Tinnitus often arrives alongside subtle hearing changes, increased listening effort, or fatigue. Even when hearing tests appear normal, the brain may be working harder than it should to interpret sound. This extra effort is sometimes called brain load. When the brain is under strain, tinnitus tends to feel more intrusive.
Hearing is not passive. The brain fills in gaps, predicts speech, and filters noise. When hearing becomes less efficient, even slightly, the brain compensates by working harder. Over time this can lead to tiredness, irritability, reduced concentration, and increased awareness of tinnitus.
“Many people are surprised to learn that tinnitus distress can be driven as much by listening effort as by the sound itself.”
When the brain is overloaded, it becomes less flexible. Attention narrows. Tinnitus often becomes the focus simply because the system has less capacity to ignore it. This is why tinnitus can worsen during stressful periods or after long days of listening, even if the sound itself has not changed.
Early assessment and support can reduce brain load before tinnitus becomes deeply entrenched. This does not always mean hearing aids. It may involve education, sound enrichment, listening strategies, or structured auditory routines. Addressing the system as a whole is often more effective than focusing on tinnitus alone.
Sound used correctly can support the auditory system rather than challenge it. Gentle, well-chosen sound can reduce contrast, ease listening effort, and give the brain space to recalibrate. The goal is not to mask tinnitus, but to support the brain so that tinnitus becomes less important.
“Tinnitus rarely exists in isolation. When hearing, attention, and mental load are supported early, tinnitus often becomes easier to live with. The brain is remarkably adaptable when given the right conditions.”
Understanding why tinnitus feels so intrusive Many people describe tinnitus as a sound in the ears, ringing, buzzing, hissing, or humming. But in practice, tinnitus is rarely just a sound. It is an experience shaped by attention, stress, emotion,
In October I attended the Tinnitus and Cognitive Decline Summit in Chicago, an international, clinically focused meeting examining the increasingly recognised links between tinnitus, hearing loss, cognitive load, and long-term brain health. The summit brought together leading clinician-scientists, epidemiologists,
