Understanding Reactive Tinnitus

Most people are familiar with tinnitus – that frustrating ringing in the ears that often comes and goes without provocation. What you may be less familiar with is a form of tinnitus that changes in loudness, quality, or pitch, in response to average or even low-level noises. This is called reactive tinnitus – and the resulting discomfort can be difficult to tolerate, and even painful.

What Is Reactive Tinnitus?

Reactive tinnitus, also known as tinnitus-induced hyperacusis or sound-sensitive tinnitus, is a unique form of tinnitus characterized by its varying loudness, quality, or pitch in reaction to even average or low-level noises. This variation happens due to changes in the brain’s neurons, which either suppress or amplify their activity to the auditory cortex, leading to a distorted perception in response to different sounds. Although related to hyperacusis, reactive tinnitus is rare, as most tinnitus cases do not typically show fluctuations or intensification due to external sound stimuli.

Patients with tinnitus may also experience hyperacusis, which is a hypersensitivity to average-level sounds. In fact the connection between the two may be a bit more common than most realize – it’s estimated that anywhere from 12 – 63% of people with tinnitus also have hyperacusis, and therefore may be more prone to reactive tinnitus. 

There are two important things to keep in mind if you struggle with reactive tinnitus. 

First, because reactive tinnitus is just that – a reaction to noise – there are therapies that can offer relief. Remember, the brain is an adaptive organ, so it has the capacity to “retrain” how to respond to any number of triggers.

The second thing to realize is that the condition can be due to fear and anxiety of sounds. For most people with reactive tinnitus, the perception that their tinnitus is worsening because of more acute episodes. These perceptual changes can cause a flood of chemicals in the brain and create negative emotions and discomfort. This in turn will compel the person to try to avoid sounds altogether. This strategy of avoidance, including the use of earplugs, usually intensifies the condition by reducing tolerance of everyday noises. Other sufferers may develop a kind of persistent anxiety for fear that routine, ambient sounds could trigger a reaction.

Treatment Options

Like so many treatments for tinnitus, Cognitive Behavioral Therapy (CBT) techniques are a great place to start. 

Because most forms of tinnitus are exacerbated by stress, CBT strategies can help ease the triggers that lead to flare-ups. CBT is an evidence-based modality that gives people experiencing tinnitus tools to better control their anxiety. While CBT is not a cure, it offers coping techniques that help people adapt, live with, and ultimately tame stressors. CBT is especially useful because with reactive tinnitus, the brain reinforces to itself that the worst will happen when it’s exposed to tinnitus or triggering external sounds; this happens through multiple interactions which can involve stress hormones, such as cortisol. CBT helps reduce this reinforcement by restructuring thoughts around the tinnitus and triggering sounds, ultimately leading to reduced triggering events and stress reactions. Lastly CBT is helpful in alleviating the fear that surrounds the sounds by recognizing those fears and dealing with them.

Another great form of intervention is sound therapy, which is usually initiated after or as part of CBT. The process uses pleasant noises to reduce or cushion the impact of triggering external sounds, and to help reduce the intrusiveness of tinnitus. Calming sounds can provide relief by redirecting attention away from tinnitus. Gradual exposure to these sounds over time help underscore to the brain that sounds are not dangerous to the ear or auditory system, and therefore reduce the brain’s reaction to various sounds. And as a bonus: sound therapy can be effective in managing hyperacusis and general tinnitus, as well.

Navigating Reactive Tinnitus with Treble Health

Treble Health is at the forefront of understanding and managing reactive tinnitus, a condition characterized by its sensitivity to external sounds. Our team, consisting of highly experienced audiologists from top practices nationwide, specializes in offering personalized solutions to those struggling with this rare form of tinnitus. We’re dedicated to providing support, insight, and individualized strategies to effectively manage your symptoms.

If you are struggling to manage reactive tinnitus, we encourage you to schedule a complimentary telehealth consultation with our team. In this complimentary 20-minute telehealth consultation, you’ll have the opportunity to explore your unique case with our experts via Zoom. We’ll address your concerns, answer questions, and suggest personalized approaches to mitigate your tinnitus symptoms. We recognize the profound impact tinnitus can have on your life, and our goal is to steer you towards a more serene and controlled experience. Book your free consultation now to start your journey toward a quieter, more comfortable life.

A Word Of Encouragement 

Like all forms of tinnitus and other hearing issues, it’s advisable to connect with your clinicians first to rule out any underlying medical conditions that may be part of your reactive tinnitus. From there, a clinician can be a key ally in referring you to the right professionals to support longer term therapies like counseling, meditation, or sound therapy. 

And although the progress may feel slow, rest assured that reactive tinnitus does respond to treatment. The sooner you start, the quicker your treatment journey begins.