How to live well with tinnitus: an expert guide

For millions of people, silence is never truly silent. Instead, everyday life is accompanied by ringing, buzzing, hissing or whooshing sounds that no one else can hear.

People suffering with tinnitus respond to noise differently, too, with no two cases being the same. It can feel like a manageable irritation that fades into the background, or it can be debilitating – leading to insomnia, depression, anxiety and isolation.

Tinnitus is surprisingly common – stats from the charity Tinnitus UK suggest 1 in 7 adults have it. So we asked Which? members to share their experiences with tinnitus, and more than 60 people responded with their stories and tips for managing it.

We also spoke to leading audiologist Peter Byrom, a trustee of the charity Tinnitus UK and senior fellow of the British Society of Audiology, to find out what causes tinnitus, whether it can be cured, options for managing it and what to avoid.

Tinnitus symptoms and what causes it?

Tinnitus is the perception of sound – such as ringing, buzzing or hissing – when there is no external source. It is often linked to hearing loss, exposure to loud noise, earwax, Ménière’s disease and some medicines, including certain chemotherapy drugs and antibiotics. 

In some people, it may also be triggered by temporary ear or sinus congestion, which can affect pressure in the middle ear. 

Where tinnitus is not caused by an objective sound, it’s thought the brain perceives an issue and tries to create equilibrium in your hearing by tuning in and, as Byrom explains, ‘turning up the information from the ear to get a more balanced sound.’ 

What then happens is an accidental misfiring and the brain perceives a sound where there isn’t one. 

‘Most everyday tinnitus is a phantom sound rather than a physical or mechanical sensation,’ he explains. 

Because tinnitus doesn’t have one specific cause – and, therefore, one direct cure – it can be difficult but not impossible to treat. 

If you think you have tinnitus, Byrom says, 'the first thing to do is to check for an underlying medical cause by seeing a registered audiologist or an ear, nose and throat specialist to rule out anything else.'  

Although, the first step is often a GP referral pathway, depending on the situation and urgency of the situation. 

Once you have a tinnitus diagnosis, you can see an audiologist who will check your hearing and give you tips for managing the noise. In some cases, the tools given to you can help you to overcome it entirely. In other cases, it’s about arming you with the tools to live your normal life without letting the tinnitus take over.

Can hearing aids help with tinnitus? Tinnitus treatments explained

Hearing aids can be a really useful tool when tinnitus is caused by hearing loss. In theory, once your hearing is corrected, it should reduce the need for your brain to try to ‘reset’ your hearing by creating the sound in the first place. Hearing aids can help correct or reduce tinnitus for many people, though not all.

‘There’s a correlation between hearing loss and tinnitus [and sometimes] tinnitus will disappear when hearing aids are in place, or can become much quieter – which [happens] in my case,’ Byrom, who has tinnitus, adds. For some people, it can remove the noise altogether.

‘If I get up in the morning and don't put my hearing aids in, [my tinnitus] is quite loud. It screams at me. I put my hearing aids in and it goes into the background. So for me, hearing aids are a really useful tool.’

Of the 64 Which? Readers who told us about their own experiences of tinnitus, 32 people said they’d either been offered hearing aids or currently use them, highlighting the correlation between hearing issues and tinnitus. They reported mixed results, but many said they found hearing aids helpful. If you have tinnitus, but don’t think you have hearing loss, it’s still worth getting this checked out.

One reader said: ‘I do find that the majority of time my hearing aids mask the background hissing that tinnitus gives me. However, from time to time, this does not seem to work. 

'Some mornings when I wake, the tinnitus is very pronounced and loud, often when I have inserted my hearing aids. This diminishes over the following hour.’

Best hearing aid providers – we reveal the best and worst hearing aid companies, and how much you can expect to pay.

Background noise is 'a lifesaver'

Another way to cope with tinnitus is to reduce your focus on it. Turning on non-stimulating sounds – such as white noise, meditation music or rain sounds – can help to push it into the background by allowing you to focus on something else. A fan, overnight, could also give you something else to focus on. 

‘People find different noises help them personally. We do know that sometimes people find that playing a certain sound will reduce it or knock it on the head for a little while and then, when they take the sound away, it comes back,’ said Byrom.

One reader wrote to us to explain: ‘My main helper is the sound generator, which I have on all night to sleep.  I take one with me if I am going to be in a quiet space for a while, and also have an app on my phone.  Choosing the sounds really helps, I think the selection suits the frequency, so I sleep through gentle thunderstorms! I feel I couldn't live, or sleep, without one.’

Some hearing aids come with this added functionality built in and allow you to set up your own background noise, which can be helpful. Speak to your audiologist to find out more.

Another reader told us: ‘I have used a white-noise generator in recent years. Firstly in-ear, like a hearing aid, and then sound generated from an app on my phone. This definitely helped.’

One of the key recommendations the NHS makes for dealing with tinnitus is to avoid silence.

‘Do not have total silence – listening to soft music or sounds may distract you from tinnitus,’ the NHS says on its website.

After you’re dressed in the morning, you’re unlikely to spend the day focusing on the feeling of your shirt against your arms. Your brain just accepts it’s there. In a way, that’s what you’re aiming for with tinnitus, where it persists – to create an environment where you can allow it to exist as far as possible in the background and not in the foreground.

Best white noise machines: our expert guide explains how to buy the right model

Cognitive behavioural therapy

The treatments with the strongest evidence and most commonly recommended by the NHS include hearing aids, where appropriate, and cognitive behavioural therapy (CBT). The NHS may also offer tinnitus counselling or sound-based approaches, such as tinnitus retraining therapy. 

Tinnitus UK told us people’s mental health can really deteriorate when they develop tinnitus, with feelings of grief (related to losing the ability to hear silence) and fear of the future very common. This can cause people to become isolated – particularly if they avoid situations they fear will trigger or exacerbate their tinnitus.

Unfortunately, this can be a vicious circle. Poor mental health as well as increased stress are both correlated with worsening tinnitus, Byrom said, and isolation means more time to focus on the noise. The aim, with CBT, is to try to ‘reframe’ the way you experience tinnitus so that you can get on with your life as much as possible.

Avoiding social situations due to fear of how you will cope with your tinnitus while socialising, for example, can make you incredibly anxious and isolated. The idea is the CBT can help you to continue to live a full life without allowing your tinnitus to take it over.

One reader, who has had tinnitus for more than 50 years, told us CBT helped him greatly. 

‘About five years ago, it was getting really bad – loud and intrusive,’ he said. ‘So I asked my GP to refer me to the local NHS audiology department. This resulted in two ‘treatments’. One was to give me a hearing aid for my left ear; the second was therapy sessions. These two treatments have made all the difference! My tinnitus is still as loud as ever, but for reasons I don’t fully understand, the distress it causes is very much reduced.’

Mindfulness, meditation and support groups

One of the hardest things to achieve with tinnitus is acceptance. While some things can reduce its presence, you may not be able to completely eradicate it. The NHS warns against focusing on it, where possible, although that can be difficult in practice.

Mindfulness and meditation, as well as practices like yoga and other exercises, are ways to distract the mind from unduly focusing on the sound.

‘I hope you will make it clear that the biggest enemy is allowing tinnitus to prey on your mind,’ said one reader with long-term tinnitus. ‘The more you think and worry about it, the worse it will get. The important thing is to calm and distract your mind. On the rare occasion it troubles me (usually at night), I use another sound – like scratching my pillow – to distract me.’

To manage his own tinnitus, audiologist Peter Byrom uses a more radical form of tinnitus acceptance, deliberately focusing on it for set periods of time to train his brain to push it into the background. This, like any other treatment, may not work for everyone but, as Byrom says, an effective treatment is the one you find works for you. Tinnitus retraining therapy can be available for some people on the NHS.

The NHS recommends joining a self-help group where you’ll be able to meet people going through a similar experience, where you might find inspiration for how to manage it. These can be found on the Tinnitus UK website. You’ll also be able to access tips for living with tinnitus on the website, which includes a free 20-minute guided meditation.

Avoid overblown claims for tinnitus treatments and 'cures'

There is no one-size-fits-all ‘cure’ for tinnitus and what works for one person may not work for another. So be wary of any claims from products that promise a guaranteed solution.

Danny Knight, partnerships manager at Tinnitus UK, warns that you should beware of anything claiming to give you a quick fix. ‘There are a lot of things sold on marketplaces that are basically just snake oil,’ he says. These include supplements, electronic devices and so-called red-light treatments for ears, which, he says, ‘is basically shining a red laser in your ear because apparently that's meant to do something, but the mechanism behind it just seems like pseudoscience.’

Tinnitus UK has a section on its website where the charity’s professional advisory committee has assessed certain products, including supplements and electronic devices. 

One of the devices it has reviewed, which it is cautiously optimistic about, is called Lenire. The device works by combining sound therapy with mild stimulation of the tongue.

We haven’t reviewed this product at Which?, and at several thousand pounds per treatment, it is costly. Plus, around one third of participants in clinical trials reported a temporary worsening of tinnitus symptoms. In most cases, this resolved by the end of the study, but it's worth knowing that not everyone benefits from treatment. 

‘In terms of affordability, our advice is always based around finding the right treatment for you. If you can afford Lenire and are willing to try it knowing that it may not work, then we think it’s promising. However, like all treatments, it’s not guaranteed – therefore, it’s all about deciding whether it’s right for you at this moment,’ Knight says.

If you commit to trying a solution that costs you money, do bear in mind that currently the only proven treatments for tinnitus as recommended by the NHS are hearing aids and CBT. 

‘Before taking any self-funded care pathway – be it high-end hearing aids, private counselling or devices like Lenire – you should always consider your finances, because additional financial stress can make your tinnitus worse,’ Knight added.

Got a build-up of earwax or a blocked ear? Read our advice on safe earwax removal methods

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