Frequently Asked Questions

FAQ's About Tinnitus

1. What is tinnitus?
2. How many people have tinnitus?
3. I have heard two different pronunciations. Which is correct?
   
4. What causes tinnitus?
5. Do children get tinnitus?
   
6. My neighbor has tinnitus but says it doesn't bother her. Mine drives me nuts. Why the difference?
7. Is tinnitus hereditary?

FAQ's About Tinnitus Prevention, Diagnosis, and Research

1. Can a one-time exposure to loud noise cause tinnitus?
2. Does tinnitus cause depression?
3. What is pulsatile tinnitus?
4. Can you tell me more about other kinds of hearing disorders?
5. Is there anything I can do to protect myself from tinnitus?
6. Can anything make tinnitus worse?
7. What kind of tinnitus research is being done?
8. What is the role of the ATA Scientific Advisory Committee?
9. Where can I find a health care professional to help me figure out the best treatment?

FAQ's About Tinnitus Treatments

1. Is there a cure for tinnitus?
2. What kinds of treatments are available?
3. Which treatment does the American Tinnitus Association recommend?
4. Does health insurance cover tinnitus treatments?
5. How do masking and sound generators help patients manage their tinnitus?
6. What is residual inhibition?
7. What kinds of drugs are available to treat tinnitus?
8. What kind of alternative treatments could I try?

FAQ's About ATA Resources

1. Where can I get help for tinnitus?
2. Your site says the ATA is a nonprofit. What does nonprofit mean?
3. Where else can I turn for answers?

If you find this information useful, consider joining ATA, and gaining access to our article archives and other member benefits!

Answers




What is tinnitus?
Tinnitus is the medical term for the perception of sound in one or both ears or in the head when no external sound is present. It is often referred to as "ringing in the ears," although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus can be intermittent or constant-with single or multiple tones-and its perceived volume can range from subtle to shattering.

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How many people have tinnitus?
The ATA estimates that over 50 million Americans experience tinnitus to some degree. Of these, about 12 million have severe enough tinnitus to seek medical attention. And about two million patients are so seriously debilitated that they cannot function on a "normal," day-to-day basis.

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I have heard two different pronunciations. Which is correct?
Tinnitus has two pronunciations: tin-NIGHT-us or TIN-it-us. Both are correct, though the American Tinnitus Association uses tin-NIGHT-us. The word comes from Latin and means "to tinkle or to ring like a bell."

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What causes tinnitus?
The exact physiological cause or causes of tinnitus are not known. There are, however, several likely sources, all of which are known to trigger or worsen tinnitus.

• Noise-induced hearing loss - Exposure to loud noises can damage and even destroy hair cells, called cilia, in the inner ear. Once damaged, these hair cells cannot be renewed or replaced. Hearing loss can also be caused by excessive noise exposure. Coincidentally, up to 90 percent of all tinnitus patients have some level of hearing loss.
• Wax build-up in the ear canal - The amount of wax ears produce varies by individual. Sometimes, people produce enough wax that their hearing can be compromised or their tinnitus can seem louder. If you produce a lot of earwax, speak to your physician about having excess wax removed manually-not with a cotton swab, but by an otolaryngologist (also called an ear, nose, and throat doctor).
• Certain medications - Some medications are ototoxic-that is, the medications are toxic to the ear. Other medications will produce tinnitus as a side effect without damaging the inner ear. Effects, which can depend on the dosage of the medication, can be temporary or permanent. Before taking any medication, make sure that your prescribing physician is aware of your tinnitus, and discuss alternative medications that may be available.
• Ear or sinus infections - Many people, including children, experience tinnitus along with an ear or sinus infection. Generally, the tinnitus will lessen and gradually go away once the infection is healed.
• Jaw misalignment - Some people have misaligned jaw joints or jaw muscles, which can not only induce tinnitus, but also affect cranial muscles and nerves and shock absorbers in the jaw joint. Many dentists specialize in this temporomandibular jaw misalignment and can provide assistance with treatment.
• Cardiovascular disease - Approximately 3 percent of tinnitus patients experience pulsatile tinnitus; people with pulsatile tinnitus typically hear a rhythmic pulsing, often in time with a heartbeat. Pulsatile tinnitus can indicate the presence of a vascular condition-where the blood flow through veins and arteries is compromised-like a heart murmur, hypertension, or hardening of the arteries.
• Certain types of tumors - Very rarely, people have a benign and slow-growing tumor on their auditory, vestibular, or facial nerves. These tumors can cause tinnitus, deafness, facial paralysis, and loss of balance.
• Head and neck trauma - Physical trauma to the head and neck can induce tinnitus. Other symptoms include headaches, vertigo, and memory loss.
• Certain disorders, such as hypo- or hyperthroidism, lyme disease, fibromyalgia, and throacic outlet syndrome, can have tinnitus as a symptom. When tinnitus is a symptom of another disorder, treating the disorder can help alleviate the tinnitus.

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Do children get tinnitus?
Tinnitus does not discriminate: people of all ages experience tinnitus. However, tinnitus is not a common complaint from children. Children with tinnitus are less likely than adults to report their experience, in part because children with tinnitus are statistically more likely to have been born with hearing loss. They may not notice or be bothered by their tinnitus because they have experienced it their entire lives.

Children, like people of all ages, can be at risk for tinnitus if they are exposed to loud noises. Recreational events like fairs or car races or sports games can all include high-decibels activities that can damage kids' ears. Hearing protection is always recommended, as is a discussion about the danger of loud noises and the choices kids have to turn it down or walk away.

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My neighbor has tinnitus but says it doesn't bother her. Mine drives me nuts. Why the difference?
Approximately 50 million Americans experience tinnitus, but not everyone experiences it to the same degree. Some people hear ringing or other noises in their ears immediately following exposure to excessive noise, like right after a concert, but the sound is temporary. Other people report hearing a slight noise all the time if they listen for it, but most of the time cannot distinguish the noise over all the other sounds in their environment. Other factors can affect the severity of the condition from patient to patient, such as different degrees of hearing loss and different kinds of noises heard. Interestingly, the loudness of the tinnitus, when measured in a laboratory setting, did not correlate to the severity of the tinnitus as rated by the patients themselves. Every person has his or her own level of tolerance to the tinnitus sounds. It is a very personal and individual experience.

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Is tinnitus hereditary?
There appears to be a predisposition based on heredity for some people when they are exposed to loud sounds, but whether or not tinnitus is genetically indicated is not certain. Scientists working on the Human Genome Project, for example, have not discovered a "tinnitus gene," but they have identified genes that are responsible for a few rare varieties of hearing loss, temporomandibular joint (TMJ) dysfunction, Ménière's Disease, and acoustic Neuroma. These conditions frequently include tinnitus as a side effect, which suggests that there might be a connection. For now, however, a connection between your mother's tinnitus and your tinnitus is still unknown.

We have recently funded a three-year study that is attempting to improve our understanding of a genetic component, if any. In 2002, Avril Holt, Ph.D., from the University of Michigan, received $200,000 from the American Tinnitus Association for "Differential Gene Expression in a Central Tinnitus Model." Her abstract states:

ABSTRACT: Tinnitus, the perception of sound in the absence of an acoustic stimulus, is a significant problem in the United States that affects more than one third of the population and is the most commonly referred otological problem. In light of recent studies implicating increased spontaneous activity in specific brain regions, testable hypotheses that address the underlying mechanisms of tinnitus can be posed. The studies proposed here will provide key insights into the mechanisms underlying central tinnitus and provide a basis for future studies to develop methods and interventions to prevent, treat, or cure central tinnitus.

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Can a one-time exposure to loud noise cause tinnitus?
Many people write to the American Tinnitus Association asking if a one-time exposure to loud noise experienced many years ago can cause tinnitus. Noise is damaging if you must shout to be heard, if your ears hurt, or if your hearing is lessened immediately following noise exposure. The noise exposure could occur just one time or over months or years. The level of noise can affect the degree of hearing loss. For example, sounds of 100 decibels experienced for more than 15 minutes can cause hearing loss. Sounds of 110 decibels experiences for more than a minute can cause hearing loss.

A one-time exposure to loud noise is not guaranteed to cause tinnitus or permanent hearing loss, since people's ears vary in sensitivity. It is also possible that the damage from noise exposure might not be noticeable for many years.

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Does tinnitus cause depression?
In some cases, yes. The chronic sound of tinnitus can cause difficulty with sleep, concentration, reading, interpersonal relationships, and other everyday activities – all of which can lead a person, especially one who is predisposed to it, towards a state of depression.

In a 2003 study on depression and tinnitus, researchers found that most people with tinnitus were neither depressed nor seriously bothered by their tinnitus. But the patients who were depressed were far more disabled by their tinnitus than the non-depressed patients. If depression is a problem for you, it would be wise to seek help from a mental health professional.

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What is pulsatile tinnitus?
Pulsatile tinnitus is a rhythmic, pulsing sound most often in time with the heartbeat. It can usually -– but not always -- be heard objectively through a stethoscope on the patient's neck or through a microphone placed inside the ear canal. While it is not a common form of tinnitus, it has some well-known causes: hypertension, a heart murmur, Eustachian tube disorder, a glomus tumor, an abnormality of a vein or artery, and others. Very often, this kind of tinnitus can be treated.

If you are experiencing pulsatile tinnitus, it is always a good idea have a medical examination.

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Can you tell me more about other kinds of hearing disorders?
Other hearing disorders are associated with tinnitus, including hearing loss, Ménière's disease, and hyperacusis.

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Is there anything I can do to protect myself from tinnitus?
First, protect your hearing. At work, make sure Occupational Safety & Health Administration (OSHA) regulations are met: hearing protection is required under OSHA for any job in which noise levels exceed 90 decibels over the course of an eight-hour workday. Many hearing specialists counsel that this sound level is too high, and for some people, 90 decibels is still too loud. Further, as noise levels increase, the recommended time of exposure decreases. OSHA mandates that workplaces with excessive noise levels must protect workers by implementing a continuing, effective hearing conservation program. In other words, wear your earplugs or earmuffs, limit the amount of time you spend in noisy environments, and follow hearing conservation guidelines established by your employer.

Recreational noise also has an impact on your hearing. The next time you are around a noise that bothers your ears—for example, a sporting event, concert, or while hunting—wear hearing protection, which can reduce noise levels 15 to 20 decibels. For extremely loud situations, earmuffs over earplugs might be necessary. Be aware of other activities or situations that include loud noises, like hair drying or lawn-mowing. Make it easy for yourself to protect your ears by hanging earmuffs over the lawn mower handle, or keeping ear plugs in the bathroom next to your hair dryer. Repeated exposure to loud noises can have a cumulative, damaging effect on your hearing.

If your physician prescribes you medications, be sure to ask if the prescribed medications are ototoxic, or harmful to the ears, or if the drugs are associated with tinnitus as a side effect. This information is easily obtained in the Physicians Desk Reference.

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Can anything make tinnitus worse?
Exposure to loud noises, as mentioned earlier, can have a negative effect on your hearing and exacerbate tinnitus. Be sure to protect yourself with earplugs, earmuffs, or by simply not taking part in noisy events.

Some medications can make tinnitus worse. Tell all of your physicians—not just your ear, nose, and throat doctor—about all prescription and over the counter medications you are currently taking or have recently taken.

Many people find that alcohol, nicotine, and caffeine can worsen their tinnitus, as can eating certain foods. Some people find that foods with a high sugar content or any amount of quinine (tonic water) make their tinnitus seem louder. Monitor how you respond to different stimuli, and find a healthy balance where you do not eliminate all the foods that you love, but also where you do not unnecessarily exacerbate your tinnitus.

Finally, stress and fatigue can affect your tinnitus. Make time to relax, and understand that life events can manifest themselves in your body in the form of increased tinnitus. Of course, this is easier said than done. Finding a good support network can help. ATA has a support network consisting of support groups and and help network volunteers who can help you learn coping skills.

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What kind of tinnitus research is being done?
Research funded by the American Tinnitus Association focuses on two main areas: mechanisms and management. "Tinnitus mechanisms" research explores what the condition is about, where it occurs, how it occurs—the who, what, where, when, and why questions. "Tinnitus management" research looks into treatments available, how well those treatments work, and how they compare to one another. The ATA attempts to find a balance between the two types of research. Read more about tinnitus research in the ATA Research section.

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What is the role of the ATA Scientific Advisory Committee?
The ATA Scientific Advisory Committee is a group of volunteer researchers and clinicians who review grant applications for tinnitus research funding. After their review, SAC members make recommendations to the ATA Board of Directors on which studies should be funded. Many SAC members are researchers, and several have applied for and received ATA grants, but they must excuse themselves from deliberations on their own submitted grants or on grants from their affiliated hospitals or universities because of conflict of interest.

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Where can I find a health care professional to help me figure out the best treatment?
ATA maintains a listing of health care professionals who self-report their interest in treating tinnitus patients. This listing is available online in our Members section. Or you can call or write to ATA headquarters for a copy. The listing is not exhaustive: there are no doubt many other physicians, audiologists, hearing instrument specialists, and other providers with an active interest in and awareness of tinnitus. If you know of a health professional not included in the listing who would be a good addition to this resource, please let an ATA staff member know. Staff members can also help you track down professionals in your area using other resources; please let us know how we can assist you.

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Is there a cure for tinnitus?
There is no cure, per se, for tinnitus in that there is no one magic pill that will make the millions of people with tinnitus no longer hear the noises in their ears and head. However, in some cases, tinnitus can be quieted. For example, some people have excessive earwax that blocks outside sound from coming in. When ear wax or any foreign object, such as a hair, touches the eardrum, tinnitus can be a result. By having a physician or audiologist remove the wax, the source of the tinnitus is also removed. Some people with severe hearing loss have found that a cochlear implant helps them hear the world around them, which in part makes the tinnitus in their heads much less noticeable. Neither of these examples is a hard and fast cure, but the examples do represent that relief is available and possible.

In the meantime, ATA enthusiastically supports tinnitus research with grants to researchers worldwide. ATA also advocates for increased federal funding of tinnitus and hearing research.

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What kinds of treatments are available?
There are many treatments for tinnitus. Please see the Tinnitus Treatment Options page. You will want to talk with your doctor, audiologist, or other healthcare professional to find the best treatment for you. Because tinnitus is so individual, treatments work differently for different people.

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Which treatment does the American Tinnitus Association recommend?
The American Tinnitus Association does not endorse or recommend any specific treatment strategy for tinnitus. Treatments, like causes of tinnitus, are varied, and what works for one does not work for all. Controlled clinical research is also limited, and so there are no data that state unequivocally that one treatment is better than all the rest. As a resource for patients, the ATA provides information on all available treatments and contact information for professionals, with the encouragement for patients to find a professional who will take the time to find the appropriate treatment for them.

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Does health insurance cover tinnitus treatments?
Health insurance rules can vary immensely by state. And private health insurance can be far different than public programs like Medicaid or Medicare. It is possible that initial visits to an ear, nose, and throat doctor or audiologist are covered by insurance, but it is also possible that many tinnitus treatments are not covered because they are considered experimental. Other treatments, like hearing aids, are not covered at all because they are expensive, and insurance companies don't have to cover them.

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How do masking and sound generators help patients manage their tinnitus?
Masking and sound generators are similar in many ways. Both treatments introduce sounds to tinnitus patients as part of their protocol.

Maskers are quite often a tinnitus management option because their goal is to provide immediate relief from the perception of tinnitus. Hearing aids, combination units and various types of sound-generating devices can all provide partial or total masking. Specifically, in-the-ear maskers emit sounds that partially or completely cover (override) tinnitus sounds. They are typically set to include a higher-frequency bandwidth of sound.

By emitting a quieter sound, sound generators allow a tinnitus sufferer to still hear their tinnitus. The intention is to help the patient habituate to their tinnitus by mixing it with the sound created by the sound generator. These devices are often used in combination with what is called directive counseling. The combination of the two approaches is to retrain the brain and help the patient habituate to the tinnitus signal so they no longer hear it. While masking generally provides immediate effectiveness, sound generators take longer to achieve significant, measurable relief – anywhere from several months to one, and sometimes two, years. See the treatments page for more information. You can also read more about this topic in the following articles: Why sound therapy works, Sound generating tinnitus devices (parts one, two, three and four), and Masking in the Millennium.

Please note: ATA members continue to find value in articles from past articles of Tinnitus Today.  For this reason, we make them available to the public when appropriate.  However, the article(s) may contain outdated product and contact information.  Please take note of the date listed on the article and keep this in mind.

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What is residual inhibition?
Residual inhibition is the temporary suppression of tinnitus after someone who uses a masker turns the masker off. Sometimes, someone may have a masker in, wear it for a little while, and then turn it off to find out that his tinnitus is either reduced or totally absent. The time period of this cessation of tinnitus after masking can vary from a few minutes to a few days. People who experience residual inhibition must have tinnitus that can be masked -- i.e., a masker must be a viable treatment for your tinnitus.

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What kinds of drugs are available to treat tinnitus?
There is no drug on the market designed specifically for tinnitus treatment. There are, however, several medications that have provided many tinnitus patients with relief. But they are not without their own caveats. For example, some medications that can help tinnitus are also habit forming and should only be used when under the care of a physician who understands tinnitus. The ATA has more information about various medications that can help, although ATA staff cannot recommend medications. The ATA also distributes a list -- compiled by the Physician's Desk Reference -- of medications that can cause tinnitus. This listing is available by calling the ATA at (800) 634-8978. We do not have copyright permission to make this listing available online.

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What kind of alternative treatments could I try?
Again, ATA does not recommend any specific treatment for tinnitus management. This is for you and your health care provider to determine. A general listing of alternative treatments is listed on the Tinnitus Treatments page. Many of these treatments are considered controversial because there is too little research on them showing overwhelmingly positive results. Furthermore, dietary supplement manufacturers are only required to demonstrate proof of safety, not proof of effectiveness, for their products to the U.S. Food and Drug Administration.

Still, some people with tinnitus report that these alternative therapies work.

If you have a question about a specific so-called alternative product, feel free to call an ATA staff member or call a naturopathic physician in your area for more information. Healthy skepticism is good for any product that purports to "cure" tinnitus—or any other ailment for that matter. But from another perspective, if something does not cause harm and may improve quality of life or overall well being, it may be something to discuss with your physician for you to try.

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Where can I get help for tinnitus?
If you have tinnitus, your first step is to see an otolaryngologist (also called an ear, nose, and throat doctor, or ENT). He or she will help you determine if your tinnitus is caused by a medical condition and if a medical treatment option is most appropriate. To find a physician near you, contact the American Tinnitus Association.

You may also want to see an audiologist, who can conduct hearing tests and prescribe non-medical treatments for your tinnitus, like masking or amplification. To find an audiologist near you, please contact ATA. Also, for suggestions on questions to ask a healthcare professional, click here.

For more help coping with your tinnitus, consider joining an ATA support group. Support groups are a wonderful resource for people with tinnitus and their family members, a place to share your experiences, ask your questions, and learning from others who have tinnitus. Many groups bring in outside speakers to discuss tinnitus treatments, coping skills, and success stories. Other groups have libraries of information available for borrowing and newsletters with helpful hints. Support groups incorporate compassionate support with meaningful suggestions to help you manage your tinnitus.

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Your site says the ATA is a nonprofit. What does nonprofit mean?
The American Tinnitus Association is a tax-exempt organization under guidelines established by the Internal Revenue Service. All money collected by the organization is used to further the ATA mission and goals, unlike a corporation, which pays out profits to its shareholders.

This also means that donations to the ATA are tax-deductible. The individuals who so generously give to the organization get to claim their donations on their year-end taxes. The ATA's budget comes from these individuals, from corporations who match employee gifts, and from foundations. Occasionally, the organization will host a special event, with donated goods and services, to help raise money.

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Where else can I turn for answers?
The American Tinnitus Association's friendly staff answers questions from 8:30 a.m. to 4:30 p.m. (Pacific time) Mondays through Fridays. Call (800) 634-8978. In addition, Dr. Jack Vernon, one of the nation's most knowledgeable tinnitus experts, answers patient questions on tinnitus. Contact Dr. Vernon on Fridays from 9 a.m. to noon and from 1 to 5 p.m. (Pacific Time) at (503) 494-2187.
Click here for additional resources.

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 If you found this information useful, consider joining ATA, and gaining access to our article archives and other member benefits!