Tinnitus, often defined as a ringing, buzzing, or humming in the ears, is a condition that affects millions of people around the world.
Dr Edmund Farrar

Dr Edmund Farrar

Medically Reviewed by
Co-Founder & CEO of Oto

What Makes Tinnitus Worse? 20 Causes You Need to Consider


Tinnitus, often defined as a ringing, buzzing, or humming in the ears, is a condition that affects millions of people around the world. It's an auditory perception where no external sound is present, and it can manifest in various ways, from constant noise to intermittent episodes. For some, tinnitus is a mild annoyance; for others, it's a debilitating condition that impacts daily life.

Understanding tinnitus is not just about recognising the sound. It's about delving into the underlying causes, triggers, and individual experiences that make this condition so complex and varied. From exposure to loud noises and certain medications to stress and underlying health conditions, the things that make tinnitus worse are numerous and multi-faceted.

This comprehensive guide aims to explore the world of tinnitus in detail, providing insights into its triggers, fluctuations, special considerations, and everyday management strategies. Whether you're someone living with tinnitus or a healthcare provider seeking to understand it better, this guide offers a compassionate and informed approach to a condition that is often misunderstood.

Understanding why your tinnitus is getting louder

Tinnitus is a complex phenomenon that requires a nuanced understanding. It's not merely a sound but a symptom that can have profound effects on daily life. This section explores the different types, common triggers, and related medical considerations.

Types of tinnitus

There are two main types: 

  • Subjective tinnitus: The most common form, only heard by the affected individual. Often linked to hearing loss, it can be caused by damage to the inner ear or auditory nerve.
  • Objective tinnitus: A rare form that can be heard by others, including healthcare providers. Often related to vascular or muscular issues, it may require medical intervention.

What causes tinnitus to get worse?

Tinnitus is often characterised by its fluctuating nature, with periods of increased intensity or ‘spikes’. These spikes refer to sudden increases in the intensity, volume, or frequency of the ringing or buzzing sound and can last from a few minutes to several days. 

Common triggers

  • Loud noises: Exposure to loud noises, whether through occupational settings like construction or recreational activities such as concerts and motorcycling, can lead to temporary or permanent tinnitus. Sudden, extremely loud noises like explosions can also cause immediate damage.
  • Stress and anxiety: Mental health issues can exacerbate existing tinnitus, creating a challenging cycle where anxiety about the condition leads to increased perception and severity. Physical reactions to stress, like increased heart rate, can also contribute to the condition.
  • Medications: Certain medications, including specific antibiotics, cancer treatments, and high-dose aspirin, have been linked to the condition. These drugs are considered ototoxic, meaning they can damage the inner ear and lead to temporary or permanent tinnitus. 
  • Diet: Excessive intake of caffeine, salt, or sugar may exacerbate symptoms by affecting blood flow and pressure in the inner ear.
  • Sleep: Lack of sleep or disrupted sleep patterns can contribute to increased stress and fatigue, which may exacerbate tinnitus symptoms. 
  • Exercise: Regular exercise contributes to general health and can positively influence tinnitus by improving blood circulation to the ear. However, strenuous or high-intensity exercise may temporarily worsen symptoms for some individuals.
  • Earwax buildup: Excessive earwax can block the ear canal, leading to irritation and an increased perception of noise. This blockage can cause sounds to be amplified within the ear, making tinnitus more noticeable.
  • Age-related hearing loss: As people age, the inner ear's hair cells, responsible for transmitting sound to the brain, can become damaged or die, leading to hearing loss. This loss of hearing function often results in tinnitus, as the brain may generate phantom noises to compensate for the missing auditory input.

Medical considerations 

  • Ear infections: Ear infections can cause temporary ringing or other symptoms due to inflammation and fluid buildup in the middle ear. Treatment of the underlying infection often resolves the tinnitus.
  • Blood pressure: Both high and low blood pressure can have a profound impact by altering the blood flow to the ear. High blood pressure may cause more noticeable symptoms, while low blood pressure might lead to faint or intermittent sounds. 
  • Health conditions: Thyroid disorders can impact the body's metabolism, leading to this condition. Similarly, anaemia may limit the oxygen supply to the ear, causing symptoms. Autoimmune diseases also have the potential to target structures within the inner ear. Finally, structural abnormalities in the inner ear can directly affect one's hearing, resulting in tinnitus.

  • Ménière's Disease: This is an inner ear disorder that can cause episodes of vertigo, hearing loss, and tinnitus. 
  • Temporomandibular Joint (TMJ) disorders: TMJ disorders affect the jaw joint and surrounding muscles, and they may cause the condition due to the close proximity of the jaw to the ear's structures. Symptoms like clicking, popping, or pain in the jaw can be accompanied by tinnitus. 
  • Tumours: Rarely, a tumour on the auditory nerve, known as an acoustic neuroma, may lead to tinnitus. This benign growth can press on the nerve, causing hearing loss and the perception of sound in one ear. 

Environmental factors

  • Seasonal allergies: Allergies can cause congestion and inflammation in the nasal passages and eustachian tube. The associated pressure changes in the ear can create or exacerbate ringing or buzzing sounds. 
  • Air pressure changes: Rapid changes in barometric pressure during weather shifts or flying can temporarily affect the ear's pressure balance, leading to flare-ups. 
  • Climate and humidity: Dry conditions may cause irritation, while high humidity can lead to infections or other ear issues. 
  • Chemical exposure: Exposure to certain chemicals, especially in industrial settings, may contribute to tinnitus. Ototoxic substances like solvents and heavy metals can damage the inner ear. 
  • Smoking: Smoking can narrow blood vessels and limit oxygen supply to the ear cells. More specifically, the nicotine and other chemicals in tobacco can affect the nervous system and exacerbate existing tinnitus or contribute to its onset.
  • Alcohol: Alcohol consumption can temporarily increase blood pressure and affect the inner ear's fluid balance. While moderate drinking may not have a significant impact, excessive alcohol intake can lead to persistent symptoms. 

How to prevent tinnitus from getting worse

Navigating the complexities of tinnitus involves a multi-faceted approach, especially when it comes to preventing the condition from worsening.

Identifying triggers

  • Personal triggers: These can vary widely among individuals and may include specific sounds, foods, medications, or stressors. Identifying personal triggers is the first step in managing spikes.
  • Tinnitus journal: Keeping a journal helps in tracking the occurrence, intensity, and potential causes of spikes. Recording daily activities, meals, and emotional states alongside tinnitus experiences can reveal patterns and guide individualised management.

Sound therapy

  • White noise machines: These devices produce soothing sounds that can mask tinnitus, especially during sleep or quiet times. They can be customised to individual preferences and are often recommended by audiologists.

  • Hearing aids: For individuals with hearing loss, hearing aids can amplify regular sounds, making the condition less noticeable. Modern hearing aids often include tinnitus-specific features.
  • Customised sound therapy: Audiologists can create personalised sound therapy based on an individual's tinnitus frequency. This targeted approach can provide significant relief during spikes.

Lifestyle adjustments

  • Dietary considerations: Identifying and avoiding foods or substances that trigger spikes, such as caffeine, salt, or alcohol, can reduce occurrences. Nutritional guidance may be beneficial.
  • Stress management: Techniques like meditation, yoga, or deep breathing can alleviate stress-related spikes. Professional counselling may also help in developing personalised relaxation strategies.
  • Sleep hygiene: Proper sleep is vital. Creating a calming bedtime routine, avoiding screens before bed, and maintaining a consistent sleep schedule can prevent fatigue-related spikes.

Medical interventions

  • Medication review: Some medications may contribute to spikes. Regular review with healthcare providers can identify problematic drugs, allowing for adjustments or alternatives.

  • Therapeutic support: Cognitive-behavioral therapy (CBT) or other therapeutic interventions can provide psychological support, teach coping strategies, and enhance emotional well-being.

Specifically, CBT offers a personalised and evidence-based approach to managing tinnitus, particularly during distressing spikes. By working closely with specialised therapists, individuals learn practical coping and emotional regulation techniques that provide lasting benefits.

  • Medical treatment: Underlying health conditions may cause spikes. Appropriate medical treatment, such as managing blood pressure or treating ear infections, is essential for overall management.

Support and community

  • Support groups: Support groups provide emotional support and practical advice from others who experience tinnitus. These connections can be empowering and comforting.
  • Professional guidance: Collaborating with audiologists, therapists, and medical professionals ensures a comprehensive and integrated approach to managing spikes, tailored to individual needs and preferences.

Discover how to tune out tinnitus with our free webinar

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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

Oto tinnitus programs: Your path to tuning out tinnitus

Living with tinnitus can be overwhelming, and finding effective solutions is often a struggle. That's where Oto comes in. The digital program offers scientifically backed methods, including CBT, mindfulness, and relaxation therapy, to help you tune out the noise and focus on what truly matters.

What is Oto?

Oto is a unique tool that provides personalised guidance with tinnitus specialists and an instant-access support platform. With a success rate where over 86% of users report feeling better within one month, Oto's programs are designed to work around your schedule and needs.

How does Oto work?

Here is an overview of what Oto offers: 

  • One-to-one tinnitus coaching: With Oto, you're not just another user; you're an individual with unique symptoms. Our expert team crafts a personalised plan specifically tailored to your needs, offering dedicated, step-by-step support to guide you through your journey towards habituating to tinnitus. The results speak for themselves: Oto has an impressive 96% success rate, meaning you can embark on your tinnitus management journey with confidence and assurance.
  • Tinnitus support app: Oto's mobile application is designed for simplicity and ease of use, making it accessible to everyone, regardless of their tech-savviness. It's the closest you can get to face-to-face therapy, right in the palm of your hand. This means you can manage your condition wherever you are, making support more accessible than ever.
  • Proven methodology: Oto isn't about quick fixes or unproven methods. We focus on therapies that have clinical backing, ensuring you're receiving techniques that are proven to be effective for the majority of cases. This commitment to evidence-based practice means you can trust Oto to offer reliable and effective strategies.

Why choose Oto?

Choosing the right approach can be challenging, given the plethora of options available. Here's why Oto stands out as a preferred choice:


  • Personalised Approach: Every person is unique, and so is their tinnitus. Oto's tailored coaching program adapts to your individual needs.
  • Expert Guidance: Award-winning audiologists and leading hearing researchers have incorporated decades of expertise into Oto's unique coaching program.
  • Real Success Stories: Users like Imran, who found Oto to be ‘the most helpful tool available’, and Claire, who credits Oto for giving her tools to reclaim her life from tinnitus, attest to the program's effectiveness.

Take control with Oto

If you're tired of the constant ringing and ready to regain control of your life, Oto's programs are the solution you've been seeking. With a blend of personalised coaching, innovative app support, and proven methodologies, Oto turns the perception of tinnitus around, helping you push it to the background. 

Download Oto on your iOS or Android device now and embark on a journey towards a life where you’re no longer bothered by tinnitus.


Tinnitus is a complex interplay of physical, emotional, and environmental factors. But with understanding, compassion, and a proactive approach, it can be managed effectively.

Embrace a lifestyle that supports well-being by understanding the importance of sleep, exercise, and dietary choices. Explore therapeutic options like CBT, which has proven to be a powerful tool in tinnitus management. Connect with support groups, engage with professional guidance, and remember that help is always available.

The path to quieter days is not just a dream; it's a journey that begins with knowledge, empathy, and the right tools. Oto's programs stand as a testament to what's achievable with personalised care, expert guidance, and clinically backed therapies. Whether you're new to tinnitus or have been navigating its challenges for years, this digital program offers a tailored approach that can turn your perception of tinnitus around. Take the first step with Oto today.

Unlock the Secret to Tinnitus Relief 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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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.
Thanks for signing up! Please check your inbox to access the course.
Oops! Something went wrong while submitting the form.