Reactive Tinnitus Induced by Headphone Listening Fatigue

[AndySomething]

Hi all.

Basically the TL;DR is that in July I bought some audiophile headphones and an amp + DAC and after 3 weeks of using them my ears felt funny and hurt until the end of August. By mid September I had bothersome static tinnitus when in a quiet room, and by October I had reactive unmaskable beeping that rides on top of external white noise. And now I have a reactive eeeee in my left ear too.

The real time progress of my issues are actually documented on the HifiGuides forums as I was trying to find out what what going on:

• Sennheiser HD650
• Cautionary Tale - How I damaged my hearing with the HD6XX

First off I noticed a very mild tinnitus in the summer of 2021 which didn't bother me, and I started protecting my ears at work around these ultrasonic baths which I thought were the culprit, however I think in hindsight it had been caused by wear and tear from using headphones every day listening to audiobooks and podcasts which I'd been doing since the start of the pandemic. Anyway at this stage I learned the whole 85 dB for 8 hours is enough to cause damage but I think this gave me a false sense of security because I kept using headphones every day to listen to audiobooks and things, as I sort of treated anything below that as automatically safe regardless of duration.

So I had the rather daft idea this summer that I should buy some audiophile headphones with DAC and amp in order to start exploring and enjoying music again.

I ended up with two amps that I would test and eventually resell the least preferred one.

So in July the kit arrived I was listening to to them using a decibel meter on my phone to ensure I wasn't listening at above 70 dB which I treated as a safe volume. In hindsight it seems crazy but I was listening to a few songs at this volume then having relaxing playlists on for hours at a gentler volume. On top of this I was probably spending my mornings and evenings listening to audiobooks on my phone so my ears will have been subjected to plenty of loud noise and not getting enough silent time to fully recover.

The headphones were fine for the first week I used them, however on the second week I found that listening to them made my ears feel strange and uncomfortable in a way that I wasn't sure if it was in my imagination or not. I had also switched to the 2nd amp at the precise time my ears started to feel funny when listening so I started to believe it might be a technical property of the amp, or the pressure of the clamp pressing on a nerve or something. Somehow I kept testing them and getting very confused.

On the 3rd week I was testing both amps and one day I had a sharp pain in my right ear and my mild tinnitus got a tiny bit louder in this ear, so I decided to sell the headphones on eBay and forget about music for the time being. At this stage I realized my ears were actually hurting more and listening to any kind of media caused this strange discomfort.

After three weeks of this I went to the doctor but they assured me that the headphones were a red herring and I had Eustachian Tube Dysfunction from seasonal allergies, as my eardrums were retracted and my ears were inflamed. I think they came to this conclusion because I was totally convinced I'd been listening at safe volumes and I assured the doctor that the tinnitus was no bother at all. The doctor gave me some menthol crystals to open up my tubes which stopped them hurting as much and they felt fine by September.

However by mid September my tinnitus was loud enough to be bothersome in a quiet room. Maybe twice as loud as my computer fan. At this stage I started to get very anxious about it because I'd lost my enjoyment of peace and quiet and went on the Sertraline which did get me back to reasonable function after a week or so.

In late September I got COVID-19 and started hearing a tone in my right ear, which gradually got louder and started reacting to the kettle boiling at first. Eventually it settled as a very quiet (in quiet room) low pitched tone repeating in a sort of rapid Morse code pattern without any gaps. At first I thought of it as flutes in my ears. This now reacts to most white noise and isn't maskable. It's hard to know if the COVID-19 infection was a coincidence or if it contributed to the tinnitus. I made sure not to take ibuprofen while unwell.

Throughout October it gradually got worse and since last week when my left ear started hurting for a few days, there is now a reactive whistling and my static hissing is louder in that ear too. This is quite a bother as my left had been my better ear and now its worse.

I also have a shimmering ringing sound that isn't really there in the mornings but seems to have a "winding up" effect so appears on days when I'm exposed to a lot of noise. It seems to be reactive too and sounds a bit like the background noise at 1:30 in this video:



So here I am. I don't have hyperacusis except to very loud noises and my tones rise with external white noise but thankfully don't drown them out so as bad as it is I can still experience the real world without being distracted all the time.

I have an ENT appointment in December but I'm going to see my GP again today as I'm concerned this keeps getting worse and see if they recommend fast tracking to see an ENT privately. Especially after the last week.

I'm not sure what I want from here but It would be interesting if anyone has any thoughts on my experience. I think really you want someone to say it's going to get better but at this stage I just hope it doesn't get worse as even though it's a miserable thing, I can still function properly even if I'm having to relearn how to enjoy many things again like this.

I think my tinnitus was caused by excessive ear fatigue as described on this Wikipedia article:

https://en.wikipedia.org/wiki/Listener_fatigue

 

[Michael Leigh]

I have an ENT appointment in December but I'm going to see my GP again today as I'm concerned this keeps getting worse and see if they recommend fast tracking to see an ENT privately. Especially after the last week.

I suspect that you live in the UK. You will get the best help and long-term aftercare for tinnitus under the NHS that no private practice can match, so wait on your appointment at NHS, as this is the correct way to do things.

I am also an audiophile and advise that you don't listen to audio through headphones even at low volume. Click on the links below and read my posts: New to Tinnitus, What to Do? Tinnitus, A Personal View.

All the best,
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

[AndySomething]

Thanks Michael.

My GP seemed to think as much so I'll stay on the NHS.

Yeah I don't listen to headphones any more.

I'm not even an audiophile really, I just thought I'd try to get into the hobby but I tend to binge things when I get a new obsession, and here I am unfortunately.

 

[Michael Leigh]

Thanks Michael.

My GP seemed to think as much so I'll stay on the NHS.

Yeah I don't listen to headphones any more.

I'm not even an audiophile really, I just thought I'd try to get into the hobby but I tend to binge things when I get a new obsession, and here I am unfortunately.

You're welcome @AndySomething.

You will be fine so try not to worry. Read my posts so you know what to expect when you are seen at ENT. My advice is never to use any type of headphones again even at low volume. This includes headset, AirPods, earbuds, noise cancelling and bone conduction headphones. The choice is yours but I strongly advise you to follow my advice. Click headphones in the search box at the top of this page and read the posts.

If you are feeling stressed, talk to your GP. Remember to use low level sound enrichment at night.

All the best,
Michael

 

[AndySomething]

Okay so in my post I said I don't have hyperacusis...

For the last week or two I've been feeling a bit of pain in my ear occasionally and today in my right ear there was a couple of times when it was more like a burning pain in response to sounds.

When people have bad hyperacusis, do you get a burning pain in the ear, which has a rather different character to the normal pain you might get from loud sounds?

 

[Michael Leigh]

When people have bad hyperacusis, do you get a burning pain in the ear, which has a rather different character to the normal pain you might get from loud sounds?

Hi @AndySomething.

You have noise-induced tinnitus. Hyperacusis or having some oversensitivity to sound often accompanies this type of tinnitus. From your description it appears that you have hyperacusis but try not to get too stressed about this. Like tinnitus, hyperacusis comes in different levels of severity and no two people will experience it the same.

Reactive tinnitus is mentioned in the title of your thread. Some people believe there is such a condition, but I don't. This terminology was made up in tinnitus forums many years ago and has become commonplace. Tinnitus can and does react to certain sounds, but in most cases the reason is due to a person suffering a noise trauma to the auditory system that causes them to develop noise-induced tinnitus. Hyperacusis can be treated and for some people it can be completely cured or reduced to very low levels. Please click on the link below and read my post: Hyperacusis, As I See It.

Michael

Hyperacusis, As I See It | Tinnitus Talk Support Forum

 

[AndySomething]

Well I think it's worth putting a bit of an update here but it's actually unbelievable how much better I'm doing than I was when I wrote this post.

I think I was going through a so called "spike" at the time so I was incredibly anxious but the tinnitus seems to have settled back to a baseline.

It's still a pain but it's surprising how you really can get used to it to the point where it doesn't stop you from enjoying things anymore.

I still need a podcast or something playing while I get to sleep, and the reactive beeping in my right ear is unpleasant, but some simple adaptations mean it's really not the end of the world.

I basically avoid busy roads when I can, I disabled the extractor fan in my bathroom, and I go into the next room for a second when the kettle finishes boiling. With this I can get on without being as regularly distressed by my reactive tinnitus.

And sure it would be nice if I could go for a piss without hearing a phantom whistling to accompany it, but in the grand scheme of life there are more interesting things to concern yourself with.

My advice to anyone new to this reactive tinnitus nonsense is that it's okay not to be okay with it. It's okay to think it's a big deal, and it's okay to be distressed by it. And finally you don't need to feel like a failure if you're still distressed and not habituated, whatever stage you are at.

Overall it's still awful and I think about my tinnitus all day but it's a positive first step that my life doesn't feel completely defined by it anymore.

Finally, in response to @Michael Leigh. A lot of your posts are very helpful but I don't understand this business of saying that reactive tinnitus doesn't exist and is just hyperacusis. On the one hand I think it's actually very disrespectful to deny people's experiences, especially when they're desperate and looking for advice when they've just come down with tinnitus.

Just because you don't have something it doesn't mean that no-one else does.

Reactive tinnitus is a real thing. I have it.

The noise of a fan is accompanied by a phantom beeping tone, which I stop hearing the moment the fan is turned off. I seem to be a bit more sensitive to very loud noises than other people, but hyperacusis isn't a problem for me. Hyperacusis and reactive tinnitus are different things so at best you're distracting people who are having problems with one by making them worry about the other. Also, if you're saying something doesn't exist, or it's just a form of something else, you need evidence to back up that claim. There's zero utility in saying X doesn't exist because I say so.

 

[Michael Leigh]

Finally, in response to @Michael Leigh. A lot of your posts are very helpful but I don't understand this business of saying that reactive tinnitus doesn't exist and is just hyperacusis. On the one hand I think it's actually very disrespectful to deny people's experiences, especially when they're desperate and looking for advice when they've just come down with tinnitus.

Just because you don't have something it doesn't mean that no-one else does.

Reactive tinnitus is a real thing. I have it.

I realize the difficulties that you are going through @AndySomething. If you are going to quote what I say, then please do so correctly. I have never said reactive tinnitus is just hyperacusis, however, I have said in my opinion reactive tinnitus is not a medical condition that exists and I stand by this.

Tinnitus does react to sound, especially when it is noise induced as in your case. Your reactive tinnitus is in fact hyperacusis, caused by noise trauma to your auditory system. Hyperacusis can manifest itself in various forms of intensity and no two people will experience it the same. Be in no doubt hyperacusis with or without pain can be a very debilitating condition. If you peruse my posts in this forum and those on my started threads, I mentioned having it so severe when in conversation with anyone, I had to ask them to please lower their voice as my ears were in pain.

My hyperacusis was completely cured in 2 years wearing white noise generators as part of TRT and having counselling with an audiologist. Fortunately, it has not returned even though I experienced a second noise trauma in 2008.

If you want to call your hyperacusis reactive tinnitus, then do so. Your oversensitivity to sound can improve by itself with time, but you might have to seek treatment with an audiologist as I did in order to cure it and wear white noise generators.

Michael

 

[Strawberryblonde]

The noise of a fan is accompanied by a phantom beeping tone, which I stop hearing the moment the fan is turned off.

Yes, I'm currently going through this and have since May. I do what you do and try to keep the noises that start up the distortions to a minimum but you can't always avoid them. Hope you have some improvements with all this

 

[Michael Leigh]

Yes, I'm currently going through this and have since May. I do what you do and try to keep the noises that start up the distortions to a minimum but you can't always avoid them. Hope you have some improvements with all this

Your oversensitivity to sound will improve and probably be cured wearing your white noise generators @Strawberryblonde. This treatment takes time and might require counselling with your audiologist. Last year @Eleanor89 was having a lot of difficulty with oversensitivity to sound and painful hyperacusis. She followed some of my suggestions on wearing white noise generators - they must be introduced slowly, and their volume kept low.

Eleanor has made substantial improvement.

Michael

 

[Strawberryblonde]

Your oversensitivity to sound will improve and probably be cured wearing your white noise generators @Strawberryblonde. This treatment takes time and might require counselling with your audiologist. Last year @Eleanor89 was having a lot of difficulty with oversensitivity to sound and painful hyperacusis. She followed some of my suggestions on wearing white noise generators - they must be introduced slowly, and their volume kept low.

Eleanor has made substantial improvement.

Michael

Hi @Michael Leigh. I have been given WNGs but wearing them for only a few minutes caused a new higher pitched tone in one ear when I removed it and for the past few days my tinnitus level seems increased so I am very reluctant to keep going on with them (I was told spikes will happen with them, which to me doesn't sound right ). My hearing therapist seemed to dismiss me and laugh when I said things sounded amplified (I could hear things far away and touching my coat and hair was giving feedback into them). I will get back in touch with my hearing therapist to see what he suggests. (I also couldn't manually change the volume like he said I could.)

I did feel I was improving slowly with my sound issues: the supermarket today didn't sound overly loud and big lorries that drive past me didn't sound as monstrously loud either as they once did. So that is looking like it's heading ever so slowly in the right direction.

I know my big problem is anxiety (I must sound like a broken record to those who come across my posts ). Working through some suggestions as what might help in the long or short term as I felt the last antidepressant I was given made my tinnitus sound a lot louder in the 4 days I was on it.

Thanks again for your suggestions @Michael Leigh And sorry to hijack your thread @AndySomething

 

[Michael Leigh]

Hi @Michael Leigh. I have been given WNGs but wearing them for only a few minutes caused a new higher pitched tone in one ear when I removed it and for the past few days my tinnitus level seems increased so I am very reluctant to keep going on with them (I was told spikes will happen with them, which to me doesn't sound right ). My hearing therapist seemed to dismiss me and laugh when I said things sounded amplified (I could hear things far away and touching my coat and hair was giving feedback into them). I will get back in touch with my hearing therapist to see what he suggests. (I also couldn't manually change the volume like he said I could.)

Hi @Strawberryblonde. I understand the difficulties you are going through and I know it's not easy. It might help to know that @Eleanor89 was having very similar experiences to what you describe. She would put the WNGs on and within a few minutes had to take them off because her oversensitivity to sound and hyperacusis spiked.

She followed my suggestions and turned down the WNGs to their lowest setting and only kept them on her ears for 3 to 5 minutes at first. She slowly increased the wearing time over many weeks. I explained to her that whenever the ears feel uncomfortable, she should take the WNGs off and give the ears a rest. The key is to persist at your own pace; it doesn't matter how long this takes. If one day you can only manage 2 minutes at a time, that's fine. The idea is not to give up but don't push yourself too hard or expect quick results. You will get there but it takes time.

It is unfortunate that your hearing therapist laughed at you, and I wish he didn't. It shows a lack of empathy and understanding and is a clear indication this person knows nothing about severe tinnitus and hyperacusis.

Take care,
Michael

 

[AndySomething]

And sorry to hijack your thread @AndySomething

It's okay. I also found that the tinnitus calmed down when I went off the antidepressants so it's not just you.

 

[Sammy0225]

It's okay. I also found that the tinnitus calmed down when I went off the antidepressants so it's not just you.

Reactiveness should resolve in a few months. Mine also started shortly after COVID-19. Fans especially aggravated mine.

 

[AndySomething]

Reactiveness should resolve in a few months. Mine also started shortly after COVID-19. Fans especially aggravated mine.

That's reassuring as I'd consider myself basically cured if the reactivity went away.

Mine did get reactive around the time I was ill with COVID-19 so maybe it's related, though the "reactivity" is much worse in the ear that seemed to get the worse acoustic trauma.

Anyway, cheers. Fingers crossed.

 

[AndySomething]

Logging in to say *yay* - it doesn't really bother me anymore. Either it's not as "reactive" as it was before or my brain just learned not to listen for it.

Crazy now to think not so long ago it seemed that every footstep I took triggered a phantom sound which would send me into a spiral of anxiety.

Still not so easy to get to sleep without YouTube or something playing but what can you do.

 

[Bruin_NJ]

Hi @Michael Leigh. I have been given WNGs but wearing them for only a few minutes caused a new higher pitched tone in one ear when I removed it and for the past few days my tinnitus level seems increased so I am very reluctant to keep going on with them (I was told spikes will happen with them, which to me doesn't sound right ). My hearing therapist seemed to dismiss me and laugh when I said things sounded amplified (I could hear things far away and touching my coat and hair was giving feedback into them). I will get back in touch with my hearing therapist to see what he suggests. (I also couldn't manually change the volume like he said I could.)

I did feel I was improving slowly with my sound issues: the supermarket today didn't sound overly loud and big lorries that drive past me didn't sound as monstrously loud either as they once did. So that is looking like it's heading ever so slowly in the right direction.

I know my big problem is anxiety (I must sound like a broken record to those who come across my posts ). Working through some suggestions as what might help in the long or short term as I felt the last antidepressant I was given made my tinnitus sound a lot louder in the 4 days I was on it.

Thanks again for your suggestions @Michael Leigh And sorry to hijack your thread @AndySomething

Hi there, how are you? How's your reactive tinnitus now?

 

[Strawberryblonde]

Hi there, how are you? How's your reactive tinnitus now?

Hello there @Bruin_NJ.

Unfortunately my reactivity is back right now, although it does come and go and I am yet to put my finger on a trigger as to why, could be one of many reasons. Only one tone reacts and that seems to be my morse code sound and it reacts to white noise or any colour noise, toilets flushing, letters boiling etc.