Is My Tinnitus Really Getting Worse?

When patients tell us, “My tinnitus is getting louder,” they usually mean one of three things:

• The sound itself has changed (louder, harsher, new pitch)
• The sound feels louder because they’re paying more attention to it
• Other changes—like stress, sleep loss, or illness—are amplifying how noticeable it is

Often, a spike is temporary and linked to something specific (noise exposure, illness, stress).
But a sudden or dramatic change—especially in one ear—should be evaluated. For a deeper dive on long-term
outlook, see Is My Tinnitus Permanent? and
Can Tinnitus Go Away on Its Own?.

Common Reasons Tinnitus Gets Louder

Here are some of the most common reasons our Bay Area patients report a spike in tinnitus loudness.

Tinnitus spikes can also be linked to Meniere’s disease,
TMJ disorders, hormonal shifts, blood pressure changes, and more—another reason a
professional evaluation is helpful. See Tinnitus Causes & Triggers.

Why Tinnitus Changes Throughout the Day

Many people notice patterns like “my tinnitus is louder at night” or “it spikes in the afternoon at work.”
Common reasons include:

• Quiet environments – At night, when the house is quiet, tinnitus has less competition and feels louder.
• End-of-day fatigue – After a long day of mental effort, your brain has fewer resources to filter tinnitus.
• Caffeine or alcohol timing – Sensitivity may increase after coffee, energy drinks, or alcohol.
  See
  Does Caffeine Affect Tinnitus?
  and
  Could Drinking Alcohol Affect Your Hearing?.
• Workday stress – Tight deadlines, long meetings, and constant notifications can ramp up nervous system arousal.
• Clenching or TMJ – Grinding teeth or clenching the jaw during the day can change tinnitus loudness; see
  TMJ and Tinnitus Connection.

Understanding your personal pattern is helpful—keep a few days of notes or use a simple journal before your
tinnitus appointment.

True Worsening vs. Perceived Loudness

As audiologists, we look at two related but different questions:

• Is your auditory system changing?
  For example, is there new or worsening hearing loss? Has
  there been a recent ear injury or illness?
• Is your brain reacting differently?
  Are stress, anxiety, or sleep problems making tinnitus feel louder or more threatening, even if the actual
  sound level hasn’t changed as much?

Tools like our Tinnitus Severity Assessment and a full hearing test help us
distinguish between the two. We also use counseling and CBT-informed strategies from
Cognitive Behavioral Therapy (CBT) for Tinnitus to change
how your brain responds to spikes.

When a Tinnitus Spike Is a Red Flag

These can signal medical conditions that need prompt attention. For more context, review:
When to See a Doctor About Tinnitus,
Sudden Tinnitus: Should I Go to the ER?, and
What Is Pulsatile Tinnitus?.

What You Can Do Right Now When Tinnitus Gets Louder

During a spike, it’s easy to panic and focus on the sound. A few practical steps can reduce distress and help
your ears recover.

How to Prevent Future Spikes

While not every spike is preventable, a few habits can make them less frequent and less intense:

• Protect your hearing with earplugs at concerts or loud events and volume limits on personal
  headphones. See
  
  Simple Steps to Protect and Preserve Your Hearing
  .
• Keep a simple “tinnitus log” noting sleep, stress, noise exposure, and spikes.
• Support sleep using strategies from
  Managing Tinnitus at Night.
• Moderate caffeine and alcohol if you notice they’re linked to louder days:
  
  Does Caffeine Affect Tinnitus?
  and
  Could Drinking Alcohol Affect Your Hearing?.
• Stay ahead of jaw and neck tension if TMJ or clenching affects your tinnitus:
  TMJ and Tinnitus Connection.
• Address hearing loss with appropriate
  hearing aids for tinnitus if recommended, and read
  
  Can Hearing Aids Help with Tinnitus?
  .

How Treatment Helps When Tinnitus Is “Getting Louder”

Tinnitus treatment doesn’t just aim to shrink the sound; it also aims to shrink the fear and attention
around that sound. Effective plans often include:

• Medical and audiologic workup to identify underlying causes and rule out red flags –
  What Is Tinnitus? and
  Tinnitus Causes & Triggers.
• Technology-based tools such as
  hearing aids with tinnitus features and
  sound therapy.
• TRT-style counseling and sound enrichment via
  Tinnitus Retraining Therapy (TRT).
• CBT-informed strategies to change thoughts like “it’s getting louder, I can’t cope,” using
  concepts from CBT for Tinnitus.
• Self-care routines combining
  Tinnitus Relief Exercises,
  relaxation, and healthy hearing habits.

For a full menu of options, visit
Comprehensive Tinnitus Treatment Options.

Next Steps with California Hearing Center

If you live in the Bay Area and feel like your tinnitus is getting louder, we’re here to help you figure out
why—and what you can do about it. During a tinnitus evaluation at our San Mateo or San Carlos office, we will:

• Review your tinnitus history, triggers, and spike patterns
• Perform a comprehensive hearing evaluation and ear exam
• Explain whether changes suggest true worsening or heightened sensitivity
• Outline a personalized treatment and coping plan

Before you come in, you might want to explore:

• Tinnitus Severity Assessment
• Tinnitus and Hearing Loss
• Is My Tinnitus Permanent?
• Coping with Tinnitus Anxiety
• Managing Tinnitus at Night