Tinnitus

Hearing sound with no external source. Around 7.6 million people in the UK, and the distress is treatable even when the sound is not.

What it is

Tinnitus is the perception of sound with no external source: ringing, buzzing, hissing, humming, sometimes a pulsing in time with the heartbeat.

Around 7.6 million people in the UK experience it. For most it is a background nuisance. For a substantial minority it is severely distressing, and the distress correlates poorly with how loud the sound actually is.

That gap is the key to treatment. The sound is generated by the brain's response to reduced input, usually from hearing loss. What makes it unbearable is the threat response attached to it, and that response is what therapy targets.

Being told nothing can be done is both wrong and one of the commonest experiences people report.

Signs you might notice

Ringing, buzzing or hissing, in one or both ears or in the head.

Worse in quiet, particularly at night and when trying to sleep.

Associated hearing loss, very frequently, even when the person has not noticed it.

Anxiety, low mood and difficulty concentrating, driven by the tinnitus rather than causing it.

Pulsatile tinnitus, in time with the heartbeat, or tinnitus in one ear only, needs medical assessment rather than reassurance.

How it can affect day-to-day life

Sleep is where it does most damage, and the resulting exhaustion amplifies everything.

The monitoring loop is the mechanism: the more attention paid to the sound, the louder it seems, and the more distressing it becomes, and the more attention it attracts.

Silence makes it worse, so the instinct to seek quiet is exactly wrong.

Supporting someone well

Get the hearing tested. Treating an unnoticed hearing loss with hearing aids often reduces tinnitus substantially, because it restores the input the brain was missing.

Use sound enrichment rather than silence: a fan, low music, a sound generator at night. Not loud enough to mask completely, just enough to reduce the contrast.

Ask for tinnitus retraining therapy or CBT for tinnitus, which have good evidence for reducing distress.

Reduce the monitoring. Checking whether it is still there keeps it foreground.

Protect hearing from further damage.

Never say nothing can be done. Something can always be done about the distress, even when the sound stays.

Where to get help

Ask a GP for audiology referral, or self-refer where available.

Tinnitus UK run a free helpline on 0800 018 0527.

Tinnitus in one ear only, pulsatile tinnitus, or tinnitus with sudden hearing loss, dizziness or facial weakness needs prompt medical assessment.