Prolonged Noise — Battling with Guilt, Variety of Disturbing Tinnitus of Sounds in Both Ears and How to Proceed

[faithup]

Greetings all,

I recently discovered this forum while dealing with revelations about the worsening of my severe tinnitus. The condition, caused by prolonged noise exposure and preventable activities, has been overwhelming. I do not wish to burden you with my personal concerns, but I wanted to post this for future reference. I apologize if this is lengthy or overly self-focused as I am currently in a state of panic and depression.

I wish I had found this forum earlier. After reading many posts here, I realize my coping methods for tinnitus have been harmful, causing additional trauma. For context, I have a long history of chronic stress, OCD, anxiety, and depression that has not been treated with medication. I have been diagnosed with PTSD due to past health-related anxieties. Historically, I would recover from these episodes without addressing root causes. Physically, I deal with excessive earwax, constant ear pressure, jaw-related clicking and cracking, misophonia triggered by certain sounds, and chronic swallowing or popping of my eustachian tubes.

Background on Noise Exposure

During the pandemic, I adopted several dogs, including Chihuahua mixes and one large dog, and took up motorcycling as a new interest. I purchased two motorcycles in 2020 and 2021, one of which had a modified exhaust. Unaware of the dangers, I rode these motorcycles weekly, sometimes on freeways, for 1.5 to 2 hours without ear protection. The exhaust likely produced noise levels of 110 to 120 decibels. I did not know such exposure could cause tinnitus or that ear protection was necessary.

I also used a HEPA filter in my bedroom during the pandemic to mask sounds from a noisy relative. This relative's constant nose blowing and utensil clinking triggered my misophonia.

Tinnitus Onset and Initial Steps

In late 2021, I noticed a faint ringing in my right ear at night, even with the HEPA filter running. An ENT evaluated me in early 2022 with normal results on an audiogram and tympanometry. They suggested sound masking at night but did not test for high-frequency hearing loss or warn me about the impact of motorcycle noise.

In 2022, I contracted COVID-19 twice and another viral infection, which may have aggravated the tinnitus. By summer 2023, I noticed a fluctuating, vibrating hum in my left ear. Plugging the ear with a finger silences it. The hum also diminishes in response to low-frequency sounds. I suspect somatic tinnitus because certain movements, like clenching my teeth or pressing specific neck areas, alter the sound.

Recent Developments

By late 2024, after continued motorcycle use and blasting the HEPA filter, my tinnitus worsened. A new audiogram showed a 5 to 10 decibel drop across several frequencies in both ears, though still within the normal range. I also bought a used convertible with a modified exhaust, unknowingly exposing myself to more harmful noise.

Over time, I became sensitive to high-pitched sounds, particularly in my left ear. I also noticed that masking sounds, such as white noise, were no longer effective, making my tinnitus more distressing. My brain MRI, done without contrast, returned normal results.

Recent Changes and Challenges

Two months ago, I stopped exposing myself to noise from vehicles. Recently, I switched from white noise masking to sound enrichment with lower-volume nature sounds. This change has disrupted my sleep, causing me to wake up with louder tinnitus or even ear pain, particularly when lying on my side.

Compounding this issue, I once used pure tones at high volumes to test my hearing via YouTube and headphones, an act I now deeply regret. I feel guilty and ashamed for the damage I have unknowingly caused.

Seeking Guidance

1. Sound Machine Positioning: I have three mini sound machines in my bedroom, set slightly below my tinnitus volume. However, during the night, the tinnitus becomes more pronounced. Can anyone suggest proper placement or adjustments to make them more effective?
   
   
2. Side-Sleeping Challenges: Tinnitus in both ears worsens when pressed against the pillow. Would an adjustable bed help? I am considering this to enable sleeping in an elevated position.
   
   
3. Dual-Tone Enrichment: My left ear has a low-frequency hum with some ringing, while my right ear has high-pitched ringing around 14500 Hz. Should I use two different sound enrichment devices for these distinct tones?
   
   
4. Neck and Posture Rehabilitation: I suspect my somatic tinnitus may benefit from addressing poor posture and neck alignment. Can anyone recommend exercises or treatments for this?
   
   
5. Dog-Related Noise: My dogs' barking has become a significant stressor, given my tinnitus and hyperacusis. I love them dearly but feel overwhelmed. How can I balance protecting my hearing while keeping them?

Final Thoughts

I have contacted audiologists and doctors, but the holiday season has delayed responses. I am considering TRT and CBT for long-term management but need immediate relief to regain stability. While I have avoided medications so far, the distress has led to insomnia and depressive thoughts.

I deeply regret the choices that led me here, but I am determined to adapt and build resilience. If anyone has insights, guidance, or resources, I would be profoundly grateful.

Thank you for taking the time to read this. I wish you all a blessed and peaceful journey.

Alex

 

[Cmspgran]

Hi Alex,

First of all, do not blame yourself. We have all felt the same way and regretted our decisions. When I think back to the countless gigs standing by speakers, blasting my car stereo and iPod day after day, I cringe. However, are these things not normal? Millions of people do the same thing every single day, and there just is not enough education or guidance about the damage it can cause.

Secondly, TRT does not really do anything. It is essentially glorified sound enrichment (which you are already doing) with a huge price tag attached. CBT might be helpful for managing anxiety and stress. Personally, I did not find it useful, but others do. If you have discovered your tinnitus frequencies, your idea of playing multiple matching white noise tones is worth trying. Dale Snale's channel on YouTube is great for this.

If the noise machines are waking you up at night, they are probably doing more harm than good. You might want to consider some form of medication. Avoid SSRIs, as they can potentially make tinnitus worse. Over-the-counter sleep aids might help initially, and you could then ask your doctor to trial you on something like Nortriptyline or Gabapentin. There is plenty of information about these options on these boards.

For inspiration, I recommend reading some of @MindOverMatter's or @billie48's posts.

As for your dogs, I completely understand the dilemma as an animal lover myself. Could you consider getting custom molded earplugs to wear around them?

 

[faithup]

Thank you for your comforting message about not blaming myself. It means a lot. Everything I did seemed to worsen my hearing, and it's been difficult not to dwell on that.

I'm familiar with Dalesnale's sound videos, but I'm now focusing on more natural sounds.

I'll definitely look into custom-molded earplugs. However, I've read that for hyperacusis, it might be wise to avoid relying too much on hearing protection. When I used to wear earplugs while riding, it made me much more aware of my tinnitus, which wasn't helpful.

Thanks for sharing the links to the two posters. I'll check them out!

Best!

 

[Dr Nick]

Hi Alex,

You are not to blame. However, I completely understand how difficult it is not to feel that way. When it is at its worst in the small hours, I often find myself wishing I could turn back time and make a different choice. Over time, I have come to view this as part of a broader disparity in health and safety attitudes and regulations. On one hand, we have significant legislation in public places regarding dust exposure, chemical substance exposure, and tobacco smoking. On the other hand, there is comparatively little protection against noise exposure, despite it being a life-changing issue.

When I was a child, I remember seeing numerous public information films on television about the dangers of dust and chemicals, but I cannot recall ever seeing anything about the consequences of excessive noise. In fact, I did not even realize that tinnitus could be a chronic condition until I was in my thirties. I had always assumed it was a temporary threshold shift that resolved within hours or days after a loud concert. Perhaps this information will be more widely understood in the future.

As an aside, I often wonder how loud something really needs to be for people to enjoy it. Does a concert truly have to be so loud that it forces the auditory system to adjust to a new normal? Why not make it just loud enough to avoid that adjustment—wouldn't it sound the same? Subsonic enhancement could be used to create the sensation of "feeling" the music without requiring such extreme volume.

Similarly, motorcycles often cannot be fully silenced due to engineering constraints. Yet, there was a trend for making them deliberately louder because more sound gives the impression of more power, which appeals to buyers. Thankfully, there is now growing public demand for quieter products. This may, in part, be influenced by experiences with electric cars. I recently test-drove a Tesla and was amazed by the enormous power it offered without the accompanying noise.

Here are a few thoughts and experiences I hope you find helpful:

1. Sound enrichment: I have found sound enrichment to be incredibly helpful. At night, I use earbuds to play very quiet soundscapes, which are set to switch off after a while. Although the earphones often fall out during sleep, the initial effect is beneficial. During the day, I rely on Apple AirPods Pro 2, which have built-in noise exposure limiters. These have been a godsend for managing my hyperacusis.
   
   
2. Side sleeping and somatic tinnitus: Like you, I experience increased severity when I sleep on my side. The somatic tinnitus often ramps up after about 30 minutes of side sleeping. The problem is that I frequently end up on my side during sleep and wake up with the tinnitus screaming, which can take days to return to baseline. I have tried various pillow setups and even used a neck brace, operating under the assumption that the increase in tinnitus is related to compression of the vestibular nerve. The results have been mixed. Unfortunately, today I woke up on my side with the tinnitus on overdrive, which is why I am here again now.
   
   
3. Multiple tones: I have several tones—13kHz in my left ear and a combination of 2.2kHz and a deep hum in my right ear. For managing this, I highly recommend the free iPhone app "TinnitusPlay." It is excellent, as it allows for custom sound enrichment that continues to play even when using other apps or listening to podcasts. You can tailor the sound for each ear, such as crickets in one ear and low-frequency binaural beats in the other. It also includes a neuromodulation feature.
   
   
4. Stretches: I have experimented with some stretches recommended by an audiologist, but the results have been limited. In some cases, they have even made the tinnitus worse if I am not careful. I am still exploring this area to see if there are effective options.
   
   
5. Managing loud sounds: I do not have any loud animals, but I think the AirPods Pro 2 could help in such situations. They include an "adaptive mode" that processes loud sounds and reduces their intensity. You can set the threshold, and I have mine set to around 75dB. These have been a lifeline for me over the past eight months. The great thing is that they do not block sound entirely like earplugs; instead, they allow most sounds to pass through. They also have a total noise cancellation feature, but I would caution against using it excessively. I overused it and suspect it contributed to my low-frequency tinnitus. Adaptive mode is a much better option.

I hope this is helpful.

Best regards,
Nick

 

[faithup]

Hi @Nick47,

Thank you so much for your informative and comforting message! I'm sorry for the delay in my response; I only just discovered your message as it didn't appear in my replies for some reason.

You're absolutely right—there aren't enough public warnings about the dangers of noise exposure. On the other hand, there's plenty of positive promotion of loud concerts, modified vehicles, and similar activities.

I'll definitely follow your excellent recommendation to try the AirPods Pro 2 for daily use, and I'll be mindful of your advice about the noise cancellation features. I have an appointment in a couple of months for another hearing test and a hearing aid consultation, so I'll see if a hearing aid is needed then.

I also have several mixed tones in both ears, and I suspect some of them might be somatic. I've been watching videos to learn how to improve my posture, care for my cervical spine and jaw muscles, and massage the trigger points around those areas. My tinnitus worsened during a period of extreme chronic stress, anxiety, and OCD, so I'm now focusing on calming my nervous system. If this helps lower the overall sound level, it would be such a blessing.

I wish you the best of luck in reducing your tinnitus and finding a solution that helps you not be bothered by it—especially when it comes to sleep.

Blessings,
Alex