Ears ringing? Here’s why and what to do

Some describe it as a ringing, whooshing or hissing noise. For others, it sounds like static on a television, an electric zap or a chorus of crickets.

Regardless of how it presents, tinnitus — perceiving sounds that have no external source — is frustrating, and in some cases debilitating.

Tinnitus can disrupt sleep and interfere with your ability to concentrate. It’s also associated with mental health conditions, such as anxiety and depression.

While there is no cure for most cases of tinnitus, there are steps you can take to minimize your perception of the sound and improve your quality of life.

What causes tinnitus?

Tinnitus has several causes, and treating the underlying cause can help reduce the level of noise you’re hearing.

The most common cause of tinnitus is hearing loss — in fact, about 70 percent of people who have hearing loss will also have tinnitus, shares Eugene Spindler, AuD, CCC-A, an audiologist at MultiCare ENT, Allergy & Medical Aesthetics – Covington.

“The most likely cause of tinnitus-related hearing loss is that the brain notices when it’s not getting enough information from the ear, so it fills in those gaps by keeping itself active,” he says. “We sense this activity as a sound.”

Another common cause of tinnitus is temporomandibular joint (TMJ) disorders. This joint, which lies on each side of the head, connects your jaw to your skull and allows the jaw to move. If one or both of these joints become injured — sometimes due to excessive teeth grinding or clenching, for example — it can lead to tinnitus.

This is likely because the cortical homunculus, the part of the brain that processes activity from your facial and jaw muscles, overlaps with the auditory cortex, the part of the brain that processes sound.

“If your cortical homunculus detects more activity than normal from the jaw or facial muscles, it naturally recruits neurons from neighboring areas, like the auditory cortex, to help process this influx of information,” Spindler says. “This can lead to the perception of a sound even when there’s nothing there.”

Other causes of tinnitus:

• Medications
• Head or neck injuries
• Migraines
• Ear infections or wax buildup in the ear
• Exposure to loud noises such as gunfire (even a single incident)
• Blood vessel disorders
• Acoustic neuroma (benign tumor on the cranial nerve)

What to do if you have tinnitus

If you’re experiencing tinnitus, the first step is to visit your primary care doctor or other health care provider. They can assess for tinnitus causes like injuries, infections, medications or other underlying problems. Sometimes stopping medications or lowering the dose of a medication can reduce or eliminate tinnitus.

Your primary care provider may refer you to an ear, nose and throat specialist as well as an audiologist, like Spindler, to assess for hearing loss or other issues.

“We can start to lose the ability to hear high frequencies of sounds and not really be aware of it,” Spindler says. “If your hearing loss is significant enough to warrant hearing aids, these devices can help relieve tinnitus.”

If your provider suspects a TMJ disorder is causing tinnitus, they may recommend that you follow up with a dentist to get fitted for a mouth guard to wear at night. While a mouth guard or other TMJ treatments may not completely eliminate tinnitus, they can reduce the noise in addition to protecting your teeth.

How to manage tinnitus

For most people, tinnitus is not temporary, even when an underlying cause has been identified and treated, so learning effective coping strategies is important.

“It’s really about keeping tinnitus at a baseline level and regulating your reaction to it,” Spindler says. “The first step — often the hardest — is making the choice to let go and ignore the sound as much as possible.”

Here are tips to help you effectively manage tinnitus:

Stop nicotine use and monitor alcohol and caffeine consumption. These substances can affect your blood pressure, level of stress hormones and the chemicals in your body that regulate brain activity, potentially heightening tinnitus sensations. Those who smoke or drink alcohol have an increased risk of developing tinnitus — find tips and resources for quitting tobacco.

Mask the sound. Spindler recommends maintaining a soft level of sound in your environment during the day, such as soothing music played at a low volume. At night, try sleeping with a fan on or some other source of continuous white noise. These tactics can help distract your brain, minimizing your awareness of tinnitus symptoms.

There are many apps and devices that may help mask tinnitus or provide other forms of support. However, these products vary in both effectiveness and price. Spindler shares that the following products have been helpful for some patients: the ReSound Relief app (free), the Widex Tinnitus Management app (free), noise-blocking earbuds and the Neosensory Duo wristband.

Know your triggers and keep stress in check. Keep track of your tinnitus symptoms, noting what behaviors or situations make your tinnitus worse. For many people, stress intensifies tinnitus or makes it harder to ignore. Effectively managing stress through exercise, meditation or other methods can help keep tinnitus under control.