Tinnitus Spike After High School 50th Reunion Dinner (98 dB)

I want to share my recent experience at the 50th reunion. The event took place in an outdoor tent, which I thought would keep the noise levels down. However, the tent had sides, so I monitored the noise using my Apple Watch dB meter. When it reached 80-98 dB over 5 minutes, I decided to skip the rest of the meal. Unfortunately, my tinnitus has been severe all week, and my audiologist informed me that I've lost another 5 dB of hearing in each ear (I currently wear a hearing aid in one ear). I never realized that such a seemingly minor exposure could have such significant impacts.

To cope, I am currently taking 0.25 mg Xanax twice a day or Ashwagandha to maintain my sanity while trying to habituate.

Typically, I wear noise-canceling Apple AirPods whenever I expect loud sounds (busy streets, airplanes, sirens, crying infants, etc.), but this was an exception. I hope it settles down soon.

I would like to know everyone's triggers so I can avoid them and be better prepared in the future. Are you willing to share the ones you KNOW trigger you? Mine have been:

- Concerts, even with earplugs!
- Dinners above 85 dB, or maybe even 80 dB
- Movies with explosive effects (I wear Apple AirPods if I really want to see them)

 

Is it possible that the noise-canceling headphones are messing with your hearing? They technically play a frequency to cancel out the noise rather than actually blocking it. Some people have attributed their tinnitus worsening to them.

 

When some people successfully habituate to noise-induced tinnitus @RHL, there is a tendency for them to forget they still need to be aware of certain situations, where exposure to loud noise could cause a prolonged spike or increase their tinnitus to a new permanent level. Having a sound level meter on one's person is not always a good idea as it can falsely represent that their sound environment is safe, which is not always the case.

You have had noise-induced tinnitus for quite some time. Therefore, I think a person with your experience should be able to judge whether the sound environment is safe rather than rely on a decibel meter. This is just my opinion.

Although you have not said, I suspect that you have been exposed to previously loud noises that you may not have been aware of. In addition, if you have been listening to audio through any type of headphones, including AirPods, headsets, earbuds, noise-canceling headphones, or bone-conduction headphones, even at low volume, the risk of making your tinnitus worse increases.

When a person habituates after a long period such as yours, the increase in tinnitus often (but not always) results from more than just one event. Usually, it's from a series of exposure to loud noises or regularly listening to audio through headphones.

I do not believe in using noise-canceling headphones or noise-reducing earplugs to reduce or cancel normal outside environmental sounds. This practice can often cause more harm than good. There is the risk of lowering the loudness threshold of the auditory system, which can make it more sensitive to sound, especially if a person has some oversensitivity or hyperacusis within the auditory system that hasn't been treated or cured.

If one isn't careful, it can also be psychologically damaging because tinnitus is an integral part of our mental and emotional well-being and cannot be separated from it. The constant reminder of wearing such devices can mean one has a problem instead of directing their thoughts to more positive things and getting on with their life.

Of course, one has to use good judgment and be aware of certain things one can and shouldn't do when being around certain sounds, which usually comes with experience. My opinions on environmental sounds and sound level meters are mentioned in my thread, Hyperacusis, As I See It.

I wish you well,
Michael

Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

I have continuous high-frequency tinnitus - no trigger is required for it to start. But exercise is the only thing that spikes it. Otherwise, it just does its own thing.

 

I don’t think so. Dr. Susan Shore told me noise-canceling headphones should not be an issue or concern. Given that she is one of the world's top experts on the subject, I am inclined to believe her. Despite that, I still try to keep the volume of my AirPods as low as possible.

I appreciate your thoughtful reply.

You are correct about judging the environment without needing the decibel meter. I try to do that so the decibel meter is my reality check. At a dinner or small gathering, I still find it easy to be lulled into a sense of complacency, and that’s where it helps the most. For example, I recently went to an event at someone’s house and thought everything was fine. Still, in the middle of a conversation, I realized it was getting louder and louder, and I quickly checked my watch and saw it was over 85 dB. I told him I had an urgent text and I ran! Unfortunately, it triggered me for several days. In theory, I should avoid all events like this, but that would mean giving up much of my social life, which is also essential for mental health. So I try to balance it, and sometimes still fail.

Regarding AirPods, as I mentioned in another reply, Susan Shore told me that noise-canceling headphones should not trigger tinnitus. Given her expertise, this is hard to argue. I don’t think there is a theoretical basis for believing it would cause any harm, but if you know of one, please share it.

Despite that, I keep them at the lowest possible volume. In fact, I live on a somewhat noisy city block and often wear my AirPods at zero volume to cancel out any loud noise or sirens on the street. Psychologically/emotionally. This is also fine for me because everyone seems to be wearing them, and I don’t stand out.

Russell

 

I don't think objectively measuring the volume of an environment is always accurate in every situation. Background noise can be deceiving sometimes. Take driving, for instance. The white noise of tires on the road can cause your car stereo not to appear very loud until you come to a complete stop. I always noticed my car stereo felt uncomfortably loud once I exited the highway and it was a stoplight even though it felt very comfortable while on the highway. Now, all I have to do is check my Apple Watch to ensure I'm within a limit that doesn't spike my tinnitus.

The only issue I have with noise cancellation is that it is really only effective at constant low-frequency noise. Any sudden violent sounds overwhelm the hardware, which isn't the greatest at cutting out high frequencies. I have a pair of Bose QC45, which I have used while flying and driving cross-country. I always pair them with earplugs, though. They help with road and airplane noise better than earmuffs.

I don't seem to be able to tolerate sounds above ~65 dBa without having a spike. My tinnitus has worsened from 85 dBa sounds with earplugs in.

 

The advice I am about to give you is entirely up to you whether you wish to follow it, so please do not take it personally. Hardly a week goes by in Tinnitus Talk, without me reading about Susan Shore and her up-and-coming tinnitus device. I get the impression she is an expert in tinnitus. I commend her for inventing a device that will hopefully help alleviate or completely cure the distressing symptoms of tinnitus that many people with this condition endure.

However, I read a piece she wrote saying that she has very mild tinnitus that isn't bothersome, which is good. In my opinion, Susan Shore may be an expert in Audiology and Audiovestibular medicine, but I very much doubt she is an expert in tinnitus, which is an entirely different kettle of fish! If you want to follow the advice of someone with mild tinnitus who believes listening to audio through noise-canceling headphones shouldn't trigger tinnitus or make it worse, then go right ahead, but I think you are playing with fire.

The moment I read in your post that you used Airpods, I believed this caused your tinnitus to worsen gradually. The 50th reunion party you attended may have worsened matters, but the underlying problem is listening to audio through headphones/AirPods, even at low volume. I hope the spike that you are currently experiencing subsides. Still, if you are not careful and stop listening to audio through all types of headphones, then you risk your tinnitus increasing and could change to what I define as variable tinnitus. This type of tinnitus is a more severe form of noise-induced tinnitus. It is ruthless and very unforgiving.

Please click the link below and read my thread: Can I Habituate to Variable Tinnitus? Please type headphones in the search box at the top of this page and read the posts.

All the best,
Michael

Can I Habituate to Variable Tinnitus? | Tinnitus Talk Support Forum

 

Keep in mind that 5 dB is within a margin of error of hearing tests, so your hearing may not have changed that much. If you went to three different hearing test places on the same day, you most likely wouldn't get 100% matching PTA values. There are fluctuations due to patient, equipment, test administrator, environment, etc.

 

Michael, as usual, thanks for your guidance.

To clarify, your comments address the use of AirPods while listening to audio, but I wear them 90% of the time without listening to anything. They are simply for noise cancellation while I’m walking, along busy streets, or in an airplane. I’m not sure whether you feel that is helpful or harmful. However, they seem to do a much better job than earplugs because they completely deaden all the sounds in my environment, while earplugs only reduce them.

I would love to speak with an audio engineer who designs noise-canceling devices and get their perspective. Are you in contact with any of them? They may have unique insights that we are overlooking. For example, the problem may be that users are still setting their volume much higher than necessary. Combined with pre-existing hearing loss, users may be deceiving themselves into feeling as though the volume is low when, in fact, it’s quite high.

That’s a great point and I appreciate you sharing it!

I agree. I have worn my AirPods underneath my Sony headphones while flying, which gives me double the noise cancellation, but it feels like overkill and not entirely comfortable, so I’ve stopped doing that.

But I am shocked at your 65 dB threshold because that’s a normal speaking level. How do you engage in indoor or outside conversations without triggering your tinnitus? Do you keep your earplugs in or headphones on whenever you leave the house? What about social situations? Do you avoid all of them?

 

I attempt conversation without earplugs, but depending on how loud the other person speaks, I usually find myself reaching for my earplugs. I haven't really measured recently, but I believe I also don't go past 55 dB or so while watching TV or movies, and I always use dynamic compression to keep low and loud parts of the audio from being too extreme.

I wear earplugs every time I step out of my front door. That may seem extreme, but many times, even that hasn't been enough protection.

I've been less and less adventurous as the past 3.5 years have passed. At first, I only wore earplugs to walk from my apartment to my car because my neighbor had a loud modified Subaru. I worsened, so I began wearing earplugs most of the time in case any unexpected motorcycles or other loud noises happened. However, I still lived my life only avoiding the loudest of places - bars, movie theaters, theme parks, etc. Then, even restaurants and coffee shops started to become too much. Now, I basically go to the grocery store and run errands, and even that has left me vulnerable.

It would be nice to be able to just put in a pair of earplugs and continue on with my life, but that hasn't been the case, no matter how hard I have tried to live normally.

 

Thank you for your kind comments @RHL and the clarification. Please accept my apologies for believing you regularly listen to audio through your AirPods. However, I would like to give you further advice for consideration. We are all different, so my advice is not absolute.

You have had noise-induced tinnitus for ten years. Suppose you have previously habituated to this. In that case, I mean the tinnitus reduced to a level that you could comfortably live without experiencing any spikes or oversensitivity to sound, which is good. Hyperacusis or oversensitivity to sound often (but not always) accompanies noise-induced tinnitus.

This is important to know because a person can habituate to noise-induced tinnitus. Still, if hyperacusis or any oversensitivity to sound is present within the auditory system, then spikes and oversensitivity to sound can become a long-term problem. Some people try to address this by wearing noise-reducing earplugs and keeping away some normal everyday sounds. However, having some oversensitivity to sound will always remain unless it is treated as mentioned in my thread: Hyperacusis, As I See It. Suppose you find it necessary to wear noise-canceling AirPods to use your words and completely deaden all sounds in the outside environment instead of using earplugs. In that case, you should see an ENT and audiologist specializing in tinnitus and hyperacusis management.

A person who wears noise-reducing earplugs or noise-canceling AirPods to suppress outside environmental sounds to the levels that I think you mean, I believe such a person needs treatment. You also say that 90% of the time, AirPods are used to cancel noise. Therefore, I get the impression that you have listened to audio through them, for you mentioned in your previous posts that you try to keep the volume low. If I were in your situation, I wouldn't listen to any type of audio through headphones, AirPods, earbuds, or headsets, no matter how low the volume is set, but it's your choice.

I am pleased that you find some relief from the tinnitus using Xanax. Please try to see the health professionals I have advised and get some treatment.

I hope you start to feel better soon.

Take care,
Michael

 

Wow, that’s really quite bad. Have you measured your tinnitus volume? It increased over the years despite all of these protections?

I measure my volume by holding my Apple Watch decibel meter 6 inches in front of me, and I make an equivalent sound hiss to what I’m actually hearing. It ranges from 55 to 70 dB. The spikes are around 70, and that’s when I start to go a little crazy.

Do you find that limiting your life like this helps to reduce the spikes or the average volume?

By the way, from your profile, it sounds like you helped write and produce portions of the Sopranos. I just saw Michael Imperioli in Enemy of the People in New York City, and he was fantastic. I understand he’s a Buddhist teacher. Meditation has been very helpful for me, especially on bad days. Do you practice?

 

Have any of you tried wearing electronic earmuffs designed for people who shoot guns? If so, how do they differ from regular noise-cancelling earmuffs? Are they basically the same and just marketed toward different types of customers, or are they significantly different in quality and intended function?

 

All the ones I’ve seen only protect against sounds greater than ~80 dBA.

 

The idea is that they protect from impulse sounds, but yet you can still have a normal conversation when the gunshots are not going off, since they have the ability to amplify quieter sounds. They are very different to your normal Peltor X5As.

 

In hindsight, I wish I had kept some sort of record of what volume originally masked my tinnitus. I know I tested it out with white noise and shower sounds. White noise doesn't seem to catch the higher frequencies of my tinnitus and so it never masks it. Shower sounds or just running water seems to work better for some reason. Maybe I'll start keeping a log now so at least I can compare in the future.

I did try to put my phone up to my ear and make a "fff" sound until it masked my tinnitus. It was challenging to get an accurate reading, but it seemed to be around ~60 dBa. I'm on Prednisone right now, so my tinnitus is more muted than usual. I'll try again in a couple of weeks.

Limiting my life like this is horrible. It's incredibly isolating. Nonetheless, I still have mishaps, and so my tinnitus has regularly gotten worse over the past 3.5 years. All I ever wish for is stability.

 

Thank you. I don't think I phrased my question correctly. What I meant was, how do the active noise-canceling shooter earmuffs differ from the active noise-canceling headphones and noise-canceling earbuds worn by office workers and subway commuters (not passive earmuffs such as Peltor X5A)?

As I understand it, all types of active noise-canceling earmuffs and earbuds selectively eliminate louder noises while allowing the user to hear softer noises. But what I want to know is whether the earmuffs for shooters are more powerful because they are designed with the expectation of gunfire and bombs, not just loud conversation in a coffee shop or the sound of a photocopier in an office.

From time to time, I have looked at the technical specs for various active noise-canceling earbuds and earmuffs on Amazon, and none of them actually said how many decibels they will protect you from. The inability to commit to a noise reduction rating doesn't sit right with me. But this morning, I looked at the specs for shooter earmuffs, and they have actual noise reduction ratings on them, which I find deeply reassuring. So maybe they are more powerful, and I've just answered my own question. But if anybody knows more on the subject, please chime in. I am genuinely curious.