Struggling Between Protection and Exposure: Finding Balance After Overprotecting from Tinnitus and Hyperacusis

[Nes]

As some of you might know, I've had tinnitus for a year and a half now, and I've been overprotecting for at least a year. At first, wearing hearing protection most of the time really helped me, and my tinnitus improved a lot. But now I feel like I should start removing them gradually. I miss not being homebound, I miss being able to listen to digital audio, and I want to at least try to bring those things back into my life.

So that's what I've been doing lately. I've been trying to wear hearing protection less and less, and so far, my hyperacusis has improved greatly. On the other hand, my tinnitus is slightly louder and more annoying. It still changes a lot and reacts strongly to even low-level sounds and to some very specific frequencies. Sometimes I even get new tones on top of certain noises, which disappear as soon as the sound stops. I believe this might be either dysacusis or reactive tinnitus, but I'm not entirely sure which one.

An example of my tinnitus getting louder is when I have conversations. I get a very loud and deep hum that disappears within ten minutes to an hour after the conversation ends. Overall, my tinnitus has also become slightly more high-pitched.

I'm not sure if I should continue to reduce my use of hearing protection or go back to using it for a while. I really don't want my tinnitus to worsen permanently. It has been a bit more bothersome lately, but I'm still not at the point where it is significantly worse, a point I really don't want to reach. I've actually been doing really well recently. I'm no longer depressed, I sleep well, and my spikes last at most two days compared to one and a half months before. Even though it makes my tinnitus a little higher-pitched, I can call my friends again without struggling to understand them through hearing protection. I've calmed my phonophobia a lot, and I'd be devastated to fall back into it because of one bad decision.

So, Tinnitus Talk community, what are your thoughts? Should I protect or not protect?

 

[Jupiterman]

It's your risk to take and your decision to make.

Only you can understand the limits of your tinnitus toleration.

Only you can know if the enjoyment of listening and exposing to sound is worth the tinnitus tax you may need to pay.

It's an awful choice.

 

[Mikr]

I do not know your specific case, but I can make some recommendations based on my past experience.

First, if you are using earplugs in environments that are not loud, I would stop doing that. When I first developed tinnitus, I used earplugs because noises would trigger it, and it made things significantly worse. Eventually, even quiet sounds would not only trigger my tinnitus, they would make it feel painfully loud. It took me a while to recover from that, and it likely delayed my habituation.

If you are looking for hearing protection, I would recommend something like AirPods 2 or AirPods 3. They protect your hearing but still allow you to hear the outside world, and you can adjust how much sound you let in. If you use masking or coping sounds, you can play them and still have conversations. In my case, there are certain sounds I can play that decrease or sometimes suppress my tinnitus without causing discomfort. I have found that combining those sounds while listening to sounds that would normally aggravate my tinnitus helps balance things out.

Your experience may be different, since everyone's tinnitus is unique.

 

[MindOverMatter]

@Nes, you've become more active again, which is good. I believe you being more bothered by tinnitus now is most likely due to two reasons:

1.
Since your hyperacusis has gotten better, your perception and awareness of tinnitus are heightened. It does not necessarily mean your tinnitus has actually become louder. Sometimes it is really hard to tell the difference.

2.
Since you have become more active and have started using less protection, it might cause a temporary shift or spike. You could think of it as ear fatigue. In my experience, this is very common.

Do not push through it. Take auditory breaks when needed, and try to keep your stress levels down. You seem to be on the right track, but the nature of tinnitus and hyperacusis is unpredictable.

It also sounds like you have some level of reactive tinnitus, which, in my opinion, is a subset of hyperacusis.