For countless individuals, tinnitus transcends the occasional ear-ringing experience.
It’s the persistent whistle that pierces the night’s silence, the phantom buzz akin to electrical static, and the deep, mechanical hum that shadows sufferers from dawn until they finally succumb to sleep.
In the United States, it’s estimated that over 27 million adults endure this condition, while in the United Kingdom, the figure stands at eight million. High-profile figures like Chris Martin, Barbra Streisand, and Steve Martin have openly shared their experiences with tinnitus.
For many, it becomes so overwhelming that it disrupts sleep, hampers concentration, adversely affects mental health, and strains relationships. Despite this, patients are frequently told there’s little to be done apart from adapting to it.
However, a prominent tinnitus expert challenges this resigned perspective as outdated.
Dr. Hamid Djalilian, a distinguished ear and tinnitus specialist at the University of California, suggests that the issue may not originate in the ears at all but rather in the brain.
‘What works best is a combination of medical therapy, medications and then lifestyle changes and dietary changes,’ he told the Daily Mail.
Djalilian said tinnitus is driven by a process called ‘central sensitization,’ in which the brain becomes hyper-alert to the ringing and treats it as something urgent and threatening.
More than 27 million adults in the US are thought to live with tinnitus, an intrusive condition that can affect sleep, concentration, mental health and relationships
Normally, the brain’s ‘salience center’ filters out unimportant background noise so we can focus on what matters.
But in people with tinnitus, that filtering system can begin to malfunction. Instead of tuning the sound out, the brain locks onto it – amplifying the perception of the ringing and making it harder to ignore.
Djalilian says tinnitus broadly falls into two categories: stable and unstable.
Stable tinnitus is by far the more common form. The sound – whether ringing buzzing, or whistling – remains relatively consistent from day to day.
While it can still be distracting or frustrating, the brain gradually learns to push it into the background over time.
‘That’s what most people with tinnitus have,’ Djalilian said.
Unstable tinnitus, however, is significantly more disruptive.
Here, the volume, pitch or quality of the sound fluctuates unpredictably. One day it may register as a faint whistle, and the next, it can erupt into a piercing screech severe enough to disrupt sleep, concentration or conversation.
Part of what makes this form so distressing is its unpredictability.
‘Patients say, “When I am around loud noise, then the ringing gets much louder,” or “If I do something with my jaw or my neck, or touch my face in a certain way, it will set off the ringing to be louder or change the ringing,”‘ Djalilian said.
Dr Hamid Djalilian, an ear and tinnitus specialist at the University of California, says there are ways to treat tinnitus
‘These are people who say, “Sometimes it’s so loud I can’t even function, or I can’t even have a conversation with somebody.”‘
The good news, he said, is that there are several evidence-based ways to reduce the intensity of tinnitus symptoms.
For people with stable tinnitus, one of the most effective approaches is known as ‘sound enrichment’ – introducing gentle background noise so the brain is not left to focus on silence.
‘So you could, during the day, use music or you could use an app on the phone to create the sound of the rain or the ocean, or something like that,’ he explained.
‘At night, you could use a fan in the room, you could use some kind of background sound again on a phone – there are these things called sleep headphones.’
Because tinnitus frequently occurs alongside hearing loss, hearing aids can also make a substantial difference for some patients by restoring missing sound input and reducing the brain’s tendency to fixate on internal noise.
‘Hearing aids typically only help tinnitus when there is actual hearing loss present,’ Djalilian said. ‘They work by improving sound input so the ear does not sit in silence.’
Coldplay’s Chris Martin on stage, where years of performing left him with tinnitus
For more severe, unstable tinnitus, migraine medication may sometimes help.
According to Djalilian, fluctuating tinnitus appears to be driven by the same neurological process involved in migraine headaches: central sensitization.
In migraine sufferers, this hypersensitive brain state may trigger throbbing head pain. In others, it manifests as intrusive ringing in the ears that worsens with stress, poor sleep, certain foods or muscle tension in the jaw and neck.
Because the underlying neurological mechanism is so similar, medications used to prevent migraines can also help calm unstable tinnitus.
The drugs work by dampening the overactive nerve pathways that keep the brain in a state of high alert and hypersensitive.
In effect, they help restore normal function to the brain’s ‘salience network’ – the system responsible for deciding which sounds deserve attention and which can safely fade into the background.
The ringing itself may not disappear entirely. But the brain stops treating it like an emergency.
Over time, patients can begin to tune it out.
Barbra Streisand performing in 2012. She has spoken openly about her tinnitus, revealing that the persistent ringing in her ears – which she attributes to years of loud orchestral playing and performing – once became so unbearable that she feared it would end her music career
Djalilian stressed, however, that medication alone is rarely enough.
Clinical studies suggest the drugs have relatively low success rates when used in isolation. Instead, the best results come when they are combined with lifestyle changes such as improving sleep, reducing stress and modifying diet.
Together, he said, those approaches can bring meaningful relief to as many as 85 to 90 percent of sufferers.
The aim is not necessarily to eliminate tinnitus completely, but to shift patients from unstable tinnitus – where the sound dominates daily life – into a more stable form that the brain can gradually learn to ignore.
Cognitive behavioral therapy (CBT) can also play an important role.
‘CBT has some of the strongest evidence, but not because it “cures” tinnitus,’ Djalilian said.
‘Instead, CBT reduces the brain’s threat response to the sound. That matters because the distress response to the tinnitus sound is often what makes it so bothersome and intrusive.’
However, while therapies such as CBT, sound enrichment and migraine treatment are backed by clinical evidence, Djalilian warned sufferers to be wary of the booming market of supplements and miracle ‘cures’ aimed at desperate patients.
Steve Martin on the red carpet at the 2025 CMA Awards. He got tinnitus from a blank pistol firing too close to his ear on the set of Three Amigos, and has said he had to either learn to live with it or go ‘insane’
Popular products include pills containing ginkgo biloba, magnesium and zinc, homeopathic ear drops claiming to ‘silence ringing naturally,’ and expensive ‘neuro-mag’ formulas promoted with dramatic online testimonials.
‘The supplement space is home to the biggest tinnitus scams out there,’ Djalilian told the Daily Mail.
‘I get why people turn to them. People are suffering from a condition that is invisible, frightening and often poorly managed by a system that tells them nothing can be done.
‘But the major guidelines, ENT organizations and clinical research all agree, there is insufficient evidence to support supplements as a stand-alone treatment for tinnitus.’
He is similarly skeptical of laser therapies and stem cell injections marketed as quick fixes.
Some low-level laser devices sold online for hundreds of dollars claim to ‘reboot’ damaged inner-ear cells and stop ringing instantly. Meanwhile, overseas stem cell clinics charge tens of thousands of dollars for experimental procedures that lack FDA approval and long-term evidence.
‘The biology is simply much more complicated than that,’ Djalilian said. ‘Complex tinnitus requires a coordinated medical approach. There is no quick fix for it.’
But, when combined appropriately, he said, these therapies can vastly improve people’s daily lives and finally quiet the invasive sounds that haunt them.
