Tinnitus: What That Ringing, Buzzing or Hissing in Your Ears Actually Is

Lie down in a quiet bedroom and you might notice it: a thin ringing, a soft hiss, or a buzz that no one else seems to hear. For some people it lasts a few moments and vanishes. For others it's a regular companion. That sound has a name, tinnitus, and understanding what it is can take away some of the worry it often brings.

What do people with tinnitus hear?

Tinnitus is the experience of hearing a sound that has no source in the world around you. There's no kettle, no electrical hum, no distant alarm; the sound is generated within the hearing system itself.

People describe it in many different ways:

• a high ringing or whistling
• buzzing, humming or a low drone
• hissing, rushing or something like static
• clicking, or a sound like wind or the sea

It can seem to come from one ear, both ears or from "inside the head". It may be faint and only noticeable now and then, or present much of the time. The pitch and character can also shift. There's no single "correct" way for tinnitus to sound, and comparing your experience with someone else's often isn't very helpful.

Is tinnitus a disease?

No. Tinnitus is a symptom: a sign that something in the hearing system has changed, rather than a condition in its own right. In that sense it's a bit like a headache, which can have many different causes.

The most common links are with hearing changes and with noise. When parts of the inner ear send weaker signals, the hearing pathways in the brain can respond by becoming more active, and that extra activity may be heard as sound. That's why tinnitus often appears alongside age-related hearing changes or after loud exposure, which how loud noise affects your hearing describes in more detail. Ringing after a concert is a familiar example; see ringing ears after a concert.

Other possible links include earwax, problems in the middle ear, some medicines and some general health conditions. Tinnitus can also occur in people whose hearing tests look typical. Because so many factors can be involved, working out what is behind it in a particular person is a job for a doctor.

Why does it seem louder in quiet?

Many people find tinnitus most noticeable at night or in a silent room. In everyday life, background sound partly covers it. In silence there's nothing to mask it, so it stands out.

Attention plays a part too. When you're tired, stressed or worried about the sound, the brain tends to focus on it more, which can make it feel louder even if the sound itself hasn't changed. That's also why tinnitus can seem to vary from day to day.

When to see a doctor

Bring tinnitus to your family doctor or an ENT doctor if it is new and doesn't fade, if it bothers you, or if it affects sleep, concentration or mood. It's especially important to get checked if:

• the tinnitus is in one ear only
• it pulses, for example in time with your heartbeat
• it comes with dizziness, ear pain or discharge
• it comes with a change in your hearing

A doctor may also suggest a hearing assessment; hearing tests explained describes what that involves.

Key takeaways

• Tinnitus means hearing a sound that has no outside source.
• It's a symptom, not a disease, and can have many possible links.
• Hearing changes and noise exposure are among the most common.
• It often seems louder in quiet, or when you're tired or stressed.
• One-sided, pulsing or persistent tinnitus, or tinnitus with hearing change, should be checked by a doctor.