Tinnitus : Not the same for everyone

Tinnitus is a hearing condition often described as a chronic ringing, hissing or buzzing in the ears. In almost all cases this is a subjective phenomenon that can only be perceived by the person with the condition.

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In addition to the different types of tinnitus sounds (e.g., ringing, hissing, buzzing, “wooshing”, high-pitched tone) the frequency or pitch as well as the loudness of tinnitus can vary from person to person.
In some cases, a person may experience more than one type of tinnitus and they can also report that their tinnitus varies in pitch or volume within the same day, between days, depending on levels of stress, or their environment.
Tinnitus can be described as being unilateral (left or right ear), bilateral, or in some cases, it is described as being “within the head” or “outside”.

Tinnitus: How it begins

Some people know when their tinnitus starts. They wake up one morning or experience an event that creates this terrible ringing sound that won’t go away. For others, it feels like the tinnitus crept up on them and they are not sure when it actually started. Tinnitus can start suddenly, build up gradually or come and go, but there are various possible causes, with some being common, and some rare. A tinnitus sufferer should always first consult with their physician when they develop the condition.

More on rare cases

In relatively rare cases the cause(s) of tinnitus can be identified by an Ear Nose and Throat Doctor and addressed through surgery. For example, an acoustic neuroma. However, there are a range of causes that cannot be dealt with through surgery including hearing loss, side effects of certain medications, head and neck injuries, Meniere’s disease, as well as stress and anxiety. While diagnosing these is challenging, a tinnitus sufferer should always first consult with their physician when they develop the condition.

By far, the most common cause of tinnitus is hearing loss due to ageing or noise trauma (e.g. from a work environment, music, or exposure to loud sounds). In these cases, tinnitus is thought to develop as a result of changes to the auditory brain as the brain attempts to compensate for hearing damage.

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Our brains normally have the capacity to adapt and change. However, in some cases, they can change in ways that lead to undesirable outcomes. In the case of tinnitus it is believed that the hearing brain becomes too excitable [3,4] leading to the perception of sound that is not caused by the outside world.
Hearing loss can initiate a process wherein the auditory cortex (the highest region of the hearing brain) attempts to compensate for reduced input [2]. Our brain has the power to change and adapt, and the hearing brain is no different. The problem is, that in some cases, the adaptation can make the hearing brain overactive, even when no external sound is present. This can contribute to the development of tinnitus.
Unfortunately, it is not just a matter of too much activity. The way the hearing brain processes information can also change [3]. Our brain makes sense of different frequencies in sound, but with hearing loss, our ability to hear and process certain frequencies is reduced. In the hearing brain, this can also lead to changes where certain frequencies take over the ones we cannot hear as well.
There are still other changes that have been linked to tinnitus. What makes tinnitus so challenging to treat is that the changes can vary from person to person. This is indicated by differences in what their tinnitus sounds like.

Tinnitus: Links to Stress and Anxiety

Many tinnitus sufferers have described their tinnitus worsening during times of stress or anxiety. Indeed, regions of our brain that deal with processing emotions are also linked with our hearing brain [6]. While a lot of research remains to be done, there is definitely a link between tinnitus and stress or anxiety.

Tell me more about the brain science behind this

The areas of our brain involved with processing emotions are part of what is called the limbic system. Irregularities in limbic brain networks have also been implicated in tinnitus [7]. While the hearing system still plays a key role in such a framework, the implication is that tinnitus is a condition that can involve several pathways in our brain.  Knowledge of how non-auditory brain structures can contribute to tinnitus has allowed researchers to develop a more complete picture of the tinnitus brain state. That being said, there is convincing evidence that tinnitus is a phenomenon mainly rooted in the central auditory system.

A relaxing sound therapy may help with this aspect of tinnitus, but more importantly, the right kind of counselling approaches can help those who notice strong links between their emotions and tinnitus.

Tinnitus: Treatment Approaches

Tinnitus reduction sound therapy – Recent research has led to a greater understanding of how tinnitus is related to changes in our hearing brain. This has allowed the development of sound therapies that can provide the hearing brain with the type of sound input it needs to reduce tinnitus over time. These forms of sound therapy must be customized to the individual tinnitus sufferer. Sound Options falls under this category and uses the most comprehensive customization by taking into account a person’s hearing and tinnitus profile and making use a computational model of the hearing brain.

Tell me more about tinnitus management methods

Counselling – Various forms of counselling have been shown to benefit tinnitus sufferers in terms of reducing the impact that tinnitus has on their life. These include cognitive behavioural therapy and tinnitus retraining therapy. Research also indicates that there are benefits to combining educational and counselling approaches with sound therapies.
Tinnitus masker – A masker is a type of sound therapy for tinnitus that attempts cover up or mask a person’s tinnitus by a different sound. These can include, white noise, chimes, random tones or similar sounds. The idea is that if a person can be distracted from their tinnitus or have it covered up, they will learn to not pay as much attention to it in general. Unlike retraining therapies, maskers are not necessarily looking to reduce the tinnitus itself, but rather to reduce attention paid to the tinnitus.


  1. Sound Options tinnitus assessment database.
  2. Noreña AJ. An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci Biobehav Rev. 2011 Apr;35(5):1089-109.
  3. Eggermont JJ, Roberts LE. The neuroscience of tinnitus. Trends Neurosci (2004) 27:676–82.
  4. Chrostowski M, Yang L, Wilson HR, Bruce IC, Becker S. Can homeostatic plasticity in deafferented primary auditory cortex lead to travelling waves of excitation? J Comput Neurosci. 2011 Apr;30(2):279-99. doi: 10.1007/s10827-010-0256-1.
  5. Roberts LE, Eggermont JJ, Caspary DM, Shore SE, Melcher JR, Kaltenbach JA. Ringing ears: the neuroscience of tinnitus. J Neurosci 2010 Nov 10; 30(45):14972-9.
  6. Kraus KS, Canlon B. Neuronal connectivity and interactions between the auditory and limbic systems. Effects of noise and tinnitus. Hear Res (2012) 288(1-2):34-46.
  7. Li SA, Bao L, Chrostowski M. Investigating the Effects of a Personalized, Spectrally Altered Music-Based Sound Therapy on Treating Tinnitus: A Blinded, Randomized Controlled Trial. Audiol Neurootol. 2016 Nov 12;21(5):296-304. [Epub ahead of print]
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