I have been asked this question a few times over the years, as people become more aware of the need to protect their hearing. Also, partners snoring is a common theme.
My gut instinct has always been 'yes they will cause tinnitus' because auditory deprivation is proven to causes tinnitus, however I never took the time out to research it. I have noticed in clinic for many years that the frequency (pitch) regions where hearing loss occurs matches up to the reported tinnitus (T) (i.e. someone with only high frequency hearing loss usually has high frequency tinnitus). I do myself, and as I lose more of my frequencies, my T develops new tones. If hearing loss causes tinnitus in this way, then an earplug could hypothetically mimic a loss and generate the dreaded T.
This has actually been proven by a small study by the University of Manchester. 18 people wore a single earplug for 7 days, which was designed to dampen certain high frequency sounds. The key findings were:
14 out of the 18 developed tinnitus during those 7 days.
The tinnitus was high pitched, corresponding roughly to the frequencies that had been dampened by the earplug.
On the day the earplugs were removed, the tinnitus continued for 4 people. After another day, only 1 person still had T, and all had returned to normal 14 days after removal.
It is thought that cutting the volume of sound people hear reduces activity in the auditory nerve. The brain is believed to have an intrinsic balancing system, with neurons being either 'excited' or 'inhibited'. This system is 'plastic', it changes in response to new situations. A reduction in activity (sound) can cause inhibition, which is then corrected with excitation. These excited neurons are picked up as a phantom sound.
What is interesting about this study is that:
The hearing loss that was simulated was only mild/high frequency. This is similar to what the Flare Audio's 'Calmer' plugs are designed to do.
You can get tinnitus very easily indeed. You don't have to have hearing damage of your inner ear, all you need is earplugs and there's a great chance you'll develop T. No wonder then, that people develop T during a cold, when their Eustachian Tubes are blocked.
Not everyone responds the same. Some people don't get tinnitus even after 7 days. This corresponds with the few patients I have who have hearing loss but no tinnitus. There is more than one factor that dictates whether you will ever develop T, and it is present in most people.
It is suggested that putting sound back in after a short break can reduce/eliminate T. The authors note that hearing aids are not capable of supplying all the frequencies we can hear. This would also correlate with what we see - that not everyone who wears hearing aids finds them a magic cure for T, but most find they help. I would add that getting hearing aids as soon as possible is a good idea if you are bothered by your tinnitus, as we do not know the long-term effects of sound deprivation.
So, should you wear earplugs for noise protection? Yes! But do so with caution. The bottom line is that hearing damage is very likely to cause tinnitus, permanently. Better to risk temporary T while you wear earplugs, than the very high risk of having it permanently through hearing damage.
Should you wear earplugs for comfort/snoring etc? Signs are good that any T you encounter will be temporary, especially if you are only wearing them for part of the day. However, long-term data would be needed to correctly advise on risk.
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