As we celebrate Veterans Day this month and honor the men and women who made the ultimate sacrifice for this country, let’s not forget the veterans who are still with us suffering with physical pain from an injury, psychological pain from post-traumatic stress disorder (PTSD), or the effects of noise exposure from the gunfire, artillery fire, explosions, and aircraft noise.
The effect of noise exposure is very prevalent in the service. Excessive noise not only can cause hearing loss immediately or gradually over time, but excessive noise can also cause tinnitus (ringing, hissing, or buzzing in the ear/s). Tinnitus and hearing loss are the number-one and number-two health issues, respectively, among military veterans.
According to the Hearing Health Foundations:
- In 2017, there were 1.79 million disability compensation recipients for tinnitus and 1.16 million compensation recipients for hearing loss.
- In addition, many veterans who score normally on hearing tests have trouble understanding speech. This condition, auditory processing disorder or central auditory processing disorder (CAPD), is often associated with blast exposure.
- A study in 2015 found that 72% of veterans with tinnitus also had a diagnosis of anxiety, 60% had depression, and 58% had both conditions.
Tinnitus is usually a symptom of hearing loss. The hearing loss can be caused by aging or damage to the hearing nerve from long-term noise exposure or from acute trauma. Though the mechanism that causes tinnitus is not known, it is thought that the brain is creating a sound that it is not hearing because of the hearing loss. Other issues that can affect tinnitus are stress, anxiety, and depression. As stated above, many veterans suffer from these conditions, and they are only made worse by a constant ringing in their ears.
Tinnitus is usually examined with a series of tests done by an audiologist to rule out a more serious medical condition, though it is rare. Testing would include an audiological evaluation, tinnitus evaluation, and auditory brainstem evoked testing. Sometimes an MRI is necessary. If all test results are normal and show no signs of a more serious medical condition, then treatment for the tinnitus is sought through an audiologist. Several treatment options are available:
- Concentration and relaxation techniques: Tinnitus can be caused by and made worse with stress, anxiety, and depression. Utilizing relaxation and concentration techniques can often help decrease the disturbance of the tinnitus. Yoga, meditation, and guided imagery are a few methods that have been found helpful. Tinnitus apps on a smart phone have often been shown to help. These apps are often free and are made by hearing aid manufacturers. They allow the user to choose relaxing soundscapes that can be played through personal headphones, the phone speaker, or an external speaker. Any activity that is enjoyable to the patient (reading, exercise, etc.) may help decrease stress and/or anxiety and will oftentimes decrease the disturbance of the tinnitus.
- White noise: Some people just like the sound of white noise that will cover their tinnitus. The white noise can be played though a sound generator or headphones, and oftentimes a hearing aid will have that option in its software. Some veterans will play a fan in the background just to have some other noise in the room. It doesn’t always have to be white noise; it can be a radio or a TV.
- Sound pillow: For those veterans who have difficulty sleeping due to the tinnitus, a pillow is available that has speakers imbedded in the pillow. These speakers connect to an MP3 player that has been pre-loaded with relaxation and meditation sounds. This allows the user to listen to sounds through the pillow when they are in bed trying to sleep. The sounds played through the pillow mask the tinnitus, promoting relaxation, so the user will find falling asleep easier and faster while not disturbing others in the room with a sound generator.
- Hearing aids/tinnitus therapy: Oftentimes, if a hearing loss is involved with the tinnitus, just correcting the hearing loss and amplifying the frequencies where there is loss will cover the tinnitus. It is thought that the hearing aids are giving the veteran back the sounds he/she is not hearing and the internal sound that the brain is creating is then decreased. Most hearing aid manufacturers have built-in tinnitus therapies in their hearing aids, which can be activated by the push of a button on the hearing aid or with the use of a smartphone. These therapies have been shown to be very helpful by decreasing the disturbance of the tinnitus. With decreased disturbance, the veteran’s stress/anxiety level then decreases.
It is unfortunate that many veterans leave the service with many health problems, but tinnitus is one they don’t have to live with. There is no magic cure, but there are ways to manage it. If you are a veteran or non-veteran with hearing loss and/or tinnitus, you can seek help from your local VA medical system or from one of our audiologists. We are specifically trained to help people with hearing loss and tinnitus and will guide you on how to get relief. Call our office to schedule a consultation.
Dianna Randolph, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327). ❦