Around 30 per cent of people worldwide will experience tinnitus at some point in their life. So what exactly is this condition and why is it so common?
Despite the many ground-breaking medical advances of the last century, there are still some conditions that continue to perplex scientists. One such impairment is tinnitus; a symptom people have reported experiencing as far back as 1600 BC.
Tinnitus is characterised by hearing unwanted sounds, such as a ringing, buzzing or humming noise in the ears or head. For one in eight, these sounds never disappear. Although the condition is more common in older adults – possibly due to the natural ageing process – tinnitus can affect people of all ages, including young children.
It’s estimated that 30 per cent of people worldwide will experience tinnitus at some point in their life. Unfortunately, this number is likely to rise, as increases in life expectancy and exposure to loud music are all reasons people develop tinnitus. We are also seeing increased reports that COVID-19 is producing hearing-related symptoms, such as dizziness, vertigo and hearing loss – and a recent study found that the pandemic has worsened tinnitus for many individuals.
So why is it so difficult to find a cure for this common condition?
One reason that finding a cure for tinnitus is so difficult is because it’s hard to quantify the condition. There’s no reliable, objective way to measure the severity of a person’s tinnitus, which means researchers must rely solely on a patient’s description of their symptoms.
Scientists also don’t know why some people develop tinnitus and others don’t. More than 200 conditions are associated with developing tinnitus. These can be anything from head or neck injuries, circulation problems, or a side-effect of some medications. Although hearing loss and loud noise exposure have been identified as the biggest risk factors, it can also be made worse by certain noises, poor sleep, allergies or infections. Another complicating factor is that not everyone with hearing loss has tinnitus and not everyone with tinnitus has hearing loss.
A further barrier to finding a cure is that tinnitus is also not fully understood. Although various theories exist, none can fully explain all aspects related to how the sound is produced, why only some become aware of these internally generated sounds, and why the sound may remain for years.
Current theories indicate that developing tinnitus involves multiple complex processes taking place in various parts of the brain. This makes it difficult for drug companies to know what area of the brain to target when developing a medical treatment. Although several drugs have shown promise in improving tinnitus during trials, none of these reported improvements were able to be reproduced later safely and over a long-term period.
Another problem researchers face in finding a cure is related to the level of impact tinnitus has on a person’s daily life. Most people with tinnitus don’t find having the condition problematic. However, a small minority are unable to lead a normal life due to its severity.
When tinnitus is severe, it can make it difficult to hear, concentrate, relax, and focus. Those who are severely distressed by tinnitus even report an inability to work. Being aware of tinnitus may also make it difficult to sleep, which can affect daytime functioning. Being unable to escape or control tinnitus might also lead to feelings of frustration, anxiety and depression.
While it can be disappointing for tinnitus sufferers to learn there is no cure, there are still several things that people can do to help them manage the condition.
Most doctors will offer a combination of treatments depending on the severity and the areas of life it affects the most:
- Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier to hear. The better one hears, the less likely they are to notice the tinnitus.
- Counselling can help one to learn how to live with tinnitus. Most counselling programs have an educational component to help one understand what goes on in the brain to cause tinnitus. Some counselling programs also will help to change the way one thinks about and reacts to tinnitus.
- Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhh,” random tones, or music.
- Tabletop sound generators are used as an aid for relaxation or sleep. Placed near the bed, one can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If the tinnitus is mild, this may be sufficient to help with falling asleep.
- Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitises the patient to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.
- Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits.
- Antidepressants and anti–anxiety drugs might be prescribed by your doctor to improve your mood and help you sleep.
- Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proved effective in clinical trials.
More than ever before collaborations are encouraged between industry, academics and people with tinnitus to work together to tackle the issue. Although it remains an enigma, there is more research into tinnitus than ever before and there are clear indications of progress regarding an understanding of the condition and how to treat it. This should be embraced as it acts as stepping stones for further breakthroughs.
