Tinnitus and flying

How to have a comfortable flight if you have tinnitus

Most people with tinnitus do not experience any problems whilst flying. If there is any adverse effect, it is likely to be only minor and temporary.

Top tips for a comfortable flight

  • Avoid using earplugs during a flight. When you seal out background noise, your tinnitus may become more noticeable.
  • Sit in the front of the plane where the engine noise isn’t as loud. Anywhere in front of the wings should be quieter.
  • Your ears will feel more comfortable if air pressure inside and outside your ears is equalised. To do this, swallow and yawn as much as possible. This will open the Eustachian tube and allow air to enter the middle ear. When outside air pressure changes, the Eustachian tube supplies a bubble of air and the ears ‘pop’. When this happens, air pressure has been equalised.
  • Chew gum or suck on a sweet. It will cause you to swallow more often and help equalise the air pressure during take-off and descent.
  • Stay awake during the descent. This is when it is harder to adjust to the pressure changes. Your Eustachian tube and ears don’t adjust as well when you are sleeping so it’s better to stay awake.
  • Try to avoid flying if you have a cold or upper respiratory infection as it can make it more difficult for your Eustachian tube to operate.
  • A nasal decongestant may be helpful. Even if you are not suffering from a cold, this may help keep those airways and tubes open for better pressure release.
  • Leave your hearing aids in place as you may find them particularly helpful during a flight.
  • Make full use of the entertainment offered on the flight. Listen to music or watch the inflight film as they help to take your focus away from your tinnitus. If you tend to get nervous when travelling by air, the entertainment may also help you relax. Avoiding stress and worry helps to minimise the effects of tinnitus.

Aircraft cabins are pressurised. When a plane takes off, the effect on the ears is minimal as the pressure in the aircraft cabin decreases.

Usually, the air in the middle ear is at relatively high pressure. It passes down the Eustachian tube (connecting to the back of the nose) rather like releasing the neck of a balloon. When flying, if there is going to be a problem with equalising pressure in the middle ear, it tends to occur when the aircraft comes down to land. At this time the air in the middle ear is at a lower pressure than the air in the cabin.

If your Eustachian tube is blocked, your ears will not ’pop’ and the pressure cannot equalise. Eustachian tube blockage can occur for a number of reasons. The most common are colds, sinus infections and nasal allergies, which stop the air flowing through the blocked tube. This causes lower pressure inside the middle ear and the eardrum is sucked inward and stretched. This means that the eardrum cannot vibrate naturally so sounds seem muffled or blocked. In extreme cases, usually during rapid descent, the ears can become painful.

If Eustachian tube blockage is experienced during flying, then tinnitus may appear to get louder temporarily.

On clearing the ears, by swallowing or yawning to open the Eustachian tube for example, the tinnitus should return to its former level.

Some people worry that the noise of the engines will damage their ears or cause their tinnitus to get louder. This is very unlikely. Many people actually find flying to be one of the times when they are completely free of their tinnitus because of the background noise of the engines. 

If you find the noise of the engines disturbing, select a seat in front of the wing, or as a last resort, use soft earplugs. If the sound level is not a problem for you, do not use earplugs as blocking outside sounds may make your tinnitus appear to be louder temporarily. If you have been fitted with wearable noise generators, it can be helpful to use them during a flight. 

If you normally wear hearing aids, you should also wear these during your flight, as removing them may make your tinnitus louder and more noticeable. For people with hearing loss, it is often “straining to hear” that makes the tinnitus seem louder when on board the aircraft. 

In some cases, changes of pressure do have small and temporary effects on tinnitus. It may change the frequency, and in some cases may temporarily increase or decrease the loudness. Most people with tinnitus do not experience these effects.

If you have grommets or a perforated eardrum you may worry that flying will be difficult for you.

Grommets are very small ventilation tubes used to treat certain ear disorders. Perforations (or holes) can occur in the eardrum as a result of infection or injury. In both cases, there is actually less of a problem flying than if the eardrum is intact. This is because any change in pressure can be equalised across the eardrum through the hole or tube and does not depend on the Eustachian tube functioning normally.

If you have recently undergone middle ear surgery, or are about to do so, it is important to check whether you will be allowed to fly immediately afterwards. If you have had an eardrum perforation repair (myringoplasty), or a stapes operation for otosclerosis, you are usually required to avoid air travel for a short period whilst the ear is healing.

Please check with your ear specialist before making travel plans.

Stress and anxiety

Many people with hearing disorders, and particularly those who have tinnitus, can find their tinnitus aggravated by varying degrees of depression and anxiety. Some people become anxious because they are worried about flying. This can make tinnitus seem worse.

Relaxation and breathing exercises can be extremely helpful, particularly if practised beforehand. If your fear of flying is well established, some commercial airlines run a “desensitisation” course and can be contacted directly about this.

Do discuss your anxieties with your GP who may suggest a small dose of a tranquilliser.