Noise in the Head: Main Causes of Ringing, Humming and Whistling

Noise in the head rarely means a separate disease. More often it is a symptom: this is how the auditory system reports a malfunction — in the ear, blood vessels or nerve pathways. Let us look at where ringing, humming and whistling come from and how they differ from tinnitus.

What noise in the head means and how it differs from tinnitus

Tinnitus is the perception of sound without an external acoustic source. It can be heard in one ear, in both, or "in the head" — the medical essence does not change.

The distinction is everyday, not diagnostic: a person attributes the sound to where it is felt. An analogy with a studio is apt here, where the microphone is off but the monitor still hums: there is a signal, but no source outside the system.

Ringing, humming, whistling and pulsatile noise: how the sensations differ

Sensations are described in different ways: ringing, buzzing, hissing, humming, whistling, clicking, the sound of falling water, chirping. The sound may be quiet or loud, high or low, constant or intermittent.

Pulsatile noise in time with the pulse is a reason for an urgent medical consultation.

The sensation is sometimes described as hissing or humming.

Causes of noise in the head

The cause is not always found. Among common associations are hearing loss, Meniere's disease, diabetes, thyroid disease, multiple sclerosis, anxiety and depression, and the use of certain medications.

A medication link is described for chemotherapy drugs, antibiotics, nonsteroidal anti-inflammatory drugs and high-dose aspirin. In some patients the noise arose after COVID.

• Age-related hearing loss and noise trauma — loud music in headphones, a tractor, a chainsaw, an explosion.
• Inflammation: otitis, sinusitis, cerumen impaction or a foreign body in the ear.
• Vascular and metabolic conditions: heart and vascular disease, atherosclerosis, hypertension, diabetes, dyslipidemia.
• Neurological and tumor causes: traumatic brain injury, acoustic neuroma, tumors of the head and neck.
• Hormonal changes in women, temporomandibular joint pathology, cervical osteochondrosis.

Up to 85% of patients with tinnitus have documented hearing loss in the 250–8000 Hz range. At the same time, most people with reduced hearing do not hear noise.

When noise is constant

Up to 35–45% of adults hear noise from time to time, 8% — constantly, and in 1% it reduces quality of life. At the age of 55–65, approximately every fifth person reports the symptom.

By duration, acute noise (up to 3 months), subacute (from 3 months to a year) and chronic (more than a year) are distinguished. By impact — compensated, which the person copes with, and decompensated, which disrupts sleep, attention and mood.

The practical scale is simple: the first degree does not interfere with work, the second is noticeable at night, the third distracts constantly, the fourth almost deprives one of working capacity.

How a doctor looks for the cause of noise

At the appointment the ears are examined: inflammation or cerumen impaction is looked for, and hearing is checked. If necessary, the patient is referred to a specialist for additional tests.

Audiometry remains a relatively objective indicator of hearing status. There is no objective measure of the severity of tinnitus itself: the doctor relies on complaints, sleep and impact on daily activities. Video nystagmography is also used in diagnosis.

When to see a doctor urgently

You should see a doctor if the noise recurs or does not go away, intensifies, interferes with sleep and concentration, or causes anxiety. Pulsatile noise in time with the pulse is a reason not to postpone the visit.

The presence of noise by itself is not a reason to call an ambulance. Call 103 or 112 if the noise appeared after a head injury or arose together with sudden hearing loss, facial muscle weakness or a sensation of rotation.

This material is for reference and does not replace a doctor's consultation: the diagnosis is made by a doctor after an examination.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer