Tinnitus and Hyperacusis

October is Audiology Awarness Month. Visit the rest of the CHS Knowledge Centre for more articles and advice on hearing loss, communication tips and more.


Tinnitus is often described as a ringing, buzzing or pulsating sound in the ear, but is defined by the American Tinnitus Association as “the perception of sound when no actual external noise is present.”
Many people who suffer from tinnitus also experience tension in their head, neck and jaw, tiredness, irritability, poor concentration, anxiety and depression that can be severe.


Who is affected by tinnitus?

37% of adult Canadians have experienced tinnitus in the last year. About 7% of the population reports bothersome tinnitus affecting day-to-day activities. According to the Canadian Health Measures Survey, 46% of individuals aged 19 to 29 have experienced tinnitus in the last year, compared to just 33% for those aged 30 to 49 and 35% for those aged 50 to 70.


What causes tinnitus?

Tinnitus is a symptom and not a disease and is often the result of an injury to the peripheral auditory system, hearing nerve and/or auditory centres in the brain.

Most cases of chronic tinnitus are thought to be a result of damage to the microscopic nerve endings in the inner ear. However, current research now suggests that a more central region of the brain, the dorsal cochlear nucleus, has been identified as a potential culprit especially when it is accompanied with a loss of hearing.

Risk factors that have been associated with the onset of tinnitus:

  • Wax buildup
  • Eardrum perforation
  • Ear infection
  • Barotitis (ear blockage due to change in air pressure)
  • Noise exposure
  • Aging
  • Head injury
  • Teeth grinding
  • Intense period of stress
  • Certain medications such as aspirin in high doses
  • Medical conditions including otosclerosis or abnormal bone growth in the middle ear


What is hyperacusis?

Hyperacusis is a problem that affects about 5% of the population and 50% of patients with troublesome tinnitus. It is defined as a reduced tolerance to everyday environmental sounds. The decreased tolerance to sound is usually noticed with sudden high-pitched noises like alarms, bus brakes, silverware and dishes, children’s crying, and clapping.


What causes hyperacusis?

The most common causes of hyperacusis are hearing loss, noise trauma (i.e. airbag explosion, gunshot from firearm), head injury, adverse reaction to some medications or surgeries, chronic ear infections and posttraumatic stress disorder. Hyperacusis can come on suddenly or gradually.


What are the treatment options for tinnitus and hyperacusis?

Although there are no cures for tinnitus and hyperacusis, there are several therapeutic approaches that provide relief and help manage the condition. Audiological solutions include directive counselling, such as Tinnitus Retraining Therapy, in conjunction with sound therapy such as table-top or ear level sound generators and/or hearing aids, this can help individuals not only habituate to tinnitus, but also improve sound tolerance.


What is Tinnitus Retraining Therapy?

Tinnitus Retraining Therapy (TRT) is a treatment program for tinnitus and hyperacusis using both directive counselling and sound therapy developed by Dr. P. J. Jastreboff in the mid-1980s. Find out more about TRT here.


What are sound conditioners?

Many tinnitus sufferers find that head and ear noises are not as disruptive in the presence of some pleasing or neutral external sound. Sound conditioners create a variety of soothing sounds that can offer relief, particularly when you are struggling to fall asleep. Consult with your audiologist to find out what might be right for you.


Other approaches for tinnitus and hyperacusis relief
For some people living with tinnitus, relief may be found by lifestyle changes such as:

  • Limiting caffeine intake
  • Quit smoking
  • alcohol and aspirin
  • Eliminating salt from your diet
  • Reducing stress
  • Reducing exposure to loud sounds
  • Addressing allergens in the environment


For severe and debilitating tinnitus, some medications may provide relief by helping to reduce the effects of sleep loss, difficulties with concentration, fatigue, depression and anxiety which may contribute to the intensity of the tinnitus. These medications must be prescribed by a physician and their suitability and effectiveness will depend on overall health and other medical considerations.

Some sufferers have found relief from tinnitus using alternative treatments such as acupuncture, chiropractic care, shiatsu massage, biofeedback, breath training, self-hypnosis, melatonin, gingko biloba, vitamin B12 injections and a personalized diet.


How CHS can help people with tinnitus and hyperacusis?

Click the links below to find out more about products and services and how CHS can help people living with tinnitus and hyperacusis.

• Tinnitus Retraining Therapy (TRT) at our Toronto office

• Hearing testing and hearing aid evaluations and sales with an audiologist at one of our convenient locations throughout Ontario

• Sound conditioners, as well as a full range of other communication devices, available through our eStore or at one of our convenient locations throughout Ontario

• Tinnitus support groups. Contact a CHS location near you to find out if there’s a support group in your area.


Frequently Asked Questions


What kind of audiological tests are performed?

The audiological evaluation for bothersome tinnitus includes a hearing test and several other specific tests which allow your audiologist to evaluate whether you have tinnitus and/or hyperacusis (i.e. a sensitivity to certain sound frequencies) and to what degree.


Will it hurt my ears?

None of the tests are painful.


What if I’m not experiencing tinnitus symptoms when I am tested?
Whether or not you are experiencing tinnitus symptoms will not influence the test results.


I recently had audiological tests done. Do they have to be repeated?

If you are visiting a different audiologist from the one who did your original hearing test, the new audiologist will likely want to perform the tests again. Equipment calibrations may vary and an audiologist will want the most accurate and up-to-date information before discussing treatment options. At CHS, we will always perform our own series of tests if you are a new client.


What should I do if I am experiencing tinnitus symptoms?
If you are experiencing ongoing sound sensations, there are a number of ways in which tinnitus can be identified and/or treated.

Contact your family doctor to schedule a complete history and physical examination. The important details you will want to share with your doctor are:

  • When did you first notice the tinnitus?
  • What precipitating factors, if any, were involved (i.e. noise exposure, medication, infection, intense stress, etc.)?
  • Description of the tinnitus (i.e. intermittent, pulsing, frequency, etc.) and the nature of the sound itself (i.e. ringing, buzzing, high-pitched squeal, etc.)
  • How severe you feel the tinnitus is and what kind of impact it is having on your concentration and ability to sleep

Depending on the results of the examination, your doctor may refer you to an audiologist to have your hearing tested and to discuss potential treatment options. You may also be referred to an otolaryngologist (i.e. ear, nose and throat specialist) or other relevant specialties to rule out any potential underlying medical conditions.

If you choose to visit your audiologist for a hearing test, indicate that you are booking the test because of your experience with tinnitus and hyperacusis. After a full audiological examination, the audiologist will discuss the results with you as well as any treatment options that may be appropriate. All your test results will be sent to your family doctor on your request.

Your visit to the audiologist is also a good opportunity to ask questions about your tinnitus and hyperacusis and possible coping strategies.


Where can I find more information on tinnitus?

You can check out these websites:

American Tinnitus Association

British Tinnitus Association

Statistics Canada