Do you suffer from Tinnitus?

Please read below to understand the causes and what can help you!

 

“Tinnitus is the conscious expression of a sound that originates in an involuntary manner in the head of its owner, or may appear to him to do so” (McFadden,1982)

When first signs of Tinnitus appear, it can be very stressful. It can be even more stressful after a patient seeks helps and receives negative counselling such as ‘there’s nothing that can be done’ or ‘you’ll just have to live with it’. This type of response from a professional  can create more distress which is known to  increase Tinnitus both in terms of its volume and its duration.

So, why do we hear Tinnitus?

Firstly, Tinnitus can be a sign of underlying condition. In a small number of cases a hearing specialist such as a highly trained Audiologist or ENT consultant may be able to offer a direct treatment for Tinnitus. More usually Tinnitus counselling and clinical support is required. Additionally, neck pain, jaw and tooth ache can all be signs of where the tinnitus stems from, but remember that it is very rare for Tinnitus to be a sign of a more sinister condition. Special attention should be given to Tinnitus that is just heard on one side, sudden and accompanied by hearing loss or dizziness, or if it is a pulsating sound. Please seek referral to an ENT consultant via your GP if this is the case.

Most commonly, the source of the noise is an activity in the body which has always been present, this could be random firing of a nerve impulse or the pulse of blood through our veins. One mechanism for this is an acquired hearing loss. The brain attempts to compensate for the change in hearing by reducing the strength of its filters at the region of the hearing loss making us more likely to detect the small background signals in the body. What can change either slowly or more rapidly is the degree to which we are capable of filtering these sounds out. Tinnitus is sometimes said to be a ‘symptom of peripheral deafferentation’ because there is less externally generated active impulses travelling up the nerve of hearing to the brain, internal noises are being selectively heard instead and possibly amplified too.

Other reasons that cause tinnitus are changes in our levels of stress. We all aware of the physiological phenomena ‘fight or flight’ which helps us to deal with real life threats but is not so helpful in case of long-term stress. In the case of feeling threatened there are a lot of mechanisms involved like release of hormones such as adrenaline, changes in our blood flow towards the muscles, slowing of digestion and the speeding up of our heart and breathing rate. Additionally, the brain turns off all its filters for background signals, enabling us to detect and react to information which we may not normally be aware of, but which may aid survival. So when it comes to Tinnitus, not only can it enable us to detect the signal, or perceive it as louder, it can also lead to us having a more negative and fearful response to it. Tinnitus is a fear response. Our initial fears, worries and anxieties about the noise we’re hearing encourage the brain to monitor and focus on the signal and because of its internal nature and our apparent lack of control over it the brain does not get the opportunity to reappraise the threat over time and ‘habituate’ the signal as it normally would.

Our Tinnitus experts can advise you on effective correction of your hearing loss, relaxation strategies and techniques to reduce and eliminate the fear response over time.

Tinnitus and hearing aids

The latest guidance from the British Society of Audiology recognises the importance of what are termed ‘Combination Hearing Aids’ in providing a significant role in the treatment and rehabilitation of Tinnitus. Combination hearing aids can provide amplification for a hearing loss, if necessary, along with therapeutic sounds to directly treat the tinnitus using various strategies.

Modern digital hearing aids have several amazing features that can really help tailor the Tinnitus treatment for the individual. These include built in therapeutic sounds such as white, pink and speech noise, nature sound and so-called ‘Zen Tones’. As part of a guided treatment these can be used to reduce the impact of your Tinnitus and regain a sense of control over your experience. There are also specialised applications for smartphones that will connect directly with your hearing aids and deliver both pre-made and custom designed therapeutic sounds directly through your hearing aids.

If we think about Tinnitus like being a symptom of sensory deprivation or hearing loss (peripheral deafferentation) it becomes clear that the more you can correct this deprivation, the better the outcomes can be. 

Our audiologist can help to find the right hearing aid for your Tinnitus! 

Self-help for Tinnitus

Where are some steps which can help you to deal with Tinnitus and enjoy your life. Of course, there is no one cure, but there are some steps which you can take now! In the following paragraph there are exercises for changing your thoughts about Tinnitus, reducing or controlling your stress levels and reducing the impact of Tinnitus through the use of sound. It is important to understand that we are all different and different techniques work differently for each of us. We would suggest trying some of these exercises and find the ones that benefit you the most!

Breathing exercises

Mindfulness is a well-respected option for treating Tinnitus. It is used to calm our often over-active minds and bring us into the present to make space for us to attend to our tinnitus in a nurturing way. Please try to follow steps bellow:

• Sit in a non-stiff, comfortable straight-back posture either in a chair or on the floor.
• Try to put all thoughts of the past and future aside and focus on what’s going on right now. Start by listening to any sounds or noises and allow them to be there in a nonattentive way. 
• Now become aware of your breath, listen to it and feel it moving in and out of your body. Concentrate on your inbreath and outbreath. Just follow the sensation of air moving in and out.
• You will have thoughts but allow them to come and go, then come back to the breath and try to stay with it a little longer than last time. Thoughts are inevitable and it doesn’t mean you’re having a bad session. 
• Start with a couple of minutes twice a day and build it up slowly. We find 20 minutes twice a day can have a profound effect on your tinnitus and other aspects of your life.

Cognitive thinking exercise

These types of exercises are best to use after professional tinnitus assessment when you are likely reassured that your tinnitus isn’t related to anything threatening. 

Affirmations are short, simple statements, which are great to bring your subconscious thoughts to your conscious mind. Based on what you now think about the hearing system, you should understand how this process might have a positive benefit. You can do this exercise on its own or incorporate it into your meditation practice. You can follow the steps below:

• In a quiet room listen to your tinnitus and say to yourself any combination of the following statements that feels right for you: 

1) It’s my inner ear noises 

2) They’re perfectly safe 

3) Perfectly healthy 

4) They’ve always been there 

5) My brain is capable of filtering them out

• Do this once per day for ONLY 15-20 seconds or when you are particularly aware of your Tinnitus.
• Make sure that you are in a positive and relaxed state when using affirmations.

Control exercise

We can ‘trick’ the brain into thinking that your tinnitus is a non-threatening sound by mixing it up with other everyday sounds. You can choose any sound for this exercise, just bear in mind – it is important that you can still hear your Tinnitus in the background when you focus on the other sound. You can follow these steps:

• While engaged in another listening task such as watching television, listening to music or your tinnitus app, change your focus of attention between the sound and your tinnitus. 
• Notice the difference in the prominence of your tinnitus as your attention shifts from one to the other. 
• Repeat this task three or four times in one go, once per day.

Sound enrichment

Sound enrichment is used by most people who have bothersome tinnitus in some form. It provides both temporary relief and potentially long-term physiological changes to the hearing centres of the brain. It can be as simple as listening to music throughout the day or having a fan running at night. It can be professionally targeted using combination hearing aids.

You can follow these steps at home:

• Find a sound you feel is pleasant and not too distracting.
• Set the volume just below the level of your tinnitus because you can’t train your brain to get used to something that it can’t hear. 
• Use one of the many tinnitus apps with a speaker. 
• Any other neutral sound sources such as a fans or water features can be useful too. You can also use the sounds whilst doing other distracting activities or ones that require your attention.

Sleep hygiene method

Tiredness is a very important factor which encourages the ‘vicious cycle of Tinnitus’. A good nights rest is very important while managing your Tinnitus. If you are struggling to sleep, you can follow these steps:

• Only go to bed when you’re tired and ready for sleep, not when you think you should.
• Don’t do any other activities in bed (TV/Reading etc.).
• Get up at the same time every morning, regardless of how poor the night’s sleep has been.
• Get up and do a low-level activity if sleep doesn’t come after about half an hour. 
• Try to have a hot bath or hot drink just before going to bed.
•  Don’t have a snack or hot drink if you wake in the night.
• Don’t nap during the day.

These exercises are great start to manage your Tinnitus! It is always good idea to check up with our professional too. Our audiologist at Clearly Hearing can help to manage your Tinnitus. Please give us a call or book an initial consultation online and feel Tinnitus relief !

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