Tag Archive: tinnitus

Another possible treatment for tinnitus

Photo credit: This photo is in the public domain.

by Daniel Fink, MD, Chair, The Quiet Coalition

Tinnitus is “ringing in the ears,” or, more technically, the perception of sound when there is no external auditory stimulus. The current theory is that tinnitus is located in the brain, possibly abnormal electrical patterns, although the exact locus and lesion are not known.

This report from Finland describes the use of trans-cranial magnetic stimulation to treat patients with severe tinnitus. Like most similar reports, it is very preliminary.

Tinnitus has many causes, but the most common cause is noise exposure. This may be via a one-time exposure to loud noise or associated with noise-induced hearing loss caused by chronic noise exposure. In either instance, tinnitus can be prevented by avoiding noise exposure.

While it’s exciting that there is a potentially promising treatment for tinnitus in the offing, I must point out that avoiding the need for treatment is always the better option.

So remember: if it sounds too loud, it is too loud. Protect your hearing.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

What to do if you hear sounds that others do not

Photo credit: bruce mars from Pexels

Finally, David M. Sykes, Vice Chair, The Quiet Coalition, addressed a query from a woman who said she heard a sound in her living space that her partner insists wasn’t there:

by David M. Sykes,Vice Chair, The Quiet Coalition

The Quiet Coalition recently received an inquiry from a woman who said she hears “a nearly imperceptible high-pitched sound” in her living space. She states that she can hear the sound, but her partner insists there is no sound. “Could a smartphone-based sound-meter app isolate and identify this sound?” she asked, adding “if so, which one do you recommend?”

First, I must note that the fact that this woman hears noise but her partner does not means nothing at all. Her partner could simply have much less sensitive hearing!

We at The Quiet Coalition agree that the best step is to try to measure the sound. There are free or inexpensive sound meter apps that you can install on your smartphone, so start there. Some are better than others, but thankfully, experts at the U.S. Centers for Disease Control and Prevention have tested and rated smartphone sound-meter apps, which we reported on last year.

But a smartphone app may not be sensitive enough to pick up the sound. What should you do if this is the case? The only alternative could be to find an acoustics engineer to visit your residence and use professional equipment to identify the noise and then help you identify the source. That person can also suggest some ways to address the problem—which could be a neighbor’s electronics. The National Council of Acoustical Consultants offers advice on how to select a professional, licensed acoustical engineer.

There is, however, another possibility that must be considered: hearing a high-pitched sound that no one else hears COULD mean that you have a hearing disorder called tinnitus or an acute sensitivity to sounds called hyperacusis. Tinnitus can be identified by first finding a truly quiet place, such as a library, or on a weekend retreat in the countryside, to see if you still hear the noise when you are away from the circumstances where you are aware of the sound.

40 million Americans have tinnitus (myself included), so it’s quite common. And many of us spent years assuming that the “background noises” we heard were actually coming from the environment and that everybody heard the same thing!

So we recommend that you pursue both of these steps, because exposure to noise can be stressful, can cause sleep loss, and can have other health effects.
First try to determine where an unseen source of high-pitched sound in your environment is coming from. If the sound cannot be isolated, then consider that the cause of the sound could be tinnitus or another hearing disorder that should be attended to.

Frankly, the best result would be that there really is an unseen source of high-pitched sound in the immediate environment. Why? Because that can be fixed once the source is identified. But tinnitus cannot be cured, though there are techniques for managing it—which include avoiding the kinds of exposures that may have caused it in the first place. And know that the onset of tinnitus can be quite sudden.

To learn more about tinnitus check out the American Tinnitus Association‘s website and the Clinical Practice Guideline for Tinnitus published in 2014 by the American Academy of Otolaryngology–Head & Neck Surgery.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Consumer Reports tackles tinnitus

Photo credit: Frmir licensed under CC BY-SA 3.0

by Daniel Fink, MD, Chair, The Quiet Coalition

This article by Hallie Levine in Consumer Reports discusses tinnitus. The advice is generally sound, with one exception–the article states that “any noise over 85 decibels can damage hearing.” This isn’t accurate.

The auditory injury threshold is only 75-78 A-weighted decibels (dBA), and 85 dBA is the National Institute for Occupational Safety and Health Recommended Exposure Level for occupational noise, not a safe noise exposure level for the public. I wrote about this in the American Journal of Public Health and the NIOSH Science Blog also covered this topic.

But the basic message is correct: avoid loud noise, protect your hearing, and you won’t develop tinnitus from noise exposure.

And remember, if it sounds too loud, it IS too loud.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Hearing noise? Here’s how to find out where it’s coming from

Photo credit: bruce mars from Pexels

by David M. Sykes,Vice Chair, The Quiet Coalition

The Quiet Coalition recently received an inquiry from a woman who said she hears “a nearly imperceptible high-pitched sound” in her living space. She states that she can hear the sound, but her partner insists there is no sound. “Could a smartphone-based sound-meter app isolate and identify this sound?” she asked, adding “if so, which one do you recommend?”

First, I must note that the fact that this woman hears noise but her partner does not means nothing at all. Her partner could simply have much less sensitive hearing!

We at The Quiet Coalition agree that the best step is to try to measure the sound. There are free or inexpensive sound meter apps that you can install on your smartphone, so start there. Some are better than others, but thankfully, experts at the U.S. Centers for Disease Control and Prevention have tested and rated smartphone sound-meter apps, which we reported on last year.

But a smartphone app may not be sensitive enough to pick up the sound. What should you do if this is the case? The only alternative could be to find an acoustics engineer to visit your residence and use professional equipment to identify the noise and then help you identify the source. That person can also suggest some ways to address the problem—which could be a neighbor’s electronics. The National Council of Acoustical Consultants offers advice on how to select a professional, licensed acoustical engineer.

There is, however, another possibility that must be considered: hearing a high-pitched sound that no one else hears COULD mean that you have a hearing disorder called tinnitus or an acute sensitivity to sounds called hyperacusis. Tinnitus can be identified by first finding a truly quiet place, such as a library, or on a weekend retreat in the countryside, to see if you still hear the noise when you are away from the circumstances where you are aware of the sound.

40 million Americans have tinnitus (myself included), so it’s quite common. And many of us spent years assuming that the “background noises” we heard were actually coming from the environment and that everybody heard the same thing!

So we recommend that you pursue both of these steps, because exposure to noise can be stressful, can cause sleep loss, and can have other health effects.
First try to determine where an unseen source of high-pitched sound in your environment is coming from. If the sound cannot be isolated, then consider that the cause of the sound could be tinnitus or another hearing disorder that should be attended to.

Frankly, the best result would be that there really is an unseen source of high-pitched sound in the immediate environment. Why? Because that can be fixed once the source is identified. But tinnitus cannot be cured, though there are techniques for managing it—which include avoiding the kinds of exposures that may have caused it in the first place. And know that the onset of tinnitus can be quite sudden.

To learn more about tinnitus check out the American Tinnitus Association‘s website and the Clinical Practice Guideline for Tinnitus published in 2014 by the American Academy of Otolaryngology–Head & Neck Surgery.

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

My 4th Noise Activist Anniversary

by Daniel Fink, MD, Chair, The Quiet Coalition

Anniversaries are special. We celebrate wedding anniversaries. Alcoholics Anonymous celebrates the anniversaries of those who are in recovery. Wounded military veterans celebrate their Alive Day, the day on which they were wounded. And yesterday was my anniversary, the fourth anniversary of my becoming a noise activist.

I developed tinnitus and hyperacusis after a one-time exposure to loud noise in a restaurant on New Year’s Eve, 2007. As midnight approached, they kept turning up the music louder and louder. My wife could tell that the noise was bothering me and suggested that we leave, but I didn’t want to offend our friends who had arranged the dinner. As soon as it was polite to leave, maybe 12:30 a.m., we did. My ears were ringing when we left, and the ringing never stopped.

I also found that noise that didn’t bother others hurt my ears: Movie soundtracks, the grind of a food processor, loud exhausts and sirens, and especially noise in restaurants. I’m a doctor and have always done what I could to stay healthy. But I had no idea that a one-time exposure to loud noise could cause tinnitus and hyperacusis for the rest of my life. When my wife would suggest an evening out, I would ask, “Can’t we eat at home?”

On December 2, 2014, I read an article about hyperacusis in the New York Times science section, written by journalist Joyce Cohen, who has since become a friend. I circled it in red and gave it to my wife, saying, “Honey, this is why I don’t want to go to restaurants any more. They are all too noisy. The noise hurts my ears. Just like it says in this article.” My wife finally understood that while I might have been getting grumpier with age, my dislike of noisy restaurants was caused by an auditory disorder.

So I decided to do something to make the world a quieter place. I reached out via email to the four experts cited in Joyce’s article. One thing led to another, and I ended up serving on the board of the American Tinnitus Association and helping create The Quiet Coalition, where I am the board chair.

I learned that I wasn’t the only person in the world with auditory disorders. Hearing loss, tinnitus, and hyperacusis are all too common. But auditory disorders are invisible, and largely occur in older people, who themselves are largely invisible in our society. Except for congenital deafness, auditory disorders tend to be ignored.

It’s been quite an odyssey. I found that via the internet, I could communicate with experts in various areas of noise, across the country and even around the world. At the urging of one of them, I submitted abstracts to scientific meetings about noise. Those were accepted for presentation, and I spoke at national and international scientific meetings. I have had publications based on my talks appear in peer-reviewed medical and scientific journals, and I have been quoted in articles and have advised national and international health authorities about noise. And I have learned, through the nonprofit Hyperacusis Research, how truly life-limiting noise-induced hearing problems can be. All because I read an article and decided to do something to make the world quieter.

The world is still too noisy, and I still can’t find a quiet restaurant, but apps like iHEARu and SoundPrint are now available.

And as more evidence becomes available about noise as a health and public health hazard, I am confident that an informed public will push legislators and public health officials to eliminate unnecessary noise.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Tinnitus and what to do about it

Photo credit: erik forsberg licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

I think the title of this report from the Harvard Medical School is misleading. I have tinnitus so part of my response is a personal one. To me, the most important sentence in the report is this: “There are no FDA approved treatments for tinnitus.” That means that none of the many proposed treatments for tinnitus–from a variety of vitamins and drugs, to various auditory training programs–has been demonstrated to be safe and effective, the FDA’s standard for approval. Cognitive behavior therapy may improve the ability to accept or deal with a constant ringing in the ears, but it doesn’t change the underlying symptoms.

It can be difficult to live with a constant ringing in the ears. I haven’t tried any of these unapproved treatments because I believe in evidence-based medicine, both for patients and for myself. Also, I am fortunate–my tinnitus is relatively low volume, and the only time it really bothers me is when I wake at night and it’s loud enough to cause difficulty in falling back to sleep–but the symptoms can be so bad that people commit suicide because of them. I suppose that if my symptoms were worse, I might be willing to try some of the treatments mentioned. And I would add that I know people who have had success using some of them.

Perhaps most significantly, the report neglects to mention three important facts:

1. The overwhelming cause of tinnitus is noise exposure, not the many other possible causes listed in the report. I haven’t been able to find a percentage, but my estimate is at least 80% and probably 90 or 95%.

2. The article implies that temporary tinnitus after noise exposure is a normal thing. No, temporary tinnitus indicates that one has been exposed to too loud noise, and that auditory damage has occurred.

3. Avoiding loud noise exposure will most likely prevent tinnitus from ever developing.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Restaurant noise in the news

by Daniel Fink, MD, Chair, The Quiet Coalition

I became a noise activist because I have tinnitus and hyperacusis and find loud restaurants unpleasant, so it was gratifying to see these two articles about restaurant noise. One is about restaurant noise in Austin, Texas, and the other more broadly reports about a study on restaurant noise sponsored by hearing aid manufacturer Oticon.

Both articles point out that the noise levels in many restaurants are loud enough to cause hearing loss, and that restaurant patrons have difficulty conversing due to the high ambient noise levels.

What the articles don’t mention is that restaurant noise is a major problem for older Americans, half of whom have hearing loss.

As long as the restaurants are busy, I don’t think they will voluntarily bother to make themselves quieter. As with smoke-free restaurants, this is something that will require enough voters complaining often enough to their elected officials to get regulations requiring quieter restaurants. Until that happens, speak up. If you go to a restaurant that is too loud, ask the manager or wait staff to lower it. If they won’t, leave.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

How a YouTube-inspired prank ruined a young girl’s life

 

photo credit: Edvvc licensed under CC BY-SA 3.0

Laurie Redmond writes about how a stupid prank by YouTube “trickster” Rick Lax inspired a miscreant to copy a video the aptly named Lax posted of his “prankster pal,” Ryan Hamilton, blasting his girlfriend with an air horn to get her to put down her phone.  Redmond notes that the video “entitled ‘How to get your girlfriend to put her phone down,’ has an astounding 246m views.” Sadly, one of the viewers was her 12-year old daughter Cindy’s friend’s ex-stepfather, who decided to play the prank on Cindy.

But after this miscreant played his prank, things fell apart for Cindy who eventually was diagnosed with “hyperacusis, or noise-induced pain.” As a result of this “prank,” Cindy has a “burning pain in her ears all the time…[and] [w]ith all noise louder than ordinary conversation, she feels like she is being stabbed in the ear. Her ears ring.”

Redmond has since learned that another “YouTube prankster, an F-list celebrity named Jake Paul, was sued for wrecking someone’s ears with an air horn.”  And yet the air horn “prank” videos remain on YouTube and Facebook, even though they “recently removed Tide Pod challenge videos so as not to encourage dangerous stunts.” Redmond asks what it will take to have these dangerously stupid and vile videos off of social media.  We would suggest litigation might do the trick, while recognizing how terrible things are when the only option is litigation.

MRIs are dangerously noisy

Photo credit: liz west licensed under CC BY 2.0

by Daniel Fink, MD, Chair, The Quiet Coalition

MRI noise is in the news in two recent reports.

People magazine reported the story of a woman who suffered permanent auditory damage from an MRI, developing hyperacusis (a sensitivity to noise, which causes pain) and tinnitus. The Quiet Coalition’s Bryan Pollard, an expert on hyperacusis, is quoted in the article.

And researchers from SUNY Buffalo and China wrote about MRI noise in The Hearing Journal.

Standard MRIs produce noise in the 110-115 decibel range, and newer more powerful MRIs are even louder. Knowing this, I have several quibbles with the information in The Hearing Journal article. Namely, the article cites occupational noise exposure standards, but these use A-weighted decibels (dBA) to reflect the frequencies of human speech. MRI noise is low frequency noise, so occupational noise limits may not protect hearing adequately. And occupational standards are not safe standards for the public. At least 25% of workers exposed to sound at occupational noise exposure standards will develop hearing loss.

Most importantly, for many people the auditory damage caused by MRI noise isn’t hearing loss but tinnitus and hyperacusis, as in the People magazine article. Exactly how noise causes tinnitus and hyperacusis isn’t yet known, but the mechanisms are likely different from cochlear hair cell damage causing noise-induced hearing loss.

Finally, the authors talk about temporary auditory damage, but many researchers think that any temporary auditory changes indicate that permanent damage has been done.

I can’t find any large-scale studies of auditory problems after MRIs–the equipment manufacturers wouldn’t be excited about funding such a study, and radiologists are interested in the image, not in the patient’s hearing–but anecdotal reports from audiologists indicate that this is a problem for too many people undergoing diagnostic MRIs.

So if you need an MRI, be sure to ask for “dual protection”– ear plugs and ear muffs. NIOSH recommends dual protection for noise exposure over 100 dBA.

And if you suffer auditory damage from an MRI, be sure to file a report with the FDA. That’s the only way the government will be induced to issue appropriate patient safety regulations.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.

Turn that down! We can prevent hearing loss

Photo credit: Anthony from Pexels

by Daniel Fink, MD, Chair, The Quiet Coalition

Dr. Vic Snyder, a former congressman from Arkansas who is now a medical director at the Blue Cross/Blue Shield affiliate there, has it exactly right: hearing loss (and tinnitus) can be prevented by turning down the volume, walking away from noise sources, and using hearing protection.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He serves on the board of the American Tinnitus Association, is the interim chair of Quiet Communities’s Health Advisory Council, and is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America.