Tinnitus is the perception of sound when no external sound source is present. It is often described as ringing in the ears, but the sound can vary considerably from person to person. Tinnitus may affect one ear, both ears, or seem to come from inside the head.
The most recognizable symptom is hearing a sound that other people cannot hear. The sound may include:
The sound may be constant or intermittent. Its loudness and pitch can also change over time.
Tinnitus can occur alongside hearing loss. Age-related hearing changes and exposure to loud noise are common factors associated with tinnitus.
Some people notice tinnitus more clearly in quiet environments because there is less background sound to mask it.
Persistent ringing or buzzing can make it difficult to fall asleep or stay asleep.
The symptoms may seem more noticeable at night when environmental sounds are reduced.
Sleep problems can also make tinnitus feel more distressing or difficult to tolerate.
Loud or persistent tinnitus may interfere with attention and concentration.
Some people find it difficult to:
The impact can vary depending on the intensity of the perceived sound and individual sensitivity.
Persistent tinnitus can sometimes contribute to:
Stress can also make tinnitus seem more noticeable for some people, creating a cycle in which symptoms and emotional distress affect each other.
Tinnitus may occasionally occur with dizziness, vertigo, or balance difficulties.
When these symptoms occur together, they can sometimes be associated with an inner-ear condition or another medical issue. A healthcare professional can evaluate the possible cause.
Pulsatile tinnitus sounds rhythmic and may seem to follow the heartbeat.
It may be described as:
Pulsatile tinnitus is different from the more common forms of tinnitus and should be medically evaluated because, in some cases, it can be associated with blood-flow or other underlying conditions.
A healthcare professional should evaluate tinnitus that is persistent, worsening, or accompanied by other symptoms.
Prompt medical attention is particularly important for:
Sudden hearing loss requires urgent medical assessment.
Tinnitus can have many possible causes, including:
Sometimes no specific cause can be identified.
An evaluation may include a medical history, ear examination, hearing tests, and questions about the type and timing of the sound.
Additional testing may be considered when tinnitus is one-sided, pulsatile, or associated with hearing loss, dizziness, or neurological symptoms.
Tinnitus can sound like ringing, buzzing, hissing, humming, clicking, roaring, or pulsing, and symptoms may range from mild and temporary to persistent and disruptive. Tinnitus itself is a symptom rather than a disease, so identifying possible underlying causes is an important part of evaluation.
Persistent tinnitus, sudden hearing changes, dizziness, one-sided symptoms, or heartbeat-like sounds should not be ignored and may require medical assessment.