Tinnitus or Auditory Halucination — My Saga

My tinnitus has generally coincided with age-related hearing loss that commenced in about 2009. Until April of 2022, my tinnitus was generally the routine high pitched endless whine. Unpleasant, but tolerable. I've worn hearing aids for about 10 years, and they do greatly lessen the awareness of my tinnitus. I also have used a White Noise machine at my bedside for several years to help mask overnight symptoms when my hearing aids are out.

In mid April of 2022, I suddenly began "hearing" a second sound, sort of a faint metallic clicking or tapping noise. It sounds like what one might hear if a fingernail gently tapped on a thin piece of aluminum. The tapping sound can change from slow to rapid. Thankfully the noise is not evident all of the time, as it does come and go with some frequency. This second noise was VERY disruptive to my sleep so I scheduled a visit with a local ENT specialist. The visit shed little to no light on the situation whatsoever, as the message relayed by the physician was simply that tinnitus manifests itself in a variety of ways. I believe what I am experiencing is sometimes referred to as "typewriter tinnitus." Unlike my primary tinnitus, this tapping noise is NOT masked to a great extent by my hearing aids, so has been far more stressful.

The story continues... In June, a third noise materialized. I'll call it the Tinnitus Trifecta. This "sound" is the most disruptive of them all, as it comes and goes at random intervals and is seemingly perceived as far louder in volume. It is heard ONLY during the transition period of trying to fall asleep during the late night and early morning hours when my hearing aids are off. I have no awareness of this sound whatsoever during the day. What I hear is somewhat difficult to describe, but it's a harsh, crisp one second SNAP. (Far louder than traditional tinnitus). Pretend you put a lot of coins in a plastic sandwich bag, seal it and then shake it briskly one time. This sound appears at completely random intervals. As I rest in bed, I am suddenly aware of the noise. The sound might repeat 10 seconds later, then 5 minutes later, then 20 minutes later, then 2 minutes later, etc. The complete utter randomness and abruptness have made sleep very, very challenging, even with the white nose machine at full volume a foot from my pillow.

The stress from this new sound nightmare resulted in a follow up call to my ENT Specialist. He urged me to consider an MRI procedure to rule out any physiological issues in the head. I had the procedure and results were negative as it might relate to anything abnormal whatsoever. In recent months this particular noise has continued, but its frequency has lessened somewhat. Exhaustion at bedtime has me falling asleep fairly quickly these days. The challenge is hearing this noise at say 3 am or 4 am when I might awaken for any number of reasons, trip to the bathroom, etc. Then it becomes very difficult to return to sleep.

I had a routine visit with my Audiologist a few days ago. This gentlemen is also a local tinnitus expert. It is his speculation that this overnight noise is somewhat atypical as it relates to those who describe tinnitus. He speculates that it might be better classified as an Auditory Hallucination. He is urging me to seek alternative medical opinions from a Neurologist or another ENT physician that might have a more unique hearing treatment focus.

So bottom line, I'm interested in feedback from anyone on Tinnitus Talk as to whether completely random/intermittent sharp sounds as I've tried to describe are indeed unusual as it might relate to tinnitus sufferers.

FYI, I'm 65 years of age, in good health overall and have no mental health issues whatsoever. I'm happy to respond to any specific follow up questions if you need clarification. Many thanks!

 

Hi @Dale29.

It is important to know the original cause of your tinnitus, because on your profile it reads cause unknown. Although age-related hearing loss can cause tinnitus, which you have had it since 2009, I am wondering whether hearing loss triggered the onset of tinnitus or was it something much more common, such as exposure to loud noise?

Before your tinnitus started, if you regularly listened to audio through any type of headphones, or attended venues where loud music was played, worked in a noisy environment, then it's likely your tinnitus was noise induced, especially if you noticed that your ears were oversensitive to sound, which is often an indication the auditory system is affected by hyperacusis. Only you will know this so it's something to think about.

The reason this is important is because noise induced tinnitus, usually remains stable for many years after habituation has been reached and any hyperacusis that was present is cured or reduced to very low levels. A few things can cause noise induced tinnitus to increase. Further exposure to loud noise and for some people (not all), a return to listening to audio through any type of headphones even at low volume. Age-related hearing loss can also cause this type of tinnitus to increase. However, once fitted with hearing aid(s) the tinnitus will usually return to baseline with time.

Have you been listening to music or podcasts through your hearing aids via Bluetooth? For some people this has been known to aggravate the tinnitus, particularly when the tinnitus was noise induced with hearing loss.

If the original cause of your tinnitus was related to hearing loss, then I believe the additional tinnitus sounds that you are now hearing, are related to some hearing impairment that you may not be aware of. I will assume you have recently had hearing tests at ENT and when you were examined by your audiologist. However, your hearing aids may need updating. If your hearing aids only provide amplification, then hearing aids fitted with white or pink noise could be something to consider. The idea is not to mask or cover-up the tinnitus with white/pink noise so it can't be heard, but to set their level lower than the tinnitus. Over time the brain will habituate to the white/pink noise, and slowly push the new tinnitus sound further into the background.

The white noise sound machine that is placed by your bedside, try setting the volume lower than the tinnitus in preference to fully masking or partially masking the tinnitus, which can often cause irritation to the user.

You are in good health and have no mental issues which is splendid news. Stress is an integral part of life because life is problematic. Most people that have tinnitus find it is affected by stress, so it helps to keep it under control. The additional tinnitus sounds that you describe, could be linked to stress which has resulted in auditory hallucinations. I am not saying for definite this is the case, just that it could be a possibility and something to discuss with your healthcare professionals.

Hope you start to feel better soon,
Michael