Beyond the Ringing: Understanding and Managing Tinnitus

That constant ringing in your ears isn’t just annoying it could be TINNITUS.  While it’s most often described as ringing, many patients also report hearing buzzing, hissing, clicking, swooshing, or humming even though no external sound is present.

Ringing in your ears is likely caused by inner ear damage that alters how your brain processes sound. Loud noise exposure at work or concerts, hearing loss, certain medications, ear infections, and head injuries can also lead to tinnitus.

For some, ringing in the ears is a minor annoyance that doesn't affect their day-to-day or that goes away with time. For others, constant tinnitus can make it difficult to sleep or lead to mood disorders like anxiety or depression.

The severity of tinnitus symptoms often fluctuates based on various factors:

• Quiet environments can make the sound more noticeable
• Stress and fatigue can increase the perception of sound
• Background noise can help mask the symptoms
• Sleep can be significantly affected

Causes of Tinnitus

Several factors can contribute to tinnitus, including:

• Exposure to loud noises
• Ear infections
• Earwax build-up
• Age-related hearing loss
• Certain medications
• Underlying health conditions

In some cases, the exact cause remains unknown. There's currently no cure for tinnitus, but there are ways to manage the symptoms

Management Strategies

While there's no universal cure for tinnitus, various approaches can help manage symptoms:

• Sound Therapy: Using background noise or "white noise" can mask the internal sounds of tinnitus, making them less noticeable. Devices like white noise machines or fans can be beneficial, especially at night.
• Cognitive Behavioral Therapy (CBT): Cognitive behavioural therapy (CBT) for tinnitus is a treatment that incorporates cognitive, behavioural, or a combination of components in a structured time-limited program, aiming to change the negative thought patterns and behaviours associated with tinnitus. CBT typically involves identifying and challenging negative thoughts related to tinnitus, developing relaxation techniques, and habituation to the tinnitus sound by distraction techniques. 
• Relaxation Techniques: Practices such as yoga, meditation, and deep breathing exercises can alleviate stress, which may exacerbate tinnitus symptoms.
• Hearing Aids: For those with hearing loss, hearing aids can amplify external sounds, making tinnitus less noticeable.
• Lifestyle Modifications: Maintaining a healthy diet, engaging in regular physical activity, and ensuring adequate sleep can positively impact tinnitus.

1. Caffeine Management: Having excess caffeine in your system might worsen tinnitus. While a morning cup of coffee is fine, excessive caffeine consumption can activate the brain's sound recognition centres and worsen symptoms. This is because caffeine stimulates the central nervous system, making it harder for your brain to filter out or ignore the tinnitus sounds.
2. Sodium Reduction: The inner ear is filled with fluid that comes from your bloodstream. High sodium intake can affect this fluid pressure, potentially impacting tinnitus symptoms. Just as excessive sodium can affect blood pressure throughout your body, it can also influence the delicate fluid balance in your inner ear. Try to maintain a moderate sodium intake by avoiding processed foods and using herbs and spices instead of salt to flavour your meals.
3. Stress Management: When stress levels are lower and you're well-rested, the brain is better able to suppress tinnitus sounds. This makes stress reduction techniques like meditation, regular exercise, and adequate sleep crucial components of tinnitus management. Consider incorporating relaxation practices such as deep breathing exercises, yoga, or mindfulness meditation into your daily routine, as these can help reduce the perception of tinnitus.
4. Physical Activity: Regular exercise helps reduce stress and improve blood circulation throughout your body, including to your ears. Aim for at least 30 minutes of moderate physical activity most days of the week. However, be mindful of extremely vigorous exercise or activities that strain your head and neck, as these might temporarily increase tinnitus symptoms in some people.
5. Sleep Routine: Good sleep habits are essential for managing tinnitus, as fatigue can make symptoms more noticeable. Create a consistent bedtime routine and ensure you're comfortable and quiet sleeping environment. Many people find that using a white noise machine or fan can help mask tinnitus symptoms during the night, making it easier to fall asleep.
6. Diet and Hydration: Beyond managing caffeine and sodium, maintaining good overall nutrition and staying well-hydrated can help minimize tinnitus symptoms. Some people report that certain foods or beverages can trigger or worsen their tinnitus. Keep a food diary to identify potential triggers, and ensure you drink enough water throughout the day to maintain proper hydration.

• Avoiding Ear Irritants: Protecting ears from loud noises and avoiding the use of cotton buds to remove earwax can prevent further irritation.

While tinnitus can be a challenging condition to live with, understanding its causes and management strategies can make a significant difference in daily life. The key is to seek proper medical evaluation and develop a comprehensive management plan that includes both medical interventions and lifestyle modifications.

Written by: Mohana, Audiologist