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Tactics to Tame Your Tinnitus: Many people with the condition find its "phantom sounds" debilitating.

More than 50 million Americans suffer from tinnitus, according to the American Tinnitus Association. The Centers for Disease Control and Prevention estimate that about 2 million of these individuals experience severe symptoms that impair their wellbeing and quality of life. Tinnitus causes people to perceive unwanted sounds in the absence of any corresponding external noise. "The sounds are most often described as ringing in the ears, although some people report hearing buzzing, hissing, roaring, clicking or chirping," says Eric Smouha, MD, professor of otolaryngology at Mount Sinai. "No matter the pattern, the sounds can interfere with a person's sleep, and affect the ability to concentrate. Tinnitus also has been linked to depression, anxiety, and stress."

Unfortunately, there are no reliable means of curing tinnitus--instead, treatment aims to help people learn to live with the condition. Therapeutic approaches that may help include hearing aids, mindfulness, tinnitus retraining therapy, cognitive behavioral therapy, and biofeedback.

Hearing Aids Many seniors with tinnitus also have some degree of hearing loss that prevents the full spectrum of external sound stimuli from reaching the brain. "In these individuals, hearing aids may help relieve tinnitus by amplifying external sounds that help to mask the problem," says Dr. Smouha. If you have hearing loss, get evaluated by an audiologist. Many modern hearing aids include supplemental sound masking with "white noise" or similar artificial ambient sounds that can further alleviate tinnitus.

Mindfulness A small 2017 study found that mindfulness based stress reduction (MBSR) helps reduce the severity of tinnitus for longer than relaxation-based treatments. While the latter provide people with specific skills to reduce their stress levels, MBSR teaches you to pay purposeful, non-judgmental attention to sensations and feelings, rather than trying to suppress them. "In the case of tinnitus, MBSR doesn't aim to change the nature of the sounds you hear," Dr. Smouha explains. "Rather it helps you learn how to allow and accept the sounds instead of becoming consumed by them and fighting them. The overall aim is to cultivate a more positive way of responding to tinnitus so that it becomes less intrusive."

Tinnitus Retraining Therapy This approach utilizes a combination of educational counseling and sound therapy via white noise. The counseling component is aimed at demystifying tinnitus and demonstrating that it becomes intrusive and disruptive only if you pay attention to it and allow it to affect you emotionally. The sound therapy is designed to match the pitch and volume of your tinnitus. "The intention is to habituate your brain to accept the sounds you are hearing as normal so that they become something you don't have to be consciously aware of, like the hiss of the air conditioning or the hum of the refrigerator," Dr. Smouha explains.

Research on the efficacy of tinnitus retraining therapy has shown mixed results. In a small 2017 study, participants reported a 50 percent or better improvement in tinnitus severity after retraining therapy. A more recent study (JAMA Otolaryngology-Head & Neck Surgery, May 23) compared retraining therapy to the standard of care for tinnitus as recommended by the American Speech-Language-Hearing Association (ASLHA). The ASLHA recommends counseling on adaptive coping behaviors and stress reduction, identification/avoidance of factors that may exacerbate La a tinnitus, and the use of hearing protection in loud environments, among other approaches. The data showed that about half of the 151 study participants showed clinically meaningful reductions in the effects of their tinnitus--however, there were few differences between the treatment groups. "There is some evidence that tinnitus retraining therapy may be less helpful for people with loud tinnitus, those who hear lower-pitch sounds, and those who have had tinnitus for a long time," Dr. Smouha notes.

Cognitive Behavioral Therapy This aims to change how you react to the tinnitus rather than eradicate the problem. A psychotherapist trained in cognitive behavioral therapy (CBT) can help you recognize negative behaviors and thought patterns related to your tinnitus, and then consciously alter them. This should help to reduce any distress from the noises, making them tolerable to the point where they eventually become less noticeable.

Biofeedback As with tinnitus retraining therapy and CBT, biofeedback aims to change the way you react to tinnitus. During a biofeedback session, you wear electrical sensors that pick up body signals and transmit them to a computer that displays the signals via images or sounds that indicate your stress levels, blood pressure, heart rate, and brain waves. "You are then guided in how to vary your thoughts and emotions so that you see a change in the signal display," Dr. Smouha says. "The idea is that you learn how to consciously control your body's responses to stimuli, including your tinnitus."


Also try these approaches:

* Protect your hearing Some people find their tinnitus worsens in response to exposure to loud noise, so if you are mowing the lawn or using power tools, wear ear plugs. Also consider wearing them at the movie theater or concerts if you find the volume excessive.

* Limit caffeine Drinking caffeinated beverages can trigger tinnitus, so think about switching to decaf coffee.

* If you have excessive earwax (common in seniors), discuss with your doctor what you can do to reduce buildup.

Caption: Tinnitus symptoms can occur constantly or intermittently. In one study, 36percent of participants had constant tinnitus, and more than 25 percent reported having had the condition for more than 15 years.
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Title Annotation:HEARING
Publication:Focus on Healthy Aging
Date:Aug 27, 2019
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