 70 per cent you only have approximately four hours of safe listening time.

“This jumps to only [one-and-a-half hours] of safe time by 80 per cent volume,” Hart says.

Coping with tinnitus

If you do have tinnitus, dietary changes, remaining physically active and keeping the brain stimulated can help manage the condition. Hart recommends introducing low-level, enjoyable or unobtrusive sounds to your environment, “such as music or an open window, which may help mask the tinnitus”. A version of this, called sound-enrichment therapy, involves using soothing music and sounds to help your brain ignore the ringing in your ears.

“There are also a number of apps designed especially for tinnitus and allow people to select from a variety of soundscapes and filtered music options to keep the brain busy and not so focused on the tinnitus.”

If your tinnitus is caused by hearing loss, an audiologist will fit a hearing aid and match the pitch the device to the tinnitus. This stops your auditory system straining to find a ‘signal’ – a strain that causes tinnitus to materialise.

“Hearing aids allow you to hear everyday sounds better and tend to make the tinnitus less noticeable,” Hart says. “Most people experience improvement with sound enrichment therapy, and hearing aids if required,” she explains.

It’s always best to talk to a health professional if you’re experiencing a persistent ringing or buzzing in your ear, however, to ensure that it is tinnitus and not another condition and to explore the options to alleviate the annoyance.