How Can Category 4 Tinnitus and Hyperacusis Patients Improve?

[Juan]

How has your sleep been since the onset of these issues? I have really struggled with it and one of my theories is that stress and sleep deprivation caused all of these issues.

Oddly, I have slept pretty well at most times. I get to sleep easily. It's my nature.

 

[Athens]

Those sounds cannot harm you. Door locks are tricky because some of them are loud. Slamming doors are very bad due to vibration on top of a loud sound. Bags are very annoying but not dangerous. Those sounds make hyperacusic ears react, but you can be around them without hearing protection.

You need to have your ears plugged before any of this happens, and that's the problem. As you said, all this can happen without a prior warning, and many times it happens too because we do not have visual contact with the sound source (i.e. neighbour doing gardening behind their fence).

I agree that these sounds (bags, running water) probably cannot damage your auditory system, but could repeated exposure to these sounds cause your tinnitus and/or hyperacusis to spike permanently? I feel that I reach a certain level with the tinnitus and hyperacusis and it stays there and then I reach another level in the subsequent months. It is possible that it has been at the same level all along and that anxiety and stress is just making it seem more pronounced. My tinnitus definitely seems to react to running water. It seems more intense just after I turn the water off.

 

[Juan]

but could repeated exposure to these sounds cause your tinnitus and/or hyperacusis to spike permanently?

No, that was not my experience... and I had severe hyperacusis. Those sound were very annoying though and could produce changes in the perception of sound afterwards, meaning extra pressure or distortion. However, in the long run, those sounds did not damage my hearing or make hyperacusis or tinnitus change permanently. Only objectively loud, very loud sounds, can produce that effect... (power tools, gunshots, firecrackers, sirens at close range, loud motorbikes etc)

 

[Athens]

No, that was not my experience... and I had severe hyperacusis. Those sound were very annoying though and could produce changes in the perception of sound afterwards, meaning extra pressure or distortion. However, in the long run, those sounds did not damage my hearing or make hyperacusis or tinnitus change permanently. Only objectively loud, very loud sounds, can produce that effect... (power tools, gunshots, firecrackers, sirens at close range, loud motorbikes etc)

It might just be anxiety and stress that make me perceive the hyperacusis and tinnitus as worsening temporarily or permanently.

 

[volsung37]

It might just be anxiety and stress that make me perceive the hyperacusis and tinnitus as worsening temporarily or permanently.

In my first years of tinnitus my perception of it reduced substantially if I went on a holiday or even a short break in the country.

As well as tinnitus, many of us have stress from work and/or relationships. I really believe this combination ramps up the sounds.

 

[Wrfortiscue]

No, that was not my experience... and I had severe hyperacusis. Those sound were very annoying though and could produce changes in the perception of sound afterwards, meaning extra pressure or distortion. However, in the long run, those sounds did not damage my hearing or make hyperacusis or tinnitus change permanently. Only objectively loud, very loud sounds, can produce that effect... (power tools, gunshots, firecrackers, sirens at close range, loud motorbikes etc)

This. If everyday normal sounds that spiked us hyperacusis folks caused permanent damage then we'd be screwed. At least I know I would lol.

 

[Stacken77]

It might just be anxiety and stress that make me perceive the hyperacusis and tinnitus as worsening temporarily or permanently.

Anxiety can definitely play a part. My personal experience have been mixed though. Some sounds induce multi-day spikes, and in those cases, I'm not always aware that the spike is reducing, since it happens so slowly. Over time, I believed that spikes were stacking on top of each other, but in reality I basically still had my baseline intact. My baseline has increased permanently though, due to very safe sound levels, but not to the extent that I've initially thought.

My loudness hyperacusis has not worsened in recent months, and I have a few reference points which I test to see where my tolerances are. It's a very rough estimate, but works reasonably well.

If you feel that exposure to everyday sounds has irritated your auditory system and worsened the tinnitus and hyperacusis, I'd advise you to lower your exposure, just to manage the conditions. Exposing yourself to the current levels is obviously not effective since you seem to worsen from it. Have you tried custom molded high fidelity ear plugs? A -25 dB filter will still let through most frequencies as it tries to attenuate similarly to a "flat eq". I think e.g. a water tap running wouldn't cause nearly as much spiking or discomfort when using such hearing protection. I personally think it's best to find a "level" in which the auditory system isn't being irritated, and from there very very gently test the boundaries, and I think high fidelity ear plugs are a great way to do so through our everyday sounds.

This. If everyday normal sounds that spiked us hyperacusis folks caused permanent damage then we'd be screwed. At least I know I would lol.

It isn't completely black and white though, since tinnitus/hyperacusis severity isn't necessarily a 1:1 correlation to hearing loss. It's pretty clear that we can worsen the tinnitus to unfathomable levels without actually having severe hearing loss.

 

[Athens]

This. If everyday normal sounds that spiked us hyperacusis folks caused permanent damage then we'd be screwed. At least I know I would lol.

Are you saying that it is unlikely that exposure to normal, everyday sounds can spike tinnitus and hyperacusis permanently or are you saying that that you are glad that you do not have this issue?

 

[Athens]

Anxiety can definitely play a part. My personal experience have been mixed though. Some sounds induce multi-day spikes, and in those cases, I'm not always aware that the spike is reducing, since it happens so slowly. Over time, I believed that spikes were stacking on top of each other, but in reality I basically still had my baseline intact. My baseline has increased permanently though, due to very safe sound levels, but not to the extent that I've initially thought.

My loudness hyperacusis has not worsened in recent months, and I have a few reference points which I test to see where my tolerances are. It's a very rough estimate, but works reasonably well.

If you feel that exposure to everyday sounds has irritated your auditory system and worsened the tinnitus and hyperacusis, I'd advise you to lower your exposure, just to manage the conditions. Exposing yourself to the current levels is obviously not effective since you seem to worsen from it. Have you tried custom molded high fidelity ear plugs? A -25 dB filter will still let through most frequencies as it tries to attenuate similarly to a "flat eq". I think e.g. a water tap running wouldn't cause nearly as much spiking or discomfort when using such hearing protection. I personally think it's best to find a "level" in which the auditory system isn't being irritated, and from there very very gently test the boundaries, and I think high fidelity ear plugs are a great way to do so through our everyday sounds.

It isn't completely black and white though, since tinnitus/hyperacusis severity isn't necessarily a 1:1 correlation to hearing loss. It's pretty clear that we can worsen the tinnitus to unfathomable levels without actually having severe hearing loss.

I have some custom earplugs but it is obviously inconvenient to always be putting them in and out. I actually put some in when I open the box of cereal because the plastic bag inside causes such an aggravation based on that type of frequency.

I wonder about the limits of tinnitus and hyperacusis levels. You mentioned "unfathomable" levels. It is interesting that there have been studies showing no correlation between tinnitus levels and tinnitus distress. Some people can have high levels of tinnitus volume and it does not seem to bother them.

 

[Wrfortiscue]

Are you saying that it is unlikely that exposure to normal, everyday sounds can spike tinnitus and hyperacusis permanently or are you saying that that you are glad that you do not have this issue?

I spike daily due to frequencies and people told me it should not increase tinnitus. Loud noises will though.

 

[Stacken77]

You mentioned "unfathomable" levels. It is interesting that there have been studies showing no correlation between tinnitus levels and tinnitus distress. Some people can have high levels of tinnitus volume and it does not seem to bother them.

I wasn't referring to tinnitus distress, but rather, what I consider "objective" increases. Some people suffer a very severe form of Category IV where the slightest sound causes immediate permanent increases in tinnitus. This cause the baseline to increase very rapidly, to what I'd assume to be "unfathomable" levels. Obviously, those people aren't losing hair cells in the inner ear, yet the tinnitus still increases endlessly, so there's a lot of variables going into tinnitus severity. Hearing loss is probably a big one, but not necessarily what defines the volume.

Regarding distress; I know that there have been studies done that shows seemingly no correlation between tinnitus distress and volume, but I completely disagree with it. It reinforces gaslighting of people not being able to habituate to a 100 dB jet engine. I for one would quit immediately had my severity been that bad. Most people I've talked to, who have pretty bad tinnitus, go about their everyday life, and it works fine, but they still suffer, silently. Those who can habituate to a 100 dB jet engine have a mental strength far beyond myself.

Edit: The 100 dB jet engine was a stretch, but you probably get my point.

 

[GoatSheep]

I have some custom earplugs but it is obviously inconvenient to always be putting them in and out. I actually put some in when I open the box of cereal because the plastic bag inside causes such an aggravation based on that type of frequency.

I wonder about the limits of tinnitus and hyperacusis levels. You mentioned "unfathomable" levels. It is interesting that there have been studies showing no correlation between tinnitus levels and tinnitus distress. Some people can have high levels of tinnitus volume and it does not seem to bother them.

I think a lot of it has to do with how we are wired.

Before tinnitus I couldn't listen to the television or music while I was working on a writing project if it was in depth to any degree. I never slept with anything except a white noise machine or air purifier running. Sometimes in complex traffic situations I would turn the radio down to focus.

So for me, introducing a constant (at first very loud) noise into my environment like that was devastating. Nowadays it has reduced to a mostly tolerable level. I still find it much harder to concentrate though and feel my work had suffered greatly in clarity.

Noxacusis is the devil though.

 

[Juan]

I have some custom earplugs but it is obviously inconvenient to always be putting them in and out. I actually put some in when I open the box of cereal because the plastic bag inside causes such an aggravation based on that type of frequency.

I wonder about the limits of tinnitus and hyperacusis levels. You mentioned "unfathomable" levels. It is interesting that there have been studies showing no correlation between tinnitus levels and tinnitus distress. Some people can have high levels of tinnitus volume and it does not seem to bother them.

The easiest thing is using earmuffs around the house, just for comfort, in case you feel the need of protecting your ears or feel more comfortable that way. You put them on and off easily... they come in handy around the kitchen...

 

[Wrfortiscue]

I wasn't referring to tinnitus distress, but rather, what I consider "objective" increases. Some people suffer a very severe form of Category IV where the slightest sound causes immediate permanent increases in tinnitus. This cause the baseline to increase very rapidly, to what I'd assume to be "unfathomable" levels. Obviously, those people aren't losing hair cells in the inner ear, yet the tinnitus still increases endlessly, so there's a lot of variables going into tinnitus severity. Hearing loss is probably a big one, but not necessarily what defines the volume.

Regarding distress; I know that there have been studies done that shows seemingly no correlation between tinnitus distress and volume, but I completely disagree with it. It reinforces gaslighting of people not being able to habituate to a 100 dB jet engine. I for one would quit immediately had my severity been that bad. Most people I've talked to, who have pretty bad tinnitus, go about their everyday life, and it works fine, but they still suffer, silently. Those who can habituate to a 100 dB jet engine have a mental strength far beyond myself.

Edit: The 100 dB jet engine was a stretch, but you probably get my point.

There are people that can overcome almost anything... I'm not one of those though lol.