Signs and Symptoms of Tinnitus

Tinnitus is the perception of hearing a sound without an external source of noise. Some people with tinnitus may have "ringing in the ears," while others may hear buzzing, hissing, whooshing, roaring, or clicking sounds. Tinnitus can affect one or both ears and be acute (temporary) or chronic (long-term).

For some people, sounds may be mild or faint—only noticeable in quiet environments or masked by everyday noises. For others, tinnitus can be loud and bothersome, disrupting sleep and affecting the ability to focus on daily tasks.

An estimated 25 million American adults experience some form of tinnitus, which can develop suddenly or gradually over time. There are two main types of tinnitus: subjective and objective—each of which comes with its own unique set of symptoms. Your healthcare provider can determine the type you have based on what's causing your symptoms (such as nerve dysfunction, hearing loss, or changes in blood flow).

Common Symptoms 

People with all forms of tinnitus hear sounds with no identifiable outside or external source. Although tinnitus is best known for a "ringing in the ears" sound, it's also possible to hear:

• Buzzing
• Roaring
• Chirping 
• Hissing
• Clicking
• Whooshing 
• Whirling

Everyone experiences tinnitus a little differently. You might experience some variation or fluctuations in the following:

• Volume: Sounds can range from subtle to loud and can worsen with some triggers (like stress) or during quiet moments (such as at night)
• Pitch: Sounds may be high or low-pitched
• Unilateral or bilateral noises: Sounds can affect one or both ears
• Duration: Sounds may last for a short (acute) or long (chronic) period of time

Tinnitus can sometimes affect your sleep and psychological well-being, making concentrating on daily tasks or conversations difficult. Many people with tinnitus also experience: 

• Insomnia: Difficulty falling asleep, staying asleep, or getting good quality sleep
• Anxiety: Up to 42% of people with tinnitus experience anxiety symptoms such as excessive worry, fear, or tension
• Depression: An estimated 33% of people with tinnitus experience depression symptoms, like low mood, loss of interest in activities, fatigue, hopelessness, or irritability

Subjective Tinnitus Symptoms 

Subjective tinnitus is the most common type of tinnitus, accounting for 99% of all cases. Common symptoms of subjective tinnitus include:

• Sounds that are inaudible to others: Only the person experiencing tinnitus can hear the perceived sounds
• Varying sound types: Sounds may include ringing, buzzing, hissing, chirping, hissing, roaring, or whooshing sounds
• Fluctuating intensity and sounds: The perceived sound can change in volume, worsen with certain triggers, feel louder in quiet situations, and vary in the sounds you hear (e.g., hearing ringing at first and buzzing later)
  

Objective Tinnitus Symptoms 

Objective tinnitus is a rare form of tinnitus that involves hearing sounds that other people can detect. Usually, a healthcare provider will be able to hear these sounds using a stethoscope during an examination. Objective tinnitus sounds originate somewhere in your body and reach your ears through various body tissues, usually due to vascular (blood vessel) disorders or muscle spasms. 

Symptoms of this type of tinnitus include: 

• Rhythmic sounds: Thumping or whooshing sounds that correspond with the rhythm of your heartbeat
• Clicking or crackling sounds: Muscle pain or spasms in or near the ear can cause clicks or crackles
  

Symptoms in Children 

Tinnitus is common in children, affecting up to 62% of hard-of-hearing children and 46% of children without hearing loss. Signs of tinnitus can sometimes be challenging to identify in children, especially young children who cannot verbalize their experience. Other children may consider hearing phantom noises as "normal" or can distract themselves with toys or activities to minimize the effects of tinnitus.

If your child develops tinnitus, they may experience the following symptoms: 

• Behavior changes: Increased irritability, difficulty concentrating, and restlessness 
• Sleep problems: Difficulty falling asleep, waking up at night, restless sleep, daytime fatigue, or trouble staying awake
• Hyperacusis: Low tolerance to loud noises or sensitivity to sound
• Physical symptoms: Headaches and dizziness
• Emotional symptoms: Mood changes, anxiety, or depression 

When to Contact a Healthcare Provider 

It's important to see a healthcare provider if your tinnitus symptoms last for a week or longer, interfere with your sleep or ability to perform daily tasks, or cause emotional distress. Your healthcare provider will perform a physical examination and may order a hearing test and other diagnostic tests to determine the cause of your symptoms.

Certain tinnitus symptoms are possible signs of neurological issues that require prompt medical attention. See a healthcare provider as soon as possible if you experience any of the following symptoms:

• Unilateral tinnitus (sounds only in one ear) 
• Dizziness or vertigo 
• Difficulty with walking or balance
  
• Blurred vision 
• Trouble speaking or swallowing 
• Tinnitus symptoms that develop after a traumatic event (e.g., a head or neck injury)

A Quick Review 

Tinnitus is the perception of hearing sounds without an outside or external source. While commonly described as "ringing in the ears," tinnitus may cause sounds like buzzing, whooshing, roaring, or chirping. For some people, tinnitus is mild and comes and goes, having few effects on daily living. For others, tinnitus can be disruptive and bothersome, interfering with sleep, concentration, and overall quality of life. Seeing a healthcare provider can help you get the support you need.