Ringing in the ear: tinnitus and hearing loss

Many people with hearing loss also have tinnitus, commonly known as ringing in the ear. This phrase is misleading, however, because some people hear ringing while others hear whistles, chirping, or a combination of sounds. Regardless of the particular sound, the distinguishing feature is that it doesn't have an external cause. People with tinnitus hear sounds that people around them don't hear. This isn't to say that tinnitus isn't real—researchers at the National Institute on Deafness and Other Communication Disorders have detected changes in brain activity that occur with tinnitus.

Strategies that can help

Some people with hearing loss and tinnitus find that both problems improve after they get a hearing aid or have a cochlear implant. Others find that their tinnitus symptoms improve somewhat when they cut down on caffeine and alcohol, reduce the amount of fat in their diets, and quit smoking. The following techniques may also help reduce your tinnitus symptoms:

1. When you're in a quiet room, put on music or use a "white noise" machine. Background noise tends to drown out tinnitus sounds.
2. Use the "tinnitus masker" on your hearing aid. This is a separate feature that is embedded into most hearing aids that allows you to choose a sound to "mask" the tinnitus sound you are hearing. How effective they are varies from person to person, but they usually do provide some level of relief for most people. Depending on the hearing aid, sounds that you could choose from may include spa music, chimes, white noise, and more. You can choose the pitch and loudness of the sound to suit your needs, and you can choose to turn it on or off.
3. Tinnitus retraining therapy is an effective method for treating tinnitus, especially in people with tinnitus and oversensitive hearing. It is a lengthy, expensive process, and can take 18 to 24 months. It relies on the principle of habituation, which occurs when your brain is exposed to a background sound, such as white noise, for long periods of time. After a while, the brain starts to filter out that particular background noise. Retraining therapy involves listening to a tone that is similar to the tinnitus sound for hours at a time. Eventually, your brain ignores the tone along with the tinnitus sound.
4. Reduce stress by whatever methods work for you. Try mindfulness meditation, which helps you learn not to focus on irritations such as the sound of tinnitus. Also try yoga, visualization, or other relaxation techniques.
5. Consider biofeedback or hypnosis. Ask your doctor to recommend qualified practitioners.

For more advice on tinnitus and other hearing ailments, buy Hearing Loss: A guide to prevention and treatment, a Special Health Report from Harvard Medical School.

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