Rex Banks, Au.D. Reg. CASLPO | Doctor of Audiology
Director, Hearing Health, Quality & Knowledge Enterprise
Tinnitus is the perception of sound that has no external source and can generally only be heard by the person experiencing it. But how do we hear a sound that isn’t really there? The answer is found in our central nervous system.  

Our central nervous system is in a constant idle state, ready to respond to any possible encounters. This idling causes background “brain noise”.  Most of us are unaware of this noise until something triggers it and causes it to become audible.  

Your ears are always working but they relax when they find a soothing sound to listen to. They are geared to naturally want to listen to sound and are always scanning the environment for it.  

For people with hearing loss, the amount of sound they are exposed to is reduced. This causes them to strain to hear the sounds around them. All of this straining increases their sensitivity to brain noise, which manifests as tinnitus.  

It is important to understand that tinnitus is not a disease, but rather a symptom. Some of the leading causes are hearing loss, exposure to loud noises, ear trauma, stress and certain medications.  And yes – an acoustic neuroma can also cause tinnitus!

An estimated 37% of adult Canadians experience tinnitus each year. But the experience is unique in everyone. Noises like ringing, humming, buzzing or even cricket like chirping are all referred to as tinnitus. For 7% of people who experience tinnitus, it is bothersome, meaning it affects their sleep, concentration, or mood. 

The severity and persistence of tinnitus can range from a short-term occurrence of no consequence to a chronic and life-interfering condition. Tinnitus has been associated with anxiety and depression, insomnia, irritation, stress, and even suicide, although the latter may be a reflection of comorbid mental health problems.

There is no cure for tinnitus; management focuses on quality of life and varies depending on factors such as severity, impact, comorbid hearing loss and individual needs. A personalized approach to treatment is recommended.  If you have tinnitus, you should avoid silence as it only intensifies your sensitivity to tinnitus. For this reason, hearing aids are often recommended as a frontline defense against tinnitus since hearing aids expose people with hearing loss to sound. For those who experience tinnitus but do not have hearing loss, custom ear sound generators may be recommended.  Another option is tinnitus retraining therapy (TRT), which retrains the subconscious part of the brain to ignore or habituate to tinnitus. This involves the use of sound therapy, along with education and counseling, which helps reduce stress and anxiety about tinnitus. Medications may be prescribed for tinnitus, particularly when comorbid conditions such as depression or insomnia are present. Cognitive Behavioral Therapy (CBT) may also be recommended. CBT does not aim to eliminate tinnitus, but to reduce one’s negative response to it. Alternative medicine, such as acupuncture, ginkgo biloba, zinc supplements and so forth, have not been well-studied and their efficacy is questionable.  

If you think you are experiencing tinnitus, contact an audiologist or your ENT physician as a starting point. Some of the most helpful things you can do is to get information, not dwell on your tinnitus or catastrophize the situation. The reality is there are no guarantees or quick fixes for tinnitus and in my experience, bouncing from treatment to treatment rarely produces a positive outcome. Find someone you trust who is empathetic, knowledgeable and offers an evidence-based approach to treating tinnitus.  Finally, stay positive. If tinnitus can happen, it can unhappen. 

To book a tinnitus consultation with Canadian Hearing Services, contact our Audiology Team at 1-866-518-0000, or by email at audiology@chs.ca .
 
To learn more about Tinnitus, read Statistics Canada Health Report on Tinnitus in Canada, co-authored by three members of Canadian Hearing Services’ (CHS) Hearing Healthcare Team: Rex Banks, Director of Hearing Healthcare, Dany Pineault and Maha Atrach, Audiologists at CHS.