Tinnitus and hearing loss: What’s the connection?

Up to 15 percent of adults experience tinnitus, which causes ringing in the ears. The sound may seem to come from inside your head, or from a distance, in one ear or both. It may be steady or pulsating, but only you can hear it.  

Some people can tune out the distraction using habituation techniques or meditation, but tinnitus can become bothersome for about 2 percent of the population. Some people experience tinnitus occasionally, some nonstop. It can ebb and flow, and even spike.

Scientists aren’t sure what happens in our brain that causes these phantom sounds. But we do know that the problem is often linked to hearing loss and exposure to noise. In addition, different health disorders can produce tinnitus as a symptom, according to the American Tinnitus Association. Another common trigger? Meniere's disease, a disorder of the inner ear that causes dizziness, tinnitus and hearing loss.

Tinnitus and hearing loss

About 90 percent of people with tinnitus also have hearing loss, though many people may not even realize they have both conditions. Tinnitus usually follows the pattern of your loss. If you have high-frequency hearing loss, your tinnitus is often a high-pitched ringing or hissing. If you have hearing loss in one ear, you’ll usually only have tinnitus in that ear, and it will often go away if you get a hearing device in that ear.

Over-compensating for loss of noise

Why would a loss of sound perception cause phantom sounds? Let’s review how hearing works: A sound wave enters your ear and arrives at the middle and inner ear, the location of the cochlea, a fluid-filled area with hair cells. The hair cells turn the vibration in the fluid into electrical signals that reach the brain through your auditory nerve.

Infections, injury, noise or aging can damage the hair cells and cause hearing loss. When your brain gets less information from the cochlea, your auditory system may compensate by becoming more sensitive—the technical term is “raising the gain”—much like when you turn up the volume on a radio when the signal is low or nearly gone. This may be why some people with tinnitus are especially sensitive to loud noise.

If you have tinnitus, you may also have hearing loss–even if you haven’t realized it.

Protect your hearing to prevent tinnitus

The bottom line: Loud noise is dangerous, and can even damage your hearing while you sleep. Wear earplugs, earmuff-style noise blockers or even a custom-fitted device if you must spend time amid loud noise.

Lifestyle changes and smart choices about noise exposure can go a long way to prevent hearing loss.

Get a hearing test—and possibly hearing aids

If you have tinnitus, you may also have hearing loss–even if you haven’t realized it. Get your hearing checked by finding a hearing specialist or audiologist that specializes in tinnitus near you. Please note that not all hearing clinics treat tinnitus, so you may need to browse several clinic pages to find the right provider.

How hearing aids help

Why is this important? Many people who have both hearing loss and tinnitus report that hearing aids for tinnitus are very helpful.

Noise-induced hearing loss and tinnitus

Loud noises can damage hair cells in the cochlea and also the nerve that carries information to the brain, known as noise-induced hearing loss. Musicians are disproportionately affected by tinnitus, even though they often keep the problem hidden. More on musicians and tinnitus.

Sometimes the sounds will appear after noise exposure when you’re young, go away, and return later in life as you age and a hidden vulnerability appears.   

Both hearing loss and tinnitus are common among veterans

Tinnitus is more common after the age of 60 but can happen at any age. It is a common complaint among U.S. veterans returning from Iraq and Afghanistan, sometimes traced to a traumatic brain injury, but also to battlefield and workplace noise.

Note: Tinnitus that pulses like a heartbeat could indicate a serious health issue and should be investigated by a doctor.

More: Top tinnitus myths