Tinnitus is a condition in which a person perceives a sound with no external source. Because of this, other people cannot hear it. Most describe the sound as a ringing, but it can also be a buzzing, roaring, or hissing noise. It may come and go or be constant and can vary in intensity. For some, it’s a mild annoyance, for others, it can deeply affect daily life.

What is tinnitus?

There are two types of tinnitus. Subjective tinnitus is the most common, where only the person experiencing it can hear the ringing sounds. In contrast, objective tinnitus is rare and can sometimes be heard by a doctor during an examination. This form is usually linked to physical issues such as problems with blood vessels, muscles, or bones in the ear.

One leading theory is that tinnitus is caused by damage to the tiny hair cells in the inner ear. These cells help convert sound vibrations into signals the brain can understand, and when they’re damaged by loud noise, aging, or injury, they can send incorrect signals to the brain, which may be interpreted as sound. Another theory suggests that the sound is generated in the brain, specifically in the auditory cortex. Abnormal activity or faulty communication between the auditory cortex and other parts of the brain may create the sensation of sound, even in the absence of actual noise.

Is there a relationship between tinnitus and hearing loss?

Tinnitus does not cause hearing loss. However, it is sometimes an early warning sign that hearing loss may be developing, especially when the inner ear has been damaged by noise exposure, aging, or other factors. Hearing loss may trigger tinnitus in some cases, as the brain attempts to compensate for the reduced input from the ears by creating phantom sounds. It’s important to note that not everyone with hearing loss experiences tinnitus, and not everyone with tinnitus will develop hearing loss. The connection lies in how the auditory system responds to damage.

What causes tinnitus?

Tinnitus often seems to appear without warning, but it usually has a root cause. While the exact cause isn’t always clear, researchers have identified several common triggers that can lead to tinnitus. Here are the most recognized causes:

• Loud noise exposure – Prolonged exposure to loud sounds, such as concerts, headphones, or industrial environments, can damage the tiny hair cells in the inner ear and lead to tinnitus.
  
  

• Age-related hearing loss – As people age, natural wear and tear on the inner ear can lead to hearing loss and trigger tinnitus.
  
  

• Earwax buildup – A blockage of earwax can change the pressure in the ear or irritate the eardrum, resulting in tinnitus.
  
  

• Ear infections or ear injuries – These can cause inflammation or damage to the structures of the ear, disrupting normal hearing and leading to the ringing or buzzing noises associated with tinnitus.
  
  

• Ototoxic medications – Some medicines, including certain antibiotics, cancer treatments, and high doses of aspirin, can damage parts of the inner ear and trigger tinnitus as a side effect.
  
  

• Health conditions – Issues such as high blood pressure, cardiovascular disease, diabetes, and temporomandibular joint (TMJ) disorders have also been linked to tinnitus in some individuals.
  
  

In some cases, no specific cause is found, but these are among the most recognized triggers.

Impacts of tinnitus and how to manage it

Tinnitus disrupts daily life. It interferes with sleep, affects concentration, and makes it difficult to focus on tasks. The constant internal noise can lead to mood changes, irritability, anxiety, and, in some cases, depression. Over time, it can impact relationships, work performance, and overall mental well-being.

While there is no cure, tinnitus can be managed effectively with the right strategies:

Sound therapy

Sound therapies are based partly on the view that tinnitus stems from changes in neural circuits in the brain brought on by hearing loss. Some evidence suggests that exposure to sound can reverse some of these neural changes and help silence tinnitus. Sound therapy may also work by masking the tinnitus sounds, helping you grow accustomed to them, or distracting you.

Sound generators are typically used as an aid for relaxation or sleep. Placed near your bed, you can program a generator or set a smartphone app to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. You may also use other sound generators, such as a radio or a household fan. If your tinnitus is mild, this might be what you need to help you fall asleep.

Hearing aids are one of the main treatment options for people with tinnitus who have hearing loss. They amplify external noises, allowing you to better engage with the world, while also making your tinnitus less noticeable. Modern hearing aids with Bluetooth can be coupled with apps that provide white noise that can stream the audio directly to your ears, giving you continuous access to therapeutic sounds throughout the day.