Tinnitus as a signal: why the brain creates phantom noises

Tinnitus—a medical term for ringing or buzzing in the ears—is rarely a primary disease. It typically serves as a neurological signal that the auditory system is overloaded or losing sensitivity. In silence, the brain lacks external acoustic stimulation and compensates by increasing the volume of internal signals, making the noise more prominent.

Mechanisms and Triggers

Tinnitus occurs when neurons in the auditory cortex become hyperactive to compensate for a deficit of incoming information in specific frequency ranges. While ambient city or office noise masks this effect during the day, the absence of sound at night forces the brain to focus on these internal phantom signals.

General practitioner Elena Morozova notes that absolute silence often catalyzes discomfort. She suggests using acoustic masking—such as a fan or recordings of rain—to shift the brain's attention toward an external sound source to aid sleep.

Causes After Age 40

In patients over 40, degenerative changes are the primary drivers. A common cause is presbycusis—the gradual death of hair cells in the inner ear. Often, a person is unaware of their hearing loss until persistent ringing appears.

Other contributing factors include:

• Vascular issues: Excessive caffeine intake can trigger spasms of the inner ear blood vessels.
• Mechanical obstructions: Earwax plugs can cause sudden noise, which typically resolves after professional cleaning.
• Musculoskeletal tension: Muscle spasms in the neck or jaw can alter the intensity of the sound during head movement. Improving posture may help by enhancing blood flow to the cervical region.

Cardiologist Valery Klimov emphasizes that a low-frequency humming sound that pulses in sync with the heartbeat may indicate hypertension or atherosclerosis, requiring an immediate blood pressure check.

Critical Warning Signs

Certain symptoms require urgent medical intervention:

• Unilateral noise: Ringing in only one ear that persists for 24 hours requires screening for auditory nerve growths.
• Sudden hearing loss: A sharp drop in hearing in one ear creates a narrow therapeutic window of 48–72 hours; failure to seek treatment within this period may result in permanent loss.
• Vascular events: Severe auditory disruptions associated with vascular catastrophes may require specialized intervention, including robotic thrombectomy to remove clots and protect brain function.

Management and Recovery

The process of the brain learning to ignore tinnitus is called habituation. This occurs when a person stops focusing on the sound with anxiety. For those with significant hearing loss, hearing aids are recommended as they restore access to natural frequencies, reducing the brain's need to generate phantom noise.

Psychologist Nadezhda Osipova points out that while supplements and ear drops lack a strong evidence base, stress and sleep deprivation are proven to amplify the perception of noise by impairing the nervous system's filtering capabilities.

General Guidelines

If noise is temporary (caused by loud events, colds, or medication side effects), it usually disappears once the cause is removed. Chronic tinnitus rarely vanishes completely, but becomes manageable through habituation.

Using headphones is safe at moderate volumes. However, attempting to drown out internal ringing with very loud music can further damage hearing and worsen tinnitus over time.

The first point of contact should be an otolaryngologist (ENT), who can perform audiometry to determine if the condition is linked to hearing loss or requires a referral to a neurologist or cardiologist.

Important: This article is for general information and does not replace medical advice. Do not start, stop, or change treatment without a qualified clinician.

Source: This article was adapted from an original Russian-language publication by Pravda.Ru.