Tinnitus Habituation Guide: Evidence-based strategies for coping. Regain control and manage tinnitus with helpful tips.
Dr Edmund Farrar

Dr Edmund Farrar

Medically Reviewed by
Dr George Leidig
Co-Founder & CEO of Oto
April 24, 2023

Tinnitus Habituation: The Comprehensive Guide

If you’re struggling with tinnitus you’ll know all too well how much of an impact it can have on your daily life. That persistent ringing, buzzing, or clicking in your ears can be incredibly debilitating. But there's hope! It is absolutely possible to tune out the sound your hear by the process of something called tinnitus habituation. In this complete guide, we'll discuss what habituation is, how it works, and the most effective way to get there.

But first, let's briefly talk about tinnitus itself. As you probably know, it’s a common condition characterised by the perception of sound in the ears or head without any external source. It affects millions of people worldwide and can result from a variety of causes, including exposure to loud noise, ear infections, certain medications, or ageing.

Although there is currently no cure for tinnitus, it’s entirely possible to live without it really bothering you. Habituation is a process that will allow you to become less aware of and troubled by the unwanted sound, until you may even stop noticing it completely.

Understanding Tinnitus Habituation

To understand tinnitus habituation, you need to first understand what’s currently happening inside your brain. Right now, there’s probably still a close link between your tinnitus and your brain’s reaction to your tinnitus. This means that when you notice the sound, it makes you feel a negative emotion. This emotion could be anxiousness, sadness, fear, anger or frustration.

The tinnitus emotional response cycle
The tinnitus emotional response cycle

Because your tinnitus makes you feel bad, your brain sees it as a threat. This means that it needs to regularly check to see whether it’s there. And as a result, you notice it all the time.

Habituation works by changing your brain’s reaction to the sound of tinnitus. Over time, you can change the automatic reaction, reduce the reaction, or perhaps even eliminate the reaction. This means that two things will happen:

  1. You stop noticing your tinnitus all the time. Your brain stops seeing it as a threat, so it doesn't need to check to see whether it’s there.
  2. Your tinnitus doesn’t bother you if you do notice it.

The end result is that you can get your life back, and you can go back to being you.

Is it possible to habituate to tinnitus?

Yes! It is absolutely possible to habituate to tinnitus. Millions of people have successfully habituated and their tinnitus no longer really impacts their quality of life. While the sound may not disappear completely, the nasty feelings that it gives you can be significantly reduced.

Often you will only hear the negative stories online. This is because this is where people first go for help and advice when they are in the initial stages of tinnitus.

Does tinnitus habituation occur naturally?

Tinnitus habituation can occur naturally over time for some people. However, the process might take a lot longer or be less effective. Factors like the severity of tinnitus, individual coping mechanisms, and underlying health conditions can influence the natural habituation process. For this reason it’s really important to understand the most effective strategies to reach habituation. We’ll cover this later.

What does tinnitus habituation feel like?

As you habituate to tinnitus, you will begin to have more days when you don't notice the ringing as much. If you do hear it, you'll realize that it bothers you less. You may even notice that the noise seems quieter, and it no longer affects your ability to focus or sleep as much as it used to. It's important to remember that tinnitus habituation is a gradual process, and it may take time and patience to experience its full benefits.

How long does tinnitus habituation take?

This can vary quite a lot. Generally, habituation will take several months to a year. In some cases, it may take longer. The duration of the process depends on many external and internal factors. These factors include:

  • Whether you have tinnitus treatment
  • The severity of tinnitus
  • Your individual coping strategies

Habituation is often not a linear process and can involve setbacks. It's completely normal to experience days when tinnitus feels more noticeable, particularly if you’re going through a difficult period.

Factors Affecting Tinnitus

Tinnitus is nearly always a fluctuating experience. Some days will feel more challenging than others. Having a good understanding of the factors that influence the severity and perception of tinnitus can help you habituate faster. Here we’ll discuss why tinnitus may feel worse on some days and why it may suddenly sound louder.

Why is tinnitus worse on some days than others?

Tinnitus volume is partially determined by your perception. The severity of tinnitus can vary from day to day due to various factors, including:

  1. Stress: Increased stress levels can make tinnitus worse, making it more noticeable and uncomfortable.
  2. Lack of sleep: Poor sleep quality or insufficient sleep will make tinnitus seem more intense. Read more about how to sleep with tinnitus.
  3. Diet: There is a small amount of research to show that consumption of caffeine, alcohol, or salty food may temporarily worsen tinnitus for some people.
  4. Environment: Exposure to loud noises or quiet environments can make tinnitus more noticeable.
  5. Underlying health conditions: Fluctuations in blood pressure, sinus congestion, or the presence of other medical conditions can affect tinnitus severity.

It can be useful to be aware of these factors for your own tinnitus. This will help you identify and address the triggers that make it worse, which means you could get to habituation faster.

Why does tinnitus suddenly get louder?

Tinnitus may suddenly sound louder due to temporary changes in your environment or physical and emotional state. Some common reasons for a sudden increase in tinnitus volume include:

  1. Exposure to loud noise: Attending a music concert without proper hearing protection can cause temporary tinnitus spikes.
  2. Stress or anxiety: Emotional distress can lead to a temporary increase in tinnitus perception.
  3. Earwax buildup: Excessive earwax can cause a sudden increase in tinnitus volume. Consult an audiologist to get this checked - they will be able to safely remove the buildup.
  4. Medication side effects: Some medications can cause temporary, or in some cases permanent tinnitus. Always check with your doctor if you suspect your medication may be affecting your tinnitus.

Next, let's discuss the most effective strategies for achieving tinnitus habituation.

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You don’t just have to “live with it"
Why we hear tinnitus
How it feels to tune it out
Clinically proven methods that really work

How To Habituate To Tinnitus

There are many proven therapies that you can use to habituate. We're going to discuss the most successful approaches, which include:

  • Cognitive Behavioural Therapy (CBT)
  • Acceptance and Commitment Therapy (ACT)
  • Mindfulness techniques
  • Daily exercises and lifestyle tips

Cognitive Behavioral Therapy (CBT)

CBT has shown to be the most effective approach to habituating tinnitus. It's a form of talking therapy that works on the basis that how you think determines how you feel. You’ll identify and change negative thought patterns and behaviours related to your tinnitus. This will change your reaction to it and teach your brain that it isn’t a threat.

Numerous scientific studies have shown that CBT can significantly reduce the distress and anxiety associated with tinnitus, leading to better habituation and a much improved quality of life.

CBT for tinnitus habituation will include:

  1. Cognitive restructuring: Identifying and challenging negative thoughts about tinnitus and replacing them with more balanced perspectives.
  2. Relaxation techniques: Learning and practicing relaxation techniques, such as deep breathing exercises and progressive muscle relaxation, to reduce stress and anxiety.
  3. STOPP technique: Using the STOPP tool, which stands for Stop, Take a breath, Observe, Pull back, and Practice, to help break the cycle of negative thoughts and emotions related to tinnitus. This technique encourages individuals to pause, reflect on their thoughts and feelings, and choose a more helpful response to their tinnitus.

Read more about CBT for tinnitus in our comprehensive guide.

Acceptance and Commitment Therapy (ACT)

ACT is another form of talking therapy. It has shown to be beneficial for tinnitus habituation. It focuses on developing psychological flexibility, allowing you to accept the presence of tinnitus while committing to actions that will improve your overall well-being.

ACT techniques include:

  1. Defusion: Learning to observe thoughts and feelings related to tinnitus without being consumed by them.
  2. Values clarification: Identifying personal values and setting goals to engage in meaningful activities that align with those values, despite the presence of tinnitus.
  3. Mindfulness: Practising tinnitus mindfulness techniques to increase present-moment awareness and reduce the focus on the ringing.

Mindfulness and Meditation

Mindfulness and meditation for tinnitus can be powerful tools for managing tinnitus and reaching habituation. If you can improve present-moment awareness and non-judgmental acceptance of tinnitus, you can learn to detach from the distressing emotions and thoughts associated with the condition.

Common mindfulness practices include:

  1. Body scan meditation: Focusing on the sensations in different parts of the body, promoting relaxation and reducing the focus on tinnitus.
  2. Breathing exercises: Paying attention to the breath, helping to anchor the mind in the present moment and minimise the impact of tinnitus.
  3. Loving-kindness meditation: Cultivating feelings of compassion and kindness towards oneself and others, fostering a more positive emotional state despite tinnitus.

Tinnitus Habituation Exercises, Techniques, and Tips

In addition to the evidence-based treatments mentioned above, there are a some simple exercises and techniques can help you on your journey to habituation:

  1. Avoid silence: Use background sounds or white noise to minimise the contrast between tinnitus and silence. This can make the tinnitus sound less noticeable.
  2. Stay active: Regular exercise helps to promote relaxation and positive well-being, which will reduce the emotional impact of tinnitus.
  3. Practise good sleep hygiene: Establish a good nighttime routine and create a sleep-friendly environment to improve sleep quality and reduce tinnitus-related sleep disturbances.
  4. Seek support: Connect with others who have tinnitus, either through support groups or online forums, to share experiences, tips, and encouragement.

What Isn't Helpful

While there are many proven strategies for reaching tinnitus habituation, some approaches may actually hinder the habituation process. Look out for common misconceptions and unhelpful strategies to avoid wasting time and energy on things that won't produce meaningful results.

Common Misconceptions

  1. Trying to ignore tinnitus: Trying to push tinnitus out of your head may seem like a reasonable strategy, but it can actually lead to increased awareness and distress. It’s OK to acknowledge the presence of your tinnitus, even if it makes you feel uncomfortable.
  2. Relying on medication: Some medication may provide temporary relief for tinnitus symptoms, there is nothing that has been shown to help in the long term.
  3. Using alternative medicines: Some alternative remedies, such as herbal supplements or homeopathy, may claim to cure tinnitus, but there is no scientific evidence to support their effectiveness. If someone claims to have a cure for tinnitus, they are deliberately misleading you.

Other things to avoid

  1. Isolating yourself: Isolating yourself from social situations or activities you enjoy will probably make you feel worse. It can also lead to feelings of loneliness and depression, making habituation far more challenging.
  2. Avoiding sound altogether: Avoiding sound entirely or using earplugs to block out normal noise can lead to hyperacusis, a condition where everyday sounds become intolerably loud and painful.
  3. Focusing on tinnitus: Constantly checking in on and focusing on tinnitus can lead to increased anxiousness and distress. Prioritise learning techniques to shift the focus away from tinnitus and engage in other activities.

The Importance of Following the Science

The most effective tinnitus habituation strategies are those supported by research and clinical evidence. Evidence-based treatments, such as CBT, ACT, and mindfulness techniques, have been shown time and time again to significantly improve outcomes and increase the likelihood of habituation.

While it may be tempting to try new remedies or treatments that you find online, remember that if something is too good to be true it probably is.

Understanding what isn't helpful for tinnitus habituation can be just as important as knowing what does work. Now you know what to avoid, you can focus on evidence-based approaches and what the science recommends. You can begin to optimise your habituation process and start to regain control over your life.

Get Help with Habituation

If you’re looking for some personalised help in getting to habituation, combining therapy with digital tools can be incredibly effective. At Oto, our solutions are designed to help you habituate as quickly as possible, so you can get your life back.

Expert Therapy Program

Oto's 1-1 program gives you access to one of the world’s top tinnitus experts. You’ll learn the latest cognitive behavioural techniques in regular online video sessions, and integrate these into your life using our companion mobile app.

The program includes:

  1. Personalised plan: Your therapist will work with you to build a tailored plan based on your own tinnitus.
  2. Expert guidance: Learn how to habituate with one of the best. We only work with the most experienced tinnitus CBT practitioners.
  3. Unlimited support: Get access to our team of ENTs, audiologists and doctors. We’ll always be on hand to answer any question you have about habituation.

Learn more about our 1-1 Program.

Digital Only Program

Looking for a starting point to manage tinnitus yourself? The Oto app provides an audio program of tinnitus CBT, mindfulness, relaxing sounds, and sleep content.

You won’t get the expert support provided in the 1-1 Program, but it may be a great place to start if you’d prefer a self-guided approach.

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Discover how to tune out tinnitus with our free webinar

Register for our 20 minute webinar and learn why you don't just have to live with tinnitus.
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Oops! Something went wrong while submitting the form.