This is a question I was asked on Quora. If you have questions you would like to have an answer to, please submit in the comments section below or email me at sally@hearingandtinnitus.co.uk
Spikes are more likely to be a result of you encountering one of your personal triggers - or stress/anxiety. Triggers such as stress, silence or loud noise can make tinnitus spike (become more intense) for seconds, minutes or hours.
What increased hearing loss does is it makes tinnitus ‘available’ to you more frequently. With a typical presentation, a person starts to develop mild hearing loss, and they infrequently experience tinnitus for seconds/minutes. The intensity of the tinnitus signal will vary, so it might be more intense if they are under pressure. But they are only able to notice it for a short period each week.
As their hearing loss progresses through moderate and severe loss, this typical person becomes capable of perceiving their tinnitus at any time day or night. The tinnitus becomes “constantly available”, and if they thought about it at any time, they would be able to hear it. However, the intensity of the signal still varies, sometimes it will seem particularly loud and this tends to be related to the noise level in the environment or how stressed they are (their triggers).
This is the typical hearing loss/tinnitus combination.
A person who is well habituated to their tinnitus can have constantly available tinnitus but still spend very little time being actively aware of it.
Spikes, where the tinnitus becomes intense and difficult to ignore, will happen to people at any point in their hearing loss journey.
Someone who is distressed by their tinnitus will experience spikes more frequently and for longer than someone who is habituated.
Someone who is habituated but is frequently meeting their triggers (be it loud noise, silence, stress and anxiety or any other trigger) will be experiencing spikes.
So… if you are someone that could summon your tinnitus forward at any time, but is now having these intense spikes much more frequently, my advice would be to look at what’s changed for you. Have you gone through a bereavement or stressful period at work? Have you started having noisy building work done on the house?
If you only had tinnitus very infrequently before, but are now noticing that it’s there more often (regardless of intensity), I would get a hearing test / ear exam to look at any changes. If you wear hearing aids and are getting more frequent tinnitus, it may be time for a re-tune to give you better access to environmental sounds. Since the brain often generates tinnitus in response to unnaturally quiet environments, having hearing aids set correctly is important.