|
Chapter Seven talks about your hearing system, tinnitus and hearing loss. Indeed, most individuals with tinnitus have some degree of hearing loss in at least one ear. Prevalence of hearing loss in the tinnitus population varies across studies, however, it is typical to find reports that between 75-90% of patients with tinnitus display reduced hearing. In truth, it is safe to say that everyone who experiences persistent tinnitus, regardless of whether hearing loss is clinically confirmed, has experienced a change to the way their hearing system functions. Hearing loss that co-occurs with tinnitus may be mild, moderate, or severe, unilateral (one ear), long-standing or sudden. Reduced hearing with or without tinnitus obviously affects the ease of communication, so it's important that patients understand the effects of hearing loss, especially if they attribute communication problems to their tinnitus.
Even slight hearing loss can impose difficulty understanding certain sounds required for speech understanding, especially in noisy backgrounds. Hearing aids are almost always helpful, but do not restore hearing to normal tinnitus, and as noted above regarding tinnitus, other family members and friends do not always appreciate the devastating nature of hearing loss. People with hearing loss may withdraw from communication situations, isolate themselves from social environments, and as a result notice their tinnitus more often. Patients with tinnitus sometimes complain of having to listen to speech "through" their tinnitus, and hearing aids can help reduce tinnitus annoyance by amplifying environmental sounds to facilitate masking, or promoting communication and activities thereby distracting the patient from tinnitus.
Tinnitus can limit enjoyment from nature sounds, TV, radio, movies, or other forms of entertainment regardless of the patient's hearing sensitivity, and such difficulties appear more pronounced when the patient believes that tinnitus is the cause of their hearing problems. Patients may report that speech is not clear or that background noise and tinnitus interfere with the ability to recognize the speech sounds that are vital for understanding. Patients may express dismay as they blame tinnitus for their difficulty localizing sounds, as well as confusion between, bells, birds or telephones ringing and their tinnitus. It is important to distinguish the effects of the hearing loss from the effects of the tinnitus. Although tinnitus can contribute to communication problems, patients need to be reminded that people with hearing loss and no tinnitus experience the same difficulties.
Chapter Eight discusses sleep hygiene and strategies to improve the quality and quantity of sleep, as sleep disruptions are among the most common difficulties associated with tinnitus. The vast majority of patients, regardless of age, gender, and tinnitus characteristics indicate that tinnitus affects the ability to get to sleep, to stay asleep, or to get back to sleep when sleep is disturbed. Andersson et al., (2005) reviewed several studies confirming sleep disorder among tinnitus patients ranged from 71% to 100%. Lack of sleep affects many aspects of a person's life as it induces fatigue and influences psychological state. Several devices are available that can provide appropriate sounds to facilitate sleep (see also Chapter 10); however the patient's family may need to appreciate the value of such a device before it is accepted easily. While the patient's supporters may have a hard time understanding tinnitus, they should recognize the effects of sleep loss due to anxiety and the presence of an unwanted distracting sound.
Chapter Nine shows how tinnitus interferes with concentration, and the effects of tinnitus on concentration. Because of concentration problems, patients may indicate that tinnitus affects a wide range of activities—from work assignments, to deciding where to go to dinner, to solving puzzles. It is easy for anyone to understand how a loud ringing sound in the background could interfere with a person's ability to follow a conversation or concentrate on a required task. Even when tinnitus doesn't overtly affect hearing, its persistence can influence the ability to keep track of a conversation's topic or nuance. In those cases when tinnitus and hearing loss are present concurrently, tinnitus distracts attention from important non-auditory cues that support communication.
|
|