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Tinnitus is a noise perceived in the ears or head that does not come from an external sound source. People often describe tinnitus as ringing, buzzing, hissing or humming, and the noise can be low, medium or high-pitched. The noise can be constant or it can come and go. Tinnitus is often more noticeable in quieter situations such as a quiet room or at bedtime. During the daytime, activity and background sound may partially “mask” or cover up the tinnitus, making it less noticeable. As a result, it may seem like tinnitus is louder at night or at bedtime, even though the tinnitus volume has likely stayed the same. The severity of an individual’s tinnitus depends on their emotional reaction and attitude toward the tinnitus. Two people may report very similar tinnitus characteristics, but one may not be bothered by it while the other finds that it greatly interferes with their everyday life. Tinnitus Treatment If you think you have tinnitus, the first step is to visit your doctor to find out if it is caused by something that is medically treatable. Also, since tinnitus is often caused by hearing loss, you should have your hearing tested by an audiologist. In many cases, a medical cause of tinnitus cannot be identified, so you may then need to take steps to treat the tinnitus itself. First and foremost, tinnitus usually gets worse when people worry about it and do things to try and get rid of it. Tinnitus can be emotionally stressful at first, but studies have shown that in most cases, even without treatment, tinnitus noises disappear or become less noticeable over time. Treatment can help by changing your reaction to the noises and making you less aware of them. You will gradually learn to stop paying attention to your tinnitus, in the same way you ignore other everyday noises such as the hum of the refrigerator or traffic outside your window. No well-designed and controlled scientific studies have shown a pill (e.g. vitamins and minerals) or alternative treatment (e.g. acupuncture, naturopathy) that cures tinnitus. Because of this, many tinnitus sufferers have been told to “learn to live with it” or “there’s nothing we can do about it.” However, we now know that there are a number of options available to treat and help people cope with tinnitus. 1. Avoid Possible Triggers High levels of nicotine, salt, and caffeine can often make tinnitus worse, and should be taken only in moderation. High noise levels are known to aggravate tinnitus and can cause hearing loss, so if you work in a noisy environment or have noisy recreational activities, wear appropriate hearing protection. Moderate everyday noises are not usually a problem for most people. If you are interested in learning more about hearing protection options for your lifestyle and noise levels, speak with an audiologist or Hearing Aid Specialist. 2. Partial Tinnitus Masking Tinnitus becomes more noticeable in quiet environments. Because of this, tinnitus sufferers should avoid complete silence wherever possible. Many devices are available that can partially “mask” the sound of the tinnitus and make it less noticeable. The volume of the masking sound should be set to a level just below the volume of the tinnitus, so that both the masking sound and the tinnitus are audible. When both the tinnitus and masking noise audible, there is less contrast between the two sounds, and the brain learns to ignore both the masking noise and the tinnitus. Partial tinnitus masking is recommended in Tinnitus Tinnitus Retraining Therapy/Auditory Habituation Therapy. Some commonly used masking devices include: 3. Hearing Aids Most people with tinnitus also have hearing loss, and could benefit from wearing hearing aids. Not only do hearing aids make listening easier, but they also amplify background sounds, which draws your attention away from the tinnitus. 4. Stress Management Many people with tinnitus report that it gets worse when they are tired or stressed. This is because your stress levels change the way you react to your tinnitus: when you feel content and happy, you forget about your tinnitus; when you are anxious and stressed, your tinnitus becomes more difficult to ignore. Stress management, along with other treatment techniques outlined above, can help change your attitude toward the tinnitus signal. Many strategies aimed at reducing stress are available, such as deep breathing, biofeedback, yoga, massage, or visiting a psychologist who specializes in stress management and/or mood disorders. 5. Tinnitus Retraining Therapy/Auditory Habituation Therapy This tinnitus management therapy uses a combination of counseling and partial tinnitus masking with hearing aids and/or noise generators. The volume of the noise generator is set to a level just below the volume of the tinnitus, so that the tinnitus is still audible. Over time, the aim of this therapy is to remove the negative association attached to tinnitus, and train the brain to classify tinnitus as a neutral signal. Tinnitus Retraining/Auditory Habituation Therapy is also effective in decreasing sensitivity to sounds (hyperacusis).