Determining the Likelihood of Temporary vs. Permanent Tinnitus

[Leodavinci]

I just got Tinnitus 5 days ago. The national health resources on Tinnitus in the US, UK and elsewhere are lacking in giving new sufferers an idea of how likely it is that symptoms of a few minutes, days or weeks will persist. I realize many posts on this subject have been written. They include personal anecdotes, their primary care doctors opinion and ENT opinions. While valuable nothing is very reliable or evidence based. The American Tinnitus Association gives the following info on its facts - demographics site, here; https://www.ata.org/understanding-facts/demographics

• 15% of all survey respondents experienced some form of tinnitus
• 67% of people reporting tinnitus had regular symptoms for over a year
• 26% of people reporting tinnitus had constant or near constant tinnitus
• 30% of people reporting tinnitus classified their condition as a "moderate" to "very big" problem in their life

This on its face is not that helpful at answering the question whether a new onset of Tinnitus will last. I found the NHANES 2011-2012 health survey with questions posed about auditory health here; http://www.cdc.gov/nchs/nhanes/nhanes2011-2012/AUQ_G.htm

I think this survey is conducted by the Centers for Disease Control and probably uses random sampling to ensure that the results accurately reflect the U.S. population. The question AUQ191 asks "Ears, ringing, buzzing or roaring in the past year?" Which would certainly include most tinnitus. The follow up questions should allow us to estimate how many new T cases lead to chronic T. This is an estimate only and certain simple assumptions have to be made, but the data set is solid and its silly that this data has not been used to estimate this probability before.

 

[Tamalak]

From browsing this board for a while it seems like:
-You are more likely to shake off T if it is for a reason other than noise damage
-You are more likely to shake off T if it sometimes goes away completely (intermittent vs constant)

 

[Thongjy]

From browsing this board for a while it seems like:
-You are more likely to shake off T if it is for a reason other than noise damage
-You are more likely to shake off T if it sometimes goes away completely (intermittent vs constant)

So can I confrim what you mean is those idiopathic T (meaning for no reason and no exposure to loud noise) and those with fluctuating T (a few days withvery low and sometimes neglible T and sometimes slightly louder or the so called having good and bad days) have higher chances of recovery?

 

[Tamalak]

Yes Thongjy, that is what it seems to me by reading these boards. And it makes sense. If you don't have hearing loss then there is no lasting reason for the T to be there. If the T sometimes drops off that means the path to recovery already exists

 

[Leodavinci]

I haven't analyzed the NHANES data completely yet but here is a first run through. Again, i'm making reasonable assumptions about a few things to get a probability that an onset of Tinnitus will last longer than 3 months and or longer than a year. That onset can include periodic Tinnitus not just constant T. We have to use the categories defined by the NHANES study questions and I will source the data beginning here; http://www.cdc.gov/nchs/nhanes/nhanes2011-2012/AUQ_G.htm#AUQ191

The first T question (AUQ191) asks if anyone was "bothered" during the last 12 months by ringing, roaring or buzzing that lasts more than 5 minutes. I think this would include most people who suffered from T within the last year, but many, perhaps who had mild T for a day or a week, may have forgotten about their episode of T and not answered affirmatively. This is important because forgetting to answer yes means that there are probably at least a few people out of the 85% who did not report having T who actually had T for a short time - probably with mild symptoms.

The most important question for this probability estimate is AUQ250. Which asks how long respondents were bothered by T. The results are;
1 Less than three months 123
2 Three months to a year 98
3 1 to 4 years 177
4 5 to 9 years 90
5 Ten or more years 193
7 Refused 0
9 Don't know 3

It may be difficult to remember how long T has lasted for those with symptoms lasting less than a year. Especially those with periodic non-constant T.

Now lets assume that the number of new people getting T symptoms is consistent with historical patterns. Then the 1 to 4 year category population remains steady and each year a percentage of the category enters the next duration category and another group gets remission as they no longer report, "bothersome ringing, roaring or buzzing". The number of people continuing beyond one year is 177/4. About 44 people of the 221 who have had T less than a year continue with T or 20%. This I hope is very reassuring for those with new T symptoms. I realize many people have it for much longer and my heart goes out to you. I have benefited greatly from your stories and courage and wanted to contribute this analysis to help people find reliable answers to simple probabilistic questions.
There is much more to be said about the data and i will continue posting an analysis about it later. I feel like the NHANES data is very reliable and representative of everyone who gets T symptoms and this first look makes clear that T does not become bothersome beyond a year for 80% of new onsets. Considering people who forget about their T and don't report it, the percentage is likely higher.

 

[Vinnitus]

I haven't analyzed the NHANES data completely yet but here is a first run through. Again, i'm making reasonable assumptions about a few things to get a probability that an onset of Tinnitus will last longer than 3 months and or longer than a year. That onset can include periodic Tinnitus not just constant T. We have to use the categories defined by the NHANES study questions and I will source the data beginning here; http://www.cdc.gov/nchs/nhanes/nhanes2011-2012/AUQ_G.htm#AUQ191

The first T question (AUQ191) asks if anyone was "bothered" during the last 12 months by ringing, roaring or buzzing that lasts more than 5 minutes. I think this would include most people who suffered from T within the last year, but many, perhaps who had mild T for a day or a week, may have forgotten about their episode of T and not answered affirmatively. This is important because forgetting to answer yes means that there are probably at least a few people out of the 85% who did not report having T who actually had T for a short time - probably with mild symptoms.

The most important question for this probability estimate is AUQ250. Which asks how long respondents were bothered by T. The results are;
1 Less than three months 123
2 Three months to a year 98
3 1 to 4 years 177
4 5 to 9 years 90
5 Ten or more years 193
7 Refused 0
9 Don't know 3

It may be difficult to remember how long T has lasted for those with symptoms lasting less than a year. Especially those with periodic non-constant T.

Now lets assume that the number of new people getting T symptoms is consistent with historical patterns. Then the 1 to 4 year category population remains steady and each year a percentage of the category enters the next duration category and another group gets remission as they no longer report, "bothersome ringing, roaring or buzzing". The number of people continuing beyond one year is 177/4. About 44 people of the 221 who have had T less than a year continue with T or 20%. This I hope is very reassuring for those with new T symptoms. I realize many people have it for much longer and my heart goes out to you. I have benefited greatly from your stories and courage and wanted to contribute this analysis to help people find reliable answers to simple probabilistic questions.
There is much more to be said about the data and i will continue posting an analysis about it later. I feel like the NHANES data is very reliable and representative of everyone who gets T symptoms and this first look makes clear that T does not become bothersome beyond a year for 80% of new onsets. Considering people who forget about their T and don't report it, the percentage is likely higher.

Interesting, but I think it is hard to say anything useful with regards to the resolution sorted by origin of one's tinnitus with this data as laid out above. I guess a lot of "stress related/wax related" tinnitus is tainting the data and it might very well be that the "acoustic trauma" and "ototoxic drug" types ultimately end up in the "ten years or more" category, while the "stress related" types will drop off the chart during the initial period.

Like you, I have acquired Tinnitus due to acoustic trauma. What I would be interested in, is to see actual data of Tinnitus resolution ordered by origin (loud noise, drugs, stress, etc.), as it is often assumed that the acoustic and ototoxic types are the "more permanent" ones. I wonder if there is any truth to that...

Did you ever resume interpreting this NHANES data? Does this dataset provide this information about initial cause?

 

[stophiss]

For those that have studied the data...and thanks for your thoughtful post OP which underscores really the signature question we each have about our particular type of tinnitus...recognizing it can be precipitated by different environmental and/or genetic factors...a basic question please.

For those that develop onset of tinnitus with no apparent physiological deficit i.e. no cochlear damage nor damage to the auditory cortex:
a. without a discernible hearing deficit...hearing still seems relatively normal...perhaps a heightened sensitivity to loud noise.
b. tinnitus was not caused by a loud noise or prolonged loud noise exposure
c. tinnitus was precipitated due to a stressful life event

Aside from this combination perhaps having a higher probability of tinnitus abating as noted above...based upon the data available, does anybody know the statistical average in terms of time duration for tinnitus resolving?...and also what sample size this data is based upon? Is the statistic average 1 year? Less? More?

Thanks

 

[Jomo]

mines all over the place but is due to trauma....dont fit the mold but i hope thats a good thing...i have moments of silence....havent had too many but had some moments today....i can only hope

 

[Emmi]

I think it all comes down to the question of damage.. although some people with hearing loss don't get T. So now it is the question if that is because their hearing loss was "natural", meaning that no event caused it suddenly so that the brain would not have to cope with a sudden reduction of auditory input.. resulting in the hyperactivity of the auditory cortex and thus T. OR that the type of damage is different meaning that with noise and ototoxic drugs the nerve fibers (and not the hair cells) are more likely to suffer from damage and this results then in T.

Personally I also think that most people have not only one cause for their T, which makes it even more complex. When I got mine for example there were a lot of other friends dancing in the club, still I was the only one to get T. Why? I was having a cold and very much stress during that time. So maybe inflammation and stress are part of my T as well and the acoustic event was only the final trigger?! Nobody knows.

But if you can more or less exclude damage through an extended audio-gram and tests like ABR & DPOAE you might have a better chance of T going away.. although I am not sure if there is any test with which you could test if the nerve fibers are broken?!

 

[Michael Leigh]

When I got mine for example there were a lot of other friends dancing in the club, still I was the only one to get T. Why?

Tinnitus can come on suddenly or over a period of time. Sometimes it's the luck of the draw because we are all different.

In your case Emmi, I believe your tinnitus has been coming on for some time and you haven't noticed the ringing in the daytime. However, at night when it's all quiet, if you knew what to listen for you would have heard tinnitus.

If memory serves me correctly you have been to nightclubs frequently? The music was probably too loud and your ears have been ringing in the passed but it would always go away. This is the thing with tinnitus. The ringing you previously experienced was a warning that your ears are being subjected to high noise levels and you must be careful and stop being around loud sounds. Unfortunately, if a person persists on one occasion the noise isn't going to stop. I suspect you also listened to music through headphones? Like many people the volume was probably too loud? This would also put you at further risk of developing tinnitus.

However, with the right treatment I believe you'll make a lot of improvement but try and get to ENT and put on a treatment propramme like TRT and be careful of being around loud sounds and limit the use of headphones better still, don't listen to music through them is my advice
Michael

 

[stophiss]

I think it all comes down to the question of damage.. although some people with hearing loss don't get T. So now it is the question if that is because their hearing loss was "natural", meaning that no event caused it suddenly so that the brain would not have to cope with a sudden reduction of auditory input.. resulting in the hyperactivity of the auditory cortex and thus T. OR that the type of damage is different meaning that with noise and ototoxic drugs the nerve fibers (and not the hair cells) are more likely to suffer from damage and this results then in T.

Personally I also think that most people have not only one cause for their T, which makes it even more complex. When I got mine for example there were a lot of other friends dancing in the club, still I was the only one to get T. Why? I was having a cold and very much stress during that time. So maybe inflammation and stress are part of my T as well and the acoustic event was only the final trigger?! Nobody knows.

But if you can more or less exclude damage through an extended audio-gram and tests like ABR & DPOAE you might have a better chance of T going away.. although I am not sure if there is any test with which you could test if the nerve fibers are broken?!

I think you said it pretty well. And...as unidentified as contributing factors to tinnitus are, people like yourself for example if you developed tinnitus at a young age, may in fact be predisposed to it by your physiology and your brain chemistry. Maybe your cochlea is shaped such that it is sensitive to high noise levels for example when another person's isn't. Or your brain chemistry is a bit different than others you were dancing with at the club...or your ear canal is shaped such that it magnifies sounds to your eardrums...or its the shape or thickness of your tympanic membrane...or a combination thereof.

I believe you touched upon a theme worth repeating. For those with varying tinnitus day in and day out...those that experience a range of tinnitus from say moderate to almost non existent, it seems to me, they have the best opportunity to recover. If there is little and no discernible hearing damage....very few have perfect hearing....it seems with this circumstance there is an opportunity for tinnitus to abate with time.

 

[stophiss]

Tinnitus can come on suddenly or over a period of time. Sometimes it's the luck of the draw because we are all different.

In your case Emmi, I believe your tinnitus has been coming on for some time and you haven't noticed the ringing in the daytime. However, at night when it's all quiet, if you knew what to listen for you would have heard tinnitus.

If memory serves me correctly you have been to nightclubs frequently? The music was probably too loud and your ears have been ringing in the passed but it would always go away. This is the thing with tinnitus. The ringing you previously experienced was a warning that your ears are being subjected to high noise levels and you must be careful and stop being around loud sounds. Unfortunately, if a person persists on one occasion the noise isn't going to stop. I suspect you also listened to music through headphones? Like many people the volume was probably too loud? This would also put you at further risk of developing tinnitus.

However, with the right treatment I believe you'll make a lot of improvement but try and get to ENT and put on a treatment propramme like TRT and be careful of being around loud sounds and limit the use of headphones better still, don't listen to music through them is my advice
Michael

I agree with your comments about onset of tinnitus pretty much for many people. People don't recognize a given condition until they do. It has to reach a certain threshold to become recognized. There is the notion of memory within the brain that seems undeniable. If you think about it, it is the opposite of habituation where focus is lost on a condition like tinnitus. Onset of tinnitus occurs due to physiologic changes interacting with the environment which affects brain chemistry...introduce an emotional or stress element which reinforces memory...a perfect storm is created to change in neuroplasticity which lingers and the false construct of a noise that doesn't exist is reinforced.

 

[Leodavinci]

[QUOTE="Did you ever resume interpreting this NHANES data? Does this dataset provide this information about initial cause?[/QUOTE]

No, I haven't looked at it any further. I remember that the cause of the tinnitus was not recorded. I actually don't have traditional noise induced tinnitus, rather I had a noise trauma which caused tinnitus the next morning and then had hearing loss develop several weeks later. The hearing loss recovered a bit and a few months ago got worse. It is probably SSNHL or Sudden Hearing Loss.

I think the vast majority of people who report having a limited duration of tinnitus just habituated - this combined with an actual lowering of volume.

 

[Tom Cnyc]

I've had tinnitus for about 5 months. It started to improve a lot at liek the 3.5 month mark. I can hear it as I type this now, but the overall quality of the noise is much much less abrasive. Whether or not it "Goes away" - for me it has "gotten better".