Tinnitus and hearing loss
Tips for people with severe-profound hearing loss to help them manage their tinnitus.
Tinnitus is more common in people who have hearing loss or ear problems. It is estimated that 80% of people with severe-profound hearing loss experience tinnitus.
What is tinnitus?
Tinnitus is the sensation of hearing a sound when there is no external source for that sound. Someone with tinnitus may hear ringing, buzzing, hissing, whistling or other noises. The sensation can be there all the time or come and go. The volume of the noises heard can vary from one episode to the next.
Tinnitus is common and is reported in all age groups, even young children. About 30% of people will experience tinnitus at some point in their lives, and around 1 in 7 adults in the UK live with persistent tinnitus.
Tinnitus is more common in people who have hearing loss or ear problems. It is estimated that 80% of people with severe-profound hearing loss experience tinnitus.
Tinnitus is a symptom rather than a disease or illness. The onset can be related to a change in hearing, trauma, illness, stress, surgery or medication. In most cases the cause is unknown.
How does hearing work?
Hearing works through specialist cells in the cochlea of each ear which convert sound into nerve impulses, which travel along the hearing nerve to the brain. The brain makes sense of the sound by filtering out any unnecessary nerve activity and background sounds. The hearing centres of our brain connect to systems in the body and brain which regulate our mood and bodily functions such as heart and breathing rate. These connections help us respond appropriately to sounds around us, for example reacting quickly to a fire alarm or relaxing while listening to music. Changes in our hearing, physical health or mental health may influence the way our brain filters, processes and reacts to sound.
Hearing loss and tinnitus
Some people become aware of tinnitus following a change in their hearing. When deterioration reduces the amount of information being sent to the hearing centres of the brain, it responds by trying to get more information from the ear – a bit like changing sensitivity settings. This increases the amount of external sound detected and can mean that internal sounds – such as electrical activity on the hearing nerve, or the sound of your blood flowing – also gets picked up.
For others, a stressful or emotional event can trigger tinnitus. Emotional stress stimulates the sympathetic nervous system, which increases nerve activity in the brain and indirectly increases the tinnitus.
Although there is no known cure for tinnitus, there are lots of things you can do to help manage tinnitus yourself. These are not specifically for people with severe-profound hearing loss but have been proven to help manage tinnitus.
Talk to a professional
Your GP and hearing aid dispenser / audiologist will be able to offer support and advice. Many audiology services have an audiologist or hearing therapist, specialising in tinnitus management.
Talk to your family and friends
Explain what you are going through. The people around you may not be able to give you the support you need if they do not understand what tinnitus is or how it is affecting you.
Talk to others
It can be helpful to talk to someone who has experience of tinnitus. There are Tinnitus Support Groups around the country where you can pick up tips from others and gain (and give) support simply by sharing your story. It can be difficult to hear what people are saying in a group or social situation, especially if you have a severe-profound hearing loss. There are devices available and techniques you can use to help you. Your audiologist, local Sensory Services team or our colleagues at RNID can advise and support.
Call our helpline
We offer a confidential tinnitus telephone helpline. Please tell the adviser if you are having difficulty hearing them and let them know what will help you to hear them better. If you struggle to use the telephone, there is a chat function on this website – click on the chat icon at the bottom of the screen.
Most people find they hear their tinnitus less when their hearing aids are switched on. If your hearing aid is not reducing your tinnitus, speak to your audiologist as they may need to review your settings.
Even with appropriately fitted hearing aids, people with severe-profound hearing loss can struggle to detect softer environmental sounds, such as bird song. This is because hearing aids are designed to help you hear speech and protect your ears from loud sounds. Your audiologist may be able to give you an extra setting on your hearing aid which focuses on amplifying soft sounds, which can be used when it is quiet.
Depending on the degree and configuration of your hearing loss, you may be able to find a suitable combination device to use as sound therapy. This is a hearing aid with a built-in sound generator. Be careful of the volume and length of time you use the noise component to avoid causing further damage to your hearing.
People with severe-profound hearing loss often struggle to hear in noisy environments. The extra listening-effort needed to hear in noisy or busy social situations can be tiring and lead to frustration and social isolation, all of which can have a negative effect on tinnitus. Speak to your audiologist about hearing aid settings, assistive listening devices and communication tactics to help you hear as well as possible in these situations.
In order to give you the best possible hearing it is important that your hearing aid is regularly serviced and that your hearing is regularly reviewed.
We have further information about hearing aids.
Hearing implants may be appropriate if you are not able to use a conventional hearing aid or when you do not get sufficient benefit from your hearing aids. Types of implants includes bone conduction, middle ear, cochlear and auditory brainstem implants.
The most common hearing implant for those with severe-profound hearing loss is a cochlear implant. This is a small electronic device that turns sound into tiny electrical pulses, which are sent directly to the nerve of hearing. The implant can therefore bypass some of the inner ear structures which are not working.
The improvements in hearing and quality of life from a cochlear implant are well documented. Many published studies also report cochlear implants can help reduce tinnitus. Despite the clear benefits, it is estimated that currently less than 7% of eligible adults have a cochlear implant. You can find out more information about cochlear implants from the British Cochlear Implant Group (BCIG).
And more about cochlear implants and tinnitus, from us.
A lot of people find that additional background sound (known as sound enrichment) helps to make their tinnitus less intrusive.
Sound enrichment can be provided in several ways including:
- CD, MP3 download or the radio
- smartphone apps
- bedside / table-top sound generator
- wearable sound generator.
The use of sound enrichment can be more challenging with a severe-profound hearing loss and you may need to experiment to find the best solution for you.
When thinking about sound enrichment the following points are useful to consider:
- severe-profound hearing loss means you will often struggle with clarity of sound, not just lack of volume. You may find some sounds on CD, MP3, radio, or smartphone apps have poor sound quality. Try a range of sounds to find one that is pleasant.
- when you remove your hearing device at night you are unlikely to be able to hear a bedside or tabletop sound generator. Some people choose to sleep wearing their hearing aid / hearing implant sound processor to be able to hear a bedside sound generator. However, this should only be done after talking to your audiologist.
- if your hearing aid / hearing implant has a direct audio input or wireless function, you may be able to play therapy sounds directly through your device.
More about sound therapy.
Stress is often linked to tinnitus. By relaxing more you may feel less stressed and so notice your tinnitus less. Relaxing your body (even if you do not feel tense) often helps with sleep and to ease the tension caused by the tinnitus.
There are lots of relaxation activities that can be done with and without sound. For further advice see our pages on stress, relaxation techniques, and relaxation activities without sound.
If you have significant anxiety, depression, or other mental health problems alongside tinnitus, or are extremely troubled by the tinnitus you may benefit from psychological support or counselling. Your audiology service may be able to refer you directly , your GP can refer you, or you may be able to self-refer via your local Improving Access to Psychological Therapies (IAPT) service.
Sleep disturbance affects most of us at some stage of our lives. There are various techniques to help when you have tinnitus and sleep disturbance.
When you take your hearing aids out or hearing implant sound processor off at night you may struggle to hear. It can be unnerving to be able to hear less, especially if you are worried about missing sounds such as a child crying. Alarms and alerting systems may offer some reassurance. Feeling anxious about not hearing at night can increase awareness of tinnitus.
Whatever your level of hearing, you may notice your tinnitus more at night when it is quieter. The shift from a relatively noisy daytime environment to the quietness of the bedroom, can make it more noticeable. Having some background sound (see above) may help make your tinnitus less intrusive and allow you to sleep better.
We have lots of tips about different techniques to help when you have tinnitus and sleep disturbance.
Acknowledgements
The author would like to acknowledge the input and support of Mark Smith, Helen Cullington, Rachel Knappett and Amanda Compton Cook in the preparation of this guide.
Help and support
Our Tinnitus Support Team can answer your questions on any tinnitus related topics:
- Telephone: 0800 018 0527
- Web chat: – click on the icon
- Email: helpline@tinnitus.org.uk
- Text/SMS: 07537 416841
We also offer a free tinnitus e-learning programme, Take on Tinnitus.
Version 1.1
Published November 2022
To be reviewed November 2025
Author: Gemma Crundwell, Cambridge University Hospitals NHS Foundation Trust
Image: Edit of a photo by Kirill Balobanov on Unsplash
Page updated 22 March 2022
Images:
Photo by Andrea Piacquadio on Pexels.