It can sound like a fire alarm, a kettle whistle, a hiss of air escaping from a balloon, a chorus of tree frogs or a roaring jet engine. For me, tinnitus is a blaring sound in my right ear, similar to the high-pitched whine that follows an explosion in a war movie, except it never fades away. (If you want to hear what that sounds like, click this link but you may want to turn down your volume.) The screeching sound is with me from the moment I wake up until I fall asleep.
More than 740 million adults worldwide experience tinnitus and some studies suggest 1 in 10 people have it. Some barely notice it. Others can’t function because of the phantom noise. It steals their sleep, fractures their relationships and triggers depression and anxiety. Severe tinnitus affects about 2 percent of adults overall.
While there is no treatment proven to silence chronic tinnitus, there are a handful of strategies you can try to reduce symptoms and the discomfort they bring. Here’s what experts suggest.
What causes tinnitus
Tinnitus is a sound without an external source, heard in one or both ears, or elsewhere in the head. Commonly called ringing in the ears, it can be temporary and resolve on its own, or persist and become chronic. The noise can vary from a faint hum to a shrieking wail.
Bruce Hubbard, a psychologist who also has tinnitus, likens his to a smoke alarm. “A smoke alarm is designed to get people’s attention and drive them away. And that’s what [some of us] have in our heads, basically a smoke alarm 24/7,” Hubbard said.
Most people with tinnitus have some level of hearing loss. Mine began with sudden sensorineural hearing loss, a medical emergency that causes abrupt hearing changes and requires early treatment for the best chance of recovery, but tinnitus is also associated with age- or noise-related hearing loss — though it might not always be apparent on hearing tests.
The Tinnitus Handicap Inventory measures how tinnitus affects your daily life, from slight to catastrophic. Two years after my tinnitus began, my score is severe. I miss silence.
The leading theory for why tinnitus occurs is that when the brain receives less auditory information, the central nervous system adapts by increasing neural activity, said Stéphane Maison, director of the Tinnitus Clinic at Mass Eye and Ear, who also has tinnitus. “Tinnitus is not a sound in your ears. Tinnitus is the result of your brain trying to adapt to a lack of information that is no longer coming from your ears,” he said, comparing it to phantom limb pain.
Medical evaluation can identify treatable or less common causes, including earwax, ear infections, head injury, vascular problems, an inner ear disorder, tumor and jaw-joint problems. Some medications, such as powerful antibiotics called aminoglycosides and certain chemotherapy drugs, can cause hearing loss, tinnitus or both.
Strategies to make tinnitus less disruptive to everyday life
There’s no cure for tinnitus, “but we’re working on it,” Maison said. (For some people with hearing loss, hearing aids or cochlear implants — surgically implanted devices that directly stimulate the auditory nerve — can improve hearing and may reduce tinnitus.)
Tinnitus treatment is often focused on changing your perception of and reaction to the noise. “The idea is not so much to make the sound go away, although that’d be great, but to help that person coexist with this thing they don’t like by improving their understanding and their ability to rationally think about it,” said Marc Fagelson, an audiologist and professor who has tinnitus and works with veterans.
Treatment options include the following:
- Cognitive behavioral therapy (CBT), a type of talk therapy that focuses on recognizing and changing unhelpful thought patterns and resulting behaviors, has the clearest evidence for reducing tinnitus-related distress.
- Acceptance and commitment therapy (ACT), another type of psychotherapy that focuses more on accepting thoughts and changing how you relate to them, may also be effective, though it can feel initially counterintuitive to people searching for a cure. “Acceptance is a practical choice,” Hubbard said.
- Tinnitus retraining therapy (TRT) aims to promote habituation, the process of paying less attention and reacting less strongly to the sound, through education, counseling and sound therapy. (The propensity to closely monitor and try to control tinnitus can keep your attention focused on the noise, making it harder to tune out.)
- Tinnitus activities treatment (TAT) focuses on addressing four problem areas: thoughts and emotions, hearing and communication, sleep and concentration. Individualized treatment may include counseling, communication and hearing strategies, exercises to redirect attention and sound therapy.
Mindfulness practices may help some people cope. Acupuncture, yoga and meditation have not been shown to treat tinnitus directly, but Maison said people who find these activities relaxing can use them to reduce overall stress.
James Henry, a retired tinnitus researcher who has tinnitus, suggested listening to an audiobook or podcast to help fall asleep at night. White noise, nature sounds or calming music may help mask tinnitus or make it less noticeable. Tinnitus can feel more intrusive in some situations, such as when you’re in a quiet room, because there are no external sounds to mask the ringing, or after exposure to a very loud environment. (Some people with tinnitus also experience hyperacusis, a hypersensitivity to everyday sounds.)
Having a strong support system can help reduce isolation, which people with tinnitus may feel if they avoid social situations because of difficulty following conversations, low tolerance of noisy environments or fear that their tinnitus will worsen. But staying socially engaged is important, Fagelson said.
Anxiety and depression may worsen tinnitus distress, and tinnitus may also contribute to anxiety and depression. While antidepressants or antianxiety medications can’t resolve tinnitus itself, they may be helpful for addressing any mental health concerns related to the condition.
Tinnitus related to a traumatic incident can be associated with PTSD, Fagelson said. Tinnitus is the most common disability for U.S. veterans. Military service can involve repeated exposure to damaging noise, including gunfire and explosions, which can trigger lasting tinnitus. “The potential is there for the tinnitus to serve as a trauma reminder and be extremely burdensome in that regard,” Fagelson said.
Although the sound may persist when trying the above tactics, many people may adapt over time and find it bothers them less or they eventually notice it less. “The brain is highly capable of adapting to it and even screening it out,” Hubbard said.
What doesn’t the evidence support? Supplements such as zinc, Ginkgo biloba, magnesium and Lipo-Flavonoid are touted online as offering relief, but studies have not shown they reliably improve tinnitus and guidelines from the American Academy of Otolaryngology-Head and Neck Surgery Foundation specifically recommend against using supplements to treat tinnitus. And while some people say that certain triggers fluctuate the volume of their tinnitus, including caffeine, salt and alcohol, research doesn’t back up any specific dietary changes.
Emerging technologies
Bimodal neuromodulation, which stimulates two sensory systems at once to prompt changes in the brain, has emerged in recent years as a potential treatment for some people with tinnitus. Lenire, a prescription device that pairs sound delivered through headphones with mild electrical stimulation of the tongue, was authorized by the Food and Drug Administration in 2023 to temporarily relieve tinnitus symptoms in adults with at least moderate tinnitus. (That authorization does not establish that the device cures tinnitus or works for everyone.)
Susan Shore, an auditory neuroscientist and researcher at the University of Michigan, developed another bimodal neuromodulation device that works a little differently. It pairs sounds tailored to a person’s tinnitus with precisely timed stimulation on the face or neck, with the aim of altering abnormal neural activity associated with tinnitus.
Studies on these devices have been relatively small and largely conducted by the companies and researchers behind the devices so more independent research is needed. (Also of note: Lenire is offered only through audiologists, and according to the company’s website, is not broadly covered by major commercial insurance plans or Medicare.)
The ultimate goals: Habituation and acceptance
Without a proven way to silence chronic tinnitus, the most realistic long-term goal is habituation, Henry said. “Habituation means not paying attention to your tinnitus most of the time. And when you do pay attention to it, you don’t react to it.”
Henry said he’s fully habituated and comfortable with his tinnitus, despite it being loud. “I hate it. I wish it would go away,” he said. “I wish there was a cure, but otherwise, I can live with it.”
Hubbard compared tinnitus to losing a loved one and processing grief and loss. “I’ve got to somehow make peace with that in order to move on,” he said. He suggested focusing on your values and the life you want to live, while acknowledging that tinnitus can be extremely difficult to deal with.
When my tinnitus first started, I couldn’t imagine spending one waking minute without noticing it. While I still make daily adjustments, avoid noisy restaurants and listen to white noise, I can now spend hours without consciously noticing my tinnitus or letting it rule my life.
For now, that’s success.
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