Four Months Into a Wild Tinnitus Spike from... Stress and Sleep Issues?

[El BUZZ]

Hi there!

I developed tinnitus 10 years ago after a childhood plagued with otitis and a life of abusing loud music through headphones, along with an acoustic trauma. I have a 60 dB loss at 8 kHz. I navigated these 10 years reasonably well, with some spikes here and there that always resolved after 3 or 4 weeks.

I started Lexapro 10 mg 5 years ago to help me through a rough patch related to tinnitus-induced moderate depression. I've always been very careful with my hearing, always wearing NRR 33 dB foam earplugs when in louder-than-normal environments, although these have been only occasional situations.

This past July, about 4 months ago, I had gone through several months of inconsistent sleep along with a brief stressful event at work. After that, I felt like my tinnitus had increased in volume. It was not a different tone, just a louder version of the previous one.

Since then, I've fallen into a cycle of anxiety, depression, and suicidal ideations. I increased my Lexapro dosage to 15 mg 5 weeks ago, but I don't feel that it is helping me much. I swing between days in which my tinnitus sounds like a loud unmaskable angle grinder inside my head, and other days in which I hear 2 much quieter and easier to ignore beeping sounds in my ears. I'm at my wits' end.

People tell me it's due to my anxiety and that it's going to settle back to baseline, which previously allowed me to feel happy and joyful. After 4 months, I'm afraid it won't, and I can't help but feel frightened.

Any input?

 

[Regis]

Hi @El BUZZ, from my own experience I know that an emotional factor plays a real role in the perception of tinnitus and in the ability to habituate.

When I first got tinnitus 2.5 years ago, I became deeply depressed. I got better over time thanks to antidepressants, CBT, changing my reactions, and accepting tinnitus. Of course, the passage of time was important as well.

Recently I did something stupid and have had a major spike for 3 weeks. I try to stay positive and not allow my depression to consume me, although I admit I had a day or two where I struggled to get out of bed. I'm doing my best to live as normally as I can in order to create good conditions for habituation.

Take care!

 

[Joeseph Stope]

Sorry to hear that you're going through a bad patch, @El BUZZ.

My tinnitus has gone into a spike too from a succession of events. It's hard to say exactly what caused it.

1. A smoke alarm going off in the room
2. Getting my flu and COVID jabs for the winter
3. Going to the dentist who wanted to clean my teeth, which caused an awful scraping noise
4. Lifting some heavy crates
5. Noise from traffic, like motorbikes with inadequate silencers

My pattern is the same as yours. Some trigger causes a spike, and it can take a few days for the spike to fully develop. Then I just hope that in the coming weeks it will subside back to normal baseline.

Sleep is also worth studying. The experts say you shouldn't count sleep in hours, but rather in 1.5 hour cycles, which is 90 minutes. You go through either 4 or maybe 5 phases of sleep, and the last two are the most important, the phase of deep sleep and then REM sleep where you dream. So if you get 5 hours of sleep like I often do, it's really only 3 cycles of 90 minutes, which totals 4.5 hours. The extra 30 minutes ends up being dozing or restlessness while trying to get to sleep.

They say that alcohol reduces REM sleep. Even still, I might take a pint of Guinness now and then.

Warm milk helps. I take muesli with milk and some probiotic yogurt, the expensive €3.00 kind, plus some walnuts in the evening. I also take Magnesium, Vitamin D, and Vitamin B.

It's gotta work. I mean, I read it on the internet. Well, it helps a little.

I'm really sorry to hear that things aren't going well for you.
All I can say to cheer you up is that the research seems to be accelerating at the moment.

 

[Robster]

I can't offer any advice, but I can certainly sympathize. I've been going through an intense spike for the last 2 weeks and haven't got a clue what, if anything, has caused it.

Normally, when my tinnitus spikes, I can pinpoint a reason. It might be a loud noise, a new medication, lack of sleep, or something similar. This time I have absolutely no idea why it's happening.

Hopefully your spike will subside. I had a spike in late 2023 caused by a smoke alarm going off right next to me, and it lasted about 3 months before eventually settling back to baseline. Don't lose hope, and with a bit of luck it will return to baseline.

 

[hubast]

When mine gets bad, I use open-ear earbuds and an ocean white noise sound from my phone, Bluetooth-connected to the earbuds. It helps quite a bit. I also use a room air filter or fan about 3 ft from my head for sleep, along with a white noise generator from Amazon placed at the foot of the bed.

On nights I can't sleep, I take half of a 7.5 mg Mirtazapine pill, and it works every time. I hate this condition as well, and it can put you through a lot. Stay busy, avoid total silence, and don't give that tinnitus the time of day. I bet you come around. Hang in there, we are here with you and hopeful, and we're praying for your recovery.

 

[Nick47]

I think most spikes come from loud noise. Often there is a delay of 1 to 3 days, which leads to misattribution of the cause. I see people looking for explanations and coming up with all sorts of possibilities that, in most cases, seem unlikely. All of my spikes have been accompanied by increased hyperacusis.

My spikes over the years have come from the following:

1. Attending bars with hearing protection
2. Using a multi-tool for 10 minutes
3. Smoke alarm
4. Ultrasonic cleaner
5. Headphones for a 1-hour Zoom meeting
6. Dog barking
7. Child screaming

They all have one thing in common. Can you guess?

 

[El BUZZ]

@Regis, @Joeseph Stope, @Robster, @hubast.

Thank you all for your valuable input.

I'm going to share a couple of audiograms here.

This one was done a month after the spike started. As I later saw a huge air-bone gap at high frequencies in my right ear, I tried to figure out what could be the conductive issue, which resulted in an earwax buildup lump impacting my eardrum.

I had the earwax removed and a new hearing test, which apparently showed some hearing recovery on this audiogram.

I think most spikes come from loud noise. Often there is a delay of 1 to 3 days, which leads to misattribution of the cause. I see people looking for explanations and coming up with all sorts of possibilities that, in most cases, seem unlikely. All of my spikes have been accompanied by increased hyperacusis.

My spikes over the years have come from the following:

1. Attending bars with hearing protection
2. Using a multi-tool for 10 minutes
3. Smoke alarm
4. Ultrasonic cleaner
5. Headphones for a 1-hour Zoom meeting
6. Dog barking
7. Child screaming

They all have one thing in common. Can you guess?

Thanks for your time and answer, @Nick47.

I always pay special attention to all of your input in this forum.

I'm really careful with my hearing. I always carry a pair of NRR 33 dB foam earplugs with me and I always insert them 100 percent correctly. I also avoid loud situations and only wear the earplugs when something suddenly gets loud.

The only loud event I can think of before the onset was when I clapped a pair of flip flops against each other to dust them off. I did it 3 or 4 times and found it slightly bothersome. I also slept in a room with a not-so-loud fan running all night, but I wore my earplugs all night long. Other than that, my neighbors had a party with loud music that reached about 85 dB at my place. Again, I wore my earplugs for around 90 minutes before leaving my home.

I've been to a number of audiologists so far, and all of them told me it's very unlikely any of that caused the spike.

As I said, I have days where I wake up to a much more bearable tinnitus, and it usually stays the same for the whole day.

May I ask you how long your longest spike has lasted?

I must say that over these 10 years I've had similar episodes in which my tinnitus spiked this way, making me think it was the loudest ever, but they've always subsided after 3 to 4 weeks at most.

I can hear this even over the shower quite loudly.