Headphones & Tinnitus: Risks, Prevention, and Safe Use

Woman wearing headphone

Tinnitus, or ringing in the ears, affects millions of people worldwide. While the exact cause of tinnitus is unknown, loud noise is a known risk factor. Headphones, earphones and earbuds are a popular way to listen to music or other audio content, but they can also be a source of loud noise, contributing to tinnitus.

If you frequently use headphones, earphones, or earbuds, you should know the potential risks and take precautions to protect your hearing. Here’s what you should know about how headphones, earbuds or earphones can cause tinnitus.

What is Tinnitus?

Tinnitus is the perception of sound without an external sound source. It can sound like a persistent ringing, buzzing, hissing, or other noises. According to Mayo Clinic, tinnitus is a common condition affecting 15-20% of the global population. In Malaysia, results from a tinnitus management survey published by the Public Service Department (Jabatan Perkhidmatan Awam) revealed that the prevalence of tinnitus among adults ranged from 10.6% to 19.9%. The survey also found that older adults (over 55 years of age) experienced the highest prevalence of tinnitus. Additionally, the prevalence was higher in men compared to women.

Tinnitus is frequently associated with hearing loss but can also occur in people with normal hearing. Several factors, including loud noise exposure, age-related hearing loss, ear infections, and certain medications, can cause it.

Do Headphones or Earbuds Cause Tinnitus?

Headphones, earphones and earbuds can all cause or exacerbate tinnitus in several ways. To begin with, if the volume is too loud, headphones or earbuds can produce sound levels loud enough to damage your hearing. This can happen even if you only use the device for short periods.

Second, in-ear or noise-cancelling headphones or earbuds can block out external sounds. This can be useful in noisy environments, but it can also make it easier to listen at high volumes, as you may need to learn how loud the sound is.

Finally, wearing headphones or earbuds for long periods can contribute to causing tinnitus. This is because prolonged exposure to sound can cause auditory system fatigue, resulting in the perception of ringing or other sounds.

Do Noise-Cancelling Headphones Make Tinnitus Worse?

Active Noise Cancellation (ANC) technology is designed to reduce unwanted background noise by generating sound waves that counteract ambient sounds. This creates a quieter listening environment, which can be beneficial for focusing on audio content or having conversations in noisy settings. 

Can noise-cancelling headphones cause tinnitus? While ANC headphones do not directly cause tinnitus, they can potentially exacerbate existing tinnitus or contribute to its development if used improperly. The primary concern lies in the potential for users to increase the volume to unsafe levels, especially in noisy environments, to overpower the residual noise that ANC cannot fully eliminate. This prolonged exposure to loud noise can damage the delicate structures of the inner ear, causing tinnitus or worsening pre-existing tinnitus symptoms.

For tinnitus sufferers, ANC headphones offer a potential upside by reducing external noise that might otherwise exacerbate their tinnitus. This can create a sense of calm and reduce the perceived intensity of tinnitus. Additionally, ANC headphones can facilitate better engagement with audio content, such as music or podcasts, which can be therapeutic and provide a welcome distraction from tinnitus.

If you suffer from tinnitus, you might be asking: “Do headphones make tinnitus worse?” or “ Can I use earphones if I have tinnitus?” For tinnitus sufferers, ANC headphones offer a potential upside by reducing external noise that might otherwise exacerbate their tinnitus. This can create a sense of calm and reduce the perceived intensity of tinnitus. Additionally, ANC headphones can facilitate better engagement with audio content, such as music or podcasts, which can be therapeutic and provide a welcome distraction from tinnitus. However, prolonged use at high volumes can be detrimental, and it's crucial to be mindful of listening habits and adhere to safe listening practices.

In general, experts agree that while ANC headphones can be beneficial for individuals with tinnitus, you should still exercise caution and prioritise listening at moderate volumes and take frequent breaks to avoid prolonged exposure. 

How to Protect Your Hearing When Using Headphones

If you use headphones frequently, there are several steps you can take to protect your hearing and reduce the risk of tinnitus:

  1. Use noise-cancelling headphones. Noise-cancelling headphones can help block out external sounds, reducing the need to listen at high volumes.
  2. Take regular breaks. Taking breaks from using headphones can help reduce fatigue in the auditory system.
  3. Use the 60/60 rule. To avoid listening at dangerous levels, set the volume to no more than 60% of the maximum, and listen for no more than 60 minutes at a time.
  4. Invest in quality headphones. Cheap headphones can produce poor sound quality, leading to the need to listen at higher volumes.
  5. See an audiologist. If you are experiencing tinnitus or have concerns about your hearing, see an audiologist for a hearing evaluation and to discuss strategies for tinnitus relief.

Can Tinnitus Patients Use Headphones or Earphones?

Tinnitus patients should exercise caution when using headphones or earphones. It's best to avoid them in extremely loud environments, even with noise-cancellation, as excessive sound levels can worsen tinnitus. If experiencing a tinnitus spike or increased sensitivity to sound, temporarily refrain from using headphones or earphones to allow your auditory system to recover. 

For tinnitus patients who wish to use headphones or earphones, look for headphones or earphones with over-ear design for a more comfortable fit and to avoid putting direct pressure on the ear canal. For earbuds, avoid in-ear models that sit directly in the ear canal, which can increase pressure and potentially worsen tinnitus symptoms for some individuals. Additionally, in-ear earbuds tend to deliver sound more directly to the eardrum, which may increase the risk of further auditory damage if used at high volumes.

If you're looking to enjoy audio content without the risk of aggravating your tinnitus, there are alternative options to consider. Using external speakers at a moderate volume can be a safer way to listen to music or podcasts. Sound therapy, using natural sounds or white noise, can also be beneficial for managing tinnitus symptoms and promoting relaxation. Experiment with different approaches to find what works best for you and allows you to enjoy audio content without compromising your hearing health.

Final Thoughts on Headphones, Tinnitus and When to Seek Help

Tinnitus is a common condition caused by loud noise, which can include using headphones or earphones at loud volumes for prolonged periods of time. To better manage their tinnitus and use headphones safely, individuals can invest in over-ear noise-cancelling headphones and adhere to the 60/60 rule, which recommends listening at no more than 60% of maximum volume for no longer than 60 minutes at a time.

If you experience any signs of worsening tinnitus, such as increased intensity, persistent ringing, or accompanying hearing loss, it's crucial to consult an audiologist. They can conduct a thorough hearing test and recommend personalised tinnitus relief and management strategies, which may include hearing aids, sound therapy, or in some cases, cochlear implants.

Listening Lab is a hearing specialist in Malaysia that offers treatment options for patients of any age group with hearing issues. Schedule a consultation with us to discuss your hearing health and explore personalised solutions for tinnitus management.