“Whose mobile’s going off?”

“Did you hear the doorbell ring?”

“Who on earth in here is whistling?”

Hardly uncommon questions – it’s likely something like this has escaped your lips at some point over time. What happens, though, if we hear these noises frequently? Or even constantly?

Tinnitus is a medical condition which describes the sensation of hearing sounds from inside the body with an absence of any external sound. The sounds can present themselves in different ways – many imagine that tinnitus is simply a ringing in the ears, but there are other ways it can manifest, including:

• Hissing
• Whistling
• Buzzing
• Sizzling
• Humming
• Grinding
• Whooshing

Many people try to find the source of the sound, without realising that it actually comes from within. Sounds can come and go, and be heard in different areas, such as the middle of the head, one ear or both, and it can be difficult to pinpoint where exactly you’re hearing the sound from.

What causes tinnitus?

The exact cause of tinnitus is still unknown, but it often happens along with some kind of loss in hearing. It is related to changes in the body of some sort – be they physical or mental. Tinnitus can be linked to inner ear damage, a build-up of wax in the ear, or an infection of the middle ear. As we age, we often experience loss in hearing, and some people develop tinnitus along with this. Occasionally, some people develop tinnitus which has no obvious connection to hearing, or the ear at all.

Who is affected by tinnitus?

Many people experience some form of tinnitus at some point in their lives, including children. However, the number of people who live with persistent tinnitus is much lower. It can affect people differently, and some find themselves not bothered by it at all, while for others, it can be incredibly problematic. Persistent tinnitus is estimated to affect about 10% of the population, but 1% report that tinnitus significantly affects their quality of life.

How can tinnitus be treated?

There is no ‘one size fits all’ treatment process for those who are affected by tinnitus. Usually patients first visit their GP, and then can be referred on to an ENT specialist.

Firstly, if there is an underlying cause (such as earwax, or abnormal bone growth in the ear), this is treated, which on many occasions can help to improve the tinnitus.

However, in those who do not have a specific underlying cause, there are different treatment paths to follow. Some treatments that are used include:

Tinnitus Retraining Therapy (TRT)

TRT is a special kind of therapy with the aim of retraining the brain, to deal with how it responds to tinnitus. This means that over time, you can start to ignore, or tune out the tinnitus, and your brain does not acknowledge it as it once did. It reduces the priority of tinnitus in the brain by using sounds played at a particular level, increasing ‘habituation’ to the tinnitus. This type of treatment is usually combined with others to increase efficacy.

Cognitive Behavioural Therapy (CBT)

CBT aims to retrain you in the way that you think about tinnitus, so it becomes less bothersome and less noticeable over time. The treatment changes how you view your tinnitus, so it is not viewed as problematic and something negative. This therapy manages your responses to tinnitus, and helps you find solutions that encourage you to view it in a less negative light.

Sound therapy

We notice our tinnitus more when our direct environment is quiet – so sometimes background noise can help to tune out the tinnitus, or make it less noticeable. This therapy uses natural sounds, or neutral sounds, to help you notice the tinnitus less.

Relaxation and self help

Sleep can sometimes be difficult for those who live with tinnitus, as it can be difficult to either fall asleep, or stay asleep. This is often due to worry, rather than the tinnitus itself. Being taught relaxation techniques can help solve this problem, and allow those with tinnitus to get to sleep more easily. Relaxation techniques can also help reduce stress, and allow you to notice your tinnitus less. Learning to relax can be incredibly beneficial for those who experience tinnitus.

Usually a combination of treatments and therapies is used as an approach to tinnitus, and many people find that in this way they can manage the condition effectively.