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What is tinnitus?
Tinnitus is a medical term to describe noise(s) that people can hear in one ear, both ears or in the head – such as ringing, buzzing or whistling. The sounds heard can vary from person to person but the common link is that they do not have an external source.
What does tinnitus sound like?
Tinnitus sounds can take a variety of forms such as buzzing, ringing, whistling, hissing or a range of other sounds. For some people it can even sound like music or singing. Sometimes people only notice these sounds when it is very quiet, such as at night. Other people find that they are much louder and can intrude on everyday life. Sometimes tinnitus noise beats in time with your pulse. This is known as pulsatile tinnitus.
How common is tinnitus?
Most people have experienced brief periods of tinnitus at some time. It is quite common to have it for a short while after you have been exposed to loud noise – for example, after a music concert. Tinnitus is very common in people of all ages, so you are not alone.
What causes tinnitus?
There are many different causes of tinnitus. We know that tinnitus can be linked to:
- Exposure to loud noise
- Hearing loss, Ear or head injuries
- Some diseases of the ear, Ear infections
- Emotional stress
- A side effect of medication or a combination of any of the above.
Many people with tinnitus have never experienced any of the above and don’t have a hearing loss. There are several theories and ongoing research as to what happens when you have tinnitus.
To understand what happens when you have tinnitus, you need to understand how your ear works.
The hearing pathway:
The ear is made up of three parts, the outer, middle and inner ear. These parts of the ear change sound waves around you into nerve signals which then travel up the hearing nerve to the brain. Once the signals reach the hearing part of the brain known as the auditory cortex you will hear them as sound.
The hearing pathway has complex filtering system that allows you to “tune in” to sounds that have meaning to you and “filter out” sounds that are not important to you. For example, you may not notice background sounds of traffic but you would notice the sound of a baby crying.
This system works all the time and stops you being bombarded with sound. Your brain also has systems that respond to the meaning of sounds and help influence the way that you filter them.
For example, if you hear your name at a party, you will tune in to hear what is being said. This is because the sound of your name is especially meaningful to you. Together, these filters and response systems help to control how you react to sound.
The tinnitus signal
Your hearing pathway, your filters and your sound response systems are all involved when you hear tinnitus. First, a tinnitus signal is created, usually in your inner ear or the auditory nerve. This is usually very weak and most people don’t notice it. However, if you become aware of tinnitus, this means that your filters have started to pick up this tinnitus signal.
If you become anxious or annoyed by tinnitus, your sound response systems will tune your filters into it and you will start to hear it more.
The aim of tinnitus management is to learn to ignore the tinnitus signal.
Why do I feel sensitive to sound?
Around 40% of people with tinnitus are more sensitive than normal to every day sounds. Broadly speaking there are two forms of sensitivity to sound:
- Hyperacusis – you may find sound in general or certain sounds uncomfortable or painfully loud, even when they don’t bother other people.
- Hyperacusis—you may find sound in general or certain sounds uncomfortable and painfully loud, even when they don't bother other people.
- Misophonia— or noise annoyance – you may find some sounds extremely irritating, even though you may not be sensitive to sounds in general. If your dislike is strong enough to be considered a phobia, the term phonphobia is used.
What is sound therapy?
Sound therapy is also known as sound enrichment. Many people find that they are more aware of tinnitus in a quiet environment. Sound therapy works by filling the silence with therapeutic sounds. These distract you from listening to your tinnitus, making it less noticeable and therefore less intrusive. This helps your filters to tune out tinnitus. Sound therapy involves listening to a range of sounds that you find pleasant such as recording of nature sounds or by using a sound generator, or a sound enricher.
How do sound generators work?
A sound generator produces a gently soft “rush” (white noise) which sounds like an off-tune or off-station radio. This can help retrain your brain to ignore tinnitus. The volume should be set at just below the level of the tinnitus. You can get different styles of sound generator. Sound generators that you wear in your ear look like hearing aids. You may not be offered all styles on the NHS as availability varies throughout the country and will also depend on what is most appropriate for your needs.
What other sounds can help?
Some people find everyday sounds helpful, such as the television, radio, an electric fan or music. You may have to experiment until you find the sort of music that works best for you. Ideally the music shouldn’t be too stimulating or emotional. Some people find natural sounds helpful, such as the sea, the rainforest or birds, either on their own or combined with pleasant music.
Be careful not to cover the sound of the tinnitus by playing any of these sounds too loudly. However, at night you may find it useful to use background sounds to help you get to sleep.
The Royal National Institute for the Deaf (RNID) sell desktop sound generators and a range of relaxation CDs and cassettes. They have all be
recommended by people with tinnitus. Contact the Tinnitus Helpline for more information.
The RNID also have a book called Understanding Tinnitus – managing the noises in your ears or in your head. This book has been written by audiology specialists who have tinnitus themselves. It tells you about:
• What we know about tinnitus
• How to get help and support
• Ways to help yourself such as relaxation and counselling
• Getting a good night’s sleep
• Alternative therapies
Why is relaxation important?
A regular relaxation routine can help you to manage the stress that is often associated with tinnitus. Many people notice their tinnitus more when they are worried or tired and this in turn increases their levels of anxiety and stress.
You can learn to control your responses to stress by using relaxation techniques. These are taught in many tinnitus clinics and audiology departments or try local adult education classes in relaxation techniques or classes in medication or yoga.
Can children get tinnitus?
Children and young people can also get tinnitus and hyperacusis. Children may be born with tinnitus or develop it in the same way that adults do. Children born with tinnitus or who develop it at a very young age may not realise it is unusual. They often do not have the words to describe their tinnitus until they reach school age. As with any childhood ear problem, get specialist help as soon as possible by contacting your child’s GP.
Contact us
If you have any queries relating to this information, please contact the Ear or nose and throat (ENT) service.
About this information
Service:
Ear, nose and throat (ENT)
Reference:
G/037
Approval date:
23 February 2026
Review date:
1 February 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.