Tinnitus perception is quite often rather analogous to the perception of the brightness of a candle. Candle during the daytime you can notice but doesn’t draw attention, same candle at night, or when you draw the blinds, turn out the lights, seems like the brightest thing in the room even though the actual candle brightness did not change.
often we I see patients with anything that might be causing a temporary reduction in their hearing, such as some fluid or pressure in the ear, allergies,cold/sinus eye al., the external environment gets quieter and the tinnitus seems louder. Usually when the conditions resolve the tinnitus goes back to the usual level of awareness.
also keep in mind tinnitus perception can be sort of a vicious self fulfilling cycle. I tell patients it’s like asking how their shoes feel. When you actively thinking about the fit you can’t wait to take them off, let your feet get some air etc, but up until talking about it, you probably didn’t give them any thought. Likewise after a while you forgot about your shoes again for the rest of the day. Problem arises when one starts thinking about tinnitus before bed etc, “how loud will it be tonight...” and similar thinking. That usually leads to turning off the tv, lights etc and focusing on the tinnitus which of course you will find, and it will be quite noticeable.
As a result, often the ‘best’ management for tinnitus is to not make it more of an issue than it needs to be, essentially just trying to ignore it. Easier said than done for some people, and those are ones I see for more intervention, but in most cases I try not to make something turn into a bigger issue than it was previously by focusing on it.
