Sounds That May Aggravate Tinnitus, And How To Avoid Them

The sound of tinnitus can be aggravating on its own, but did you know that there are sounds that may actually worsen the sound of your tinnitus? Your tinnitus triggers may not be the same as someone else’s, but knowing which troublesome sounds to avoid can protect your hearing and help quiet that ringing in your ears. 

What Causes Tinnitus?

Tinnitus is defined as the perception of sound when there is no external noise. Frequently hearing these phantom sounds in one or both ears affects about 25% of the US population, and almost everyone has experienced brief mild tinnitus at least once. Tinnitus is commonly described as a ringing in the ears, but to some people, it sounds more like buzzing, hissing, chirping, clicking, or whooshing sound. 

Tinnitus itself is not harmful, but the distress, frustration, and distraction can have a major impact on quality of life, as those with severe bothersome tinnitus often struggle with insomnia, stress, depression, anxiety, and even socialization. 

Common Causes Of Tinnitus

The primary cause of tinnitus is hearing loss. As many as 90% of people with hearing loss experience tinnitus. There are three primary types of hearing loss that can contribute to tinnitus:

• Sensorineural hearing loss. This common type of hearing loss may be due to noise exposure, age-related hearing loss (presbycusis), an inner ear disorder such as Meniere’s disease, damage to the cochlear hair cells, or damage to the auditory nerve function.
• Conductive hearing loss. Less commonly, you may experience hearing loss due to an ear infection (otitis externa or otitis media) or abnormal bone growth on the middle ear bones called the ossicles. This is called otosclerosis.
• Mixed hearing loss. Some people experience a combination of sensorineural hearing loss and conductive hearing loss.

Tinnitus can also be caused by a neck or head injury, illness, infection, earwax blockage, certain ototoxic medications, or even dental issues. Tinnitus is very rarely related to a serious medical condition, but it may be a symptom of a health issue, so it’s a good idea to speak with your doctor to rule out any underlying causes.

15 Triggers That May Worsen Tinnitus

In addition to the many possible causes of tinnitus, there are also commonly known environmental triggers that can set off your symptoms. 

• Loud noise
  • Loud noise exposure is one of the main causes of tinnitus. If exposure to extreme sound continues or increases, tinnitus symptoms can worsen and may persist long after exposure.
• Earwax build-up
  • Earwax or foreign objects can block the external auditory canal, causing temporary hearing loss. This sudden change in hearing can result in the onset of tinnitus or worsen your existing symptoms until the blockage is removed.
• Congestion
  • Congestion from a head cold, allergies, or sinus infection can lead to a type of conductive hearing loss which can temporarily increase your awareness of tinnitus symptoms. Usually, tinnitus resolves after the cold or infection clears up.
• Blood pressure
  • Both high and low blood pressure have been shown to trigger tinnitus symptoms. Heart problems may also be linked to pulsatile tinnitus. Be sure to have your cardiovascular health evaluated and blood pressure monitored if you are at risk for these conditions.

• Certain medications
  • New medications, changes to dosages, or taking ototoxic (ear-damaging) medications can trigger tinnitus. Ototoxic medications range from common NSAIDs to cancer drugs, so be sure to talk to your doctor about any changes to your tinnitus noticed when both starting new medications or changing dosages.
• Alcohol, caffeine, refined sugar, and salt
  • Making healthy lifestyle choices can help lessen tinnitus. Rarely, patients report that alcohol, sugar, salt, or caffeine triggers their tinnitus. If you think your diet is impacting your hearing, try using a food diary to monitor your symptoms – if there seems to be a link to your tinnitus, it may be time to make some changes to your diet.
• Tobacco use
  • Because tobacco can affect blood pressure, blood flow, and deprive blood vessels of oxygen-rich blood, some people report that their smoking habits can worsen tinnitus. However, stopping smoking can be so stressful, it can worsen your tinnitus. If you’re ready to stop smoking, talk to your doctor about an action plan.
• Jaw problems
  • If you grind your teeth or notice your jaw popping when you open and close your mouth, the nerves, ligaments, and muscles can become inflamed. Since your jaw joint – called the temporomandibular joint (TMJ) – is very close to your middle ear, the inflammation can trigger or worsen tinnitus.
• Stress, nervousness, and tension
  • Stress can have a tremendous effect on the body. The ever-present tinnitus signal from the auditory brain may trigger the fight or flight response in your limbic system, which can lead to a sense of uneasiness or worry when you notice tinnitus. Finding ways to relax, practice mindfulness, and unwind (like deep breathing) have shown positive results in reducing tinnitus symptoms.
• Anxiety and depression
  • Your emotional well-being is also related to the intensity of tinnitus. Anxiety and depression can trigger tinnitus, but some of the medications used to treat these conditions have tinnitus listed as a side effect. Talk to your doctor about balancing your medications and your mental health.

• Headaches
  • The pounding in your head could leave you with a ringing in your ears. If you suffer from migraines or headaches, you may be at higher risk of chronic tinnitus. It’s not entirely clear why headaches and tinnitus seem to be related, but it’s important to address potential headache triggers to reduce your tinnitus symptoms.
• Sleep problems
  • A good night’s sleep is crucial to our overall health, and if you’re listening to an annoying ringing in the ears all night long, your rest may suffer. Falling asleep and staying asleep can be difficult for those with tinnitus, and that lack of rest can worsen tinnitus. If you struggle to get quality sleep at night, try using a sound machine. Sound therapy at your bedside or through ear-level sound generators can help your body relax and make you less aware of your tinnitus.

Loud Noises To Avoid With Tinnitus

Avoiding loud sounds is key to protecting your hearing, and it’s important to know what to watch out for. Some people – like machinists, hunters, military personnel, and people who work with heavy machinery – have greater risk factors for noise exposure and are therefore more likely to develop tinnitus.

• Music. Exposure to loud music, whether from headphones, concerts, or other events, can worsen tinnitus. Listening to headphones at a high volume can deliver intense sound directly into the ears, which can damage the auditory system.
• Machinery or industrial noise. Noise from construction sites, heavy machinery, tools, lawnmowers, and other sounds can increase symptoms.
• Gunshots and explosions. Sudden, extremely loud sounds like gunshots, explosions, or fireworks can have a severe and sudden impact on tinnitus symptoms. 
• Household appliances. Loud appliances like blenders, hairdryers, or power tools can worsen symptoms if you hear them at close proximity or for an extended period of time.
• Traffic. Living in an environment with constant traffic noise or sirens, especially if you’re exposed to the sound regularly or for long periods of time, can cause hearing damage.

Hearing sounds at the same pitch or frequency as your perceived tinnitus can worsen symptoms as well. When you hear this matching sound, you might not notice tinnitus for awhile, but when that external sound is removed, tinnitus becomes more noticeable than before. 

How Loud Is Too Loud?

Some extreme sounds are relatively easy to avoid, but it’s important to be aware of the volume of the world around you. 

Sound is measured in decibels (abbreviated dB), and prolonged exposure to sounds above 85 dB can cause permanent hearing damage. Over 105 dB can cause damage to inner ear hair cells within five minutes, and noise above 120 dB can cause immediate hearing damage. Volume levels at or above 140 dB are known to cause acoustic trauma, resulting in instantaneous, irreparable damage to the inner structures of the ear.

For reference, a typical rock concert can be over 110 dB, a power tool can range from 80-120 dB, a gunshot can be over 140 dB, and a NASCAR race can be as loud as 130dB.  Normal conversation clocks in at about 60 dB, and it is safe to listen to the soft sounds of daily life without causing damage to your hearing. 

It is not necessary to avoid every loud sound, but those that are over 85dB and will be sustained for longer than one hour will likely trigger tinnitus.

How Do Loud Noises Worsen Tinnitus?

There are two ways excessive noise can make your symptoms worse: physically and psychologically.

• Physical Damage
  • If you have chronic tinnitus, the hair cells in your inner ear are already damaged. Subsequent exposure to loud sounds can cause further permanent damage, which may lead to increased tinnitus severity. This could happen if, for example, you hear a gunshot at close proximity without wearing proper ear protection.
  • Loud noise exposure could also result in the temporary increase in tinnitus because of overstimulation. After the loud sound is removed, tinnitus will typically return to its normal level after a few days. This would be the case if you attended a loud concert.
  • Unfortunately, it is not possible to tell which will be the case until a period of time has passed and tinnitus symptoms have been observed.
• Psychological Response
  • Chronic tinnitus is distressing, and many people live in constant fear of making their condition worse. Simply by being around loud noises, some tinnitus patients may feel so worried and over-reactive that their emotional response makes tinnitus seem louder. This response is usually temporary and does not cause further damage to the inner ear.

How Can I Avoid Triggering My Tinnitus?

In most cases, you can continue to live your usual life by using hearing protection when you may be exposed to loud sounds – this is your first line of defense in protecting the delicate hair cells in your inner ear. However, hearing protection should not be worn constantly, since earplugs can put pressure on your ear canal and contribute to wax buildup.

Foam, silicone, or custom-made earplugs from your audiologist can allow you to safely participate in your noisy hobbies. Some earplugs like Westone’s Tru Custom are specifically made for enjoying high-fidelity music while protecting your ears from further damage and worsening tinnitus. 

If earplugs are not a reasonable solution for you, avoid excessive sound whenever possible. If you suffer from severe tinnitus, try to avoid attending loud events like concerts, race car events, or shooting ranges when possible. This type of avoidance is more extreme, but in some severe cases, it may be necessary to protect your remaining hearing.

How To Manage Tinnitus

Persistent tinnitus rarely indicates a serious health problem, but it sure can be annoying. Thankfully, there are ways to treat tinnitus and allow that ringing sound to fade into background noise.

• Tinnitus Retraining Therapy (TRT). This technique balances education, counseling, and sound therapy to help you retrain your emotional response to tinnitus, so you can learn to ignore it.
• Cognitive Behavioral Therapy (CBT). Counseling and learning coping techniques are effective ways to manage the distress that tinnitus can cause.
• Sound Therapy. Using soothing sounds helps you habituate to tinnitus and suppress those distracting sounds.
• Hearing Aids. It is possible to have chronic tinnitus and normal hearing, but for those who have hearing loss, using hearing aids may be key to quieting unwanted tinnitus sounds and focusing on the sounds around you.
• Treating root causes. If an underlying medical condition such as high blood pressure is causing tinnitus, finding appropriate treatment may be enough to silence tinnitus.

Closing Thoughts

In almost all cases, only you can hear tinnitus – but that doesn’t mean you have to suffer in silence. At Treble Health, our audiologists have decades of experience and have helped thousands of tinnitus patients manage their tinnitus and regain control of their lives. If you have any tinnitus related questions or are searching for the best treatment options to match your specific needs, we suggest scheduling a complimentary telehealth consultation with our team. This is a free, 20 minute Zoom call where you can meet with an audiologist on our team and learn more about managing tinnitus. To get started, click here.