What Is Reactive Tinnitus?

Hi @Michael Leigh, the reactivity of my tinnitus has worsened the last month, coincidentally so has my hyperacusis. If this worsening is due to medication or over-protection, I leave unsaid.

I have a question for you; did you yourself experience "reactive tinnitus" when you suffered with hyperacusis? - if so, how did the reactivity manifest?

My tinnitus seem to spike up slightly in response to any sound whatsoever, this usually goes down to "baseline" within minutes, hours or until I get a good nights sleep. Have you experienced anything similar? - just curious.

Wish you well!

 

I thought the opposite was true, that I was overstimulating my brain by sleeping with the constant bombardment of noise. Maybe this is why, 3 months in, my tinnitus is loud, intrusive and unchanged. I just don't know what is right or wrong.

 

I understand the reason for your way of thinking AliasM. However, playing low level sound enrichment by the bedside throughout the night, isn't bombarding the brain with noise. In fact it's quite the opposite, the brain is being supplied with what it needs, to help prevent it from increasing its background activity and thus, increasing the tinnitus too. This can make the tinnitus louder and more intrusive during waking hours.

Please go to my started threads and read my articles: Tinnitus, A Personal View, The Habituation Process, Sound Machines and Tinnitus, as I go into more detail the benefits of using sound enrichment during the day and night.

Michael

 

Hey @Michael Leigh - I just joined the forum and could really use your advice.

I've had tinnitus since I was 9 years old (27 now) and habituated to it pretty easily over the subsequent 2 or so years, but 3 months ago, it got suddenly worse (mostly in my right ear) and is now reactive in the way that most people describe as characteristic of "reactive tinnitus". External sounds especially things like a running sink, crumpling paper, etc. elicit a piercing/squealing sound that is very uncomfortable. I'm also experiencing what I think it TTTS, also mostly in my right ear. Louder sounds make my eardrum flutter a bit, and it's especially noticeable when I speak loudly. Again, it's mostly in my right ear. I've been back to my ENT who ran me through every test and said everything looks normal.

There was no obvious trauma when my tinnitus started all those years ago nor when it got worse 3 months ago. I was using headphones regularly in the context of work, but I'd been doing that for almost two decades prior. The only other factor at play in my life that I can think of is that I was quite stressed and had/have been experiencing some bad chronic anxiety for the better part of 2 years now. I was working in a "hacker house" environment staying up very late when it spiked and became reactive 3 months ago.

What is the best way to get through this? Is it simply sound enrichment? I haven't been avoiding external noise or anything like that since it began, but I haven't really noticed any improvement. Should I be playing white noise on my phone while I sleep? I'd really like to believe there is a path to recovery here. It's making my life very difficult right now.

 

Hi @Spencer332.

Welcome to the forum. Some people believe there is such a thing as reactive tinnitus, but I don't. Tinnitus can and does react to sound but to my knowledge there is no medical condition called reactive tinnitus. Even if there was, I still wouldn't recognise it as one.

People that complain of reactive tinnitus have usually been exposed to loud noise or regularly listened to audio through headphones, earbuds, AirPods, or headsets at too high a volume and developed noise-induced tinnitus. This type of tinnitus is often (but not always) accompanied with hyperacusis or having some oversensitivity to sound because the auditory system has become highly sensitive. This hypersensitivity varies from person to person and comes in different levels of severity. It can be mild, moderate or severe that can result in some people experiencing severe pain, when exposed to quite mild external sound.

Hyperacusis or having some oversensitivity to sound is a separate condition. It can improve by itself over time but in many instances, it requires professional help with an audiologist that specialises in tinnitus and hyperacusis management. The affected person will need to use wearable sound generators also called white noise generators, to desensitise the auditory system's oversensitivity to sound - regular counselling with the audiologist is also advised. This helps to remove and demystify the negative thinking that is often attached to tinnitus and hyperacusis, without the counselling treatment may not be successful.

I suspect that your tinnitus has been made worse by using headphones and I advise you to stop using them even at low volume.

Please click on my Avatar and a box will appear. Choose started threads and read the following posts: New to Tinnitus, What to Do, Tinnitus, a Personal View, Hyperacusis, As I See It, The Habituation Process, How to Habituate to Tinnitus, Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, Will My Tinnitus Get Worse? The Complexities of Tinnitus and Hyperacusis.

Please print the posts rather than read them on your phone or computer screen. This way you will absorb and retrain the information better, because it's a lot to read. How to use sound enrichment is covered in the above posts and ways to manage stress and anxiety, that may require you to see your doctor.

All the best,
Michael

 

Thanks Michael.

Is there a reason white noise generators are that much better than just ambient white noise being played from a speaker? Also, any idea why tinnitus is more prevalent in my right ear?

Curious if you experienced this form of tinnitus at any point in your journey where it reacts to sound as I've described. If so, how long did it take you to get through it?

Thanks again,
Spencer

 

Hi @Spencer332.

Wearable white noise generators are one of the best devices to use for treating tinnitus and hyperacusis, because they fit closely to the ear and the white noise is high quality and specifically designed for smooth delivery of white or pink noise into the auditory system and shouldn't cause irritation when properly used. They should be introduced slowly, by wearing them for 1 or 2 hours, then taken off for the same duration, then put back on. Continue doing this for the first week or two, always keeping the white noise low so it doesn't irritate the ears.

Over the following weeks slowly increase the wearing time of the white noise generators. Patience is required because any attempt to rush this process can irritate the tinnitus and hyperacusis if it is present. The goal is to be able to wear them for up to 8 to 10 hours a day and this is often achievable. Ideally, regular counselling is advised with an audiologist that specialises in tinnitus and hyperacusis management. This helps to remove and demystify the negative thinking that is often attached to tinnitus and hyperacusis.

Counselling and wearing white noise generators cannot do all the work. One has to make a conscious effort to reinforce positivity into their life, and this is the reason counselling is so important. A good therapist preferably one that lives with tinnitus understands this and can open the door, but it's the patient that has to work through it. Take up a new interest or hobby, no matter how small. Go out for walks which helps to clear the mind and to think more positively. Try to socialise. These things are not easy so one must proceed at their own pace and not push themselves too hard.

Whilst ambient white noise from a speaker is good for sound enrichment, it's not in the same class as dedicated white noise generators. It doesn't matter whether the tinnitus is in one ear or both or more prominent in one ear. The reason being the brain has only one auditory centre for hearing, according to a good friend of mine who is an Audiologist and works with tinnitus patients.

She advises her patients to only use one white noise generator for this reason with counselling. I don't agree with this, but she informs me all her patients have good results with tinnitus and especially hyperacusis. The only ones that don't do well, are those that don't stick to the treatment programme.

Yes I did in the early stages when I had hyperacusis in 1996. It was completely cured after 2 years with TRT and wearing white noise generators with counselling. In 2008 I had a second noise trauma and my tinnitus changed to variable, but the hyperacusis did not return. I had to wear white noise generators for 2 years and have counselling with my hearing therapist for the same duration.

It all depends how intrusive your tinnitus is and how severe the hyperacusis is. You may be able to treat it with self-help as mentioned in many of my posts. However, you may need to see an audiologist that specialises in tinnitus and hyperacusis treatment.

Michael

 

Thank you very much for your detailed thoughts/guidance. I really do appreciate it.

One question I forgot to ask after your initial response - you said that "reactive tinnitus" (sorry for using the term, but you know what I'm referring to) is usually tinnitus with co-morbid hyperacusis, but that that isn't ALWAYS the case. I'm reading that to imply that "reactive tinnitus" can be experienced sometimes in the absence of hyperacusis. Is that right? If so, is sound therapy/enrichment still the right approach for getting the "reactivity" to go down over time? When there is co-morbid hyperacusis, the sound therapy approach seems really intuitive to me given it can desensitize the auditory system to sound over time and then a coincident decrease in the reactivity can occur as the system becomes less sensitive to sound, but when there's no hyperacusis, I don't exactly know what the logic is.

Spencer

 

Hi @Spencer332.

Thank you for your kind comments. The advice I give in this forum is advice; it is not absolute because we are all different. No two people will experience tinnitus the same. Tinnitus can be very complex due to the way it can affect a person's mental and emotional well-being and thus, many factors are involved. I note that on your profile it mentions your tinnitus was brought on by anxiety and stress. This may well be the case, however, please keep in mind the most common cause of tinnitus is exposure to loud noise.

When the onset of your tinnitus started in 2005, if you regularly listened to audio through any type of headphones, including earbuds, headsets, AirPods, etc, worked in a noisy environment or frequently went to clubs, concerts where loud music was played, then the original cause of your tinnitus was likely to be noise induced. Only you will know this.

The majority of people that I have corresponded with that complain of reactive tinnitus usually have noise induced tinnitus. Caused by being exposed to some form of loud noise, usually listening to audio through headphones at too high a volume or regularly using them and not giving the ears sufficient rest. Frequently visiting clubs and concerts where loud music is played or playing a loud instrument in a band can bring it on too.

When tinnitus randomly spikes for no reason or reacts to certain types of sound, usually (but not always) the underlying cause is an overactive auditory system. The way to treat this overactivity is to use sound therapy to desensitize the hyperactivity. This can be achieved by using a tabletop sound machine for sound enrichment or in more complex cases, white noise generators may need to be worn in conjunction with having counselling (talk therapy) with an audiologist trained in tinnitus and hyperacusis management.

I am not saying that people whose tinnitus wasn't noise induced can't react to sound. All I'm saying I don't believe the term reactive tinnitus is a medical condition. It is a sign the auditory system is hypersensitive and usually indicates the person has some form of hyperacusis, which affects people differently and can be treated in the ways that I have mentioned.

Hope this helps,
Michael