Tinnitus & Vertigo FAQ

Tinnitus is the perception of sound — typically ringing, buzzing, hissing, or humming — without an external source. It affects approximately 15–20% of the global population (roughly 750 million people). Tinnitus is not a disease itself but a symptom of an underlying condition, most commonly noise-induced hearing loss, age-related hearing loss (presbycusis), or ear injury.

There is currently no universal cure for tinnitus. However, multiple evidence-based management strategies can significantly reduce its perceived loudness and impact on daily life. These include sound therapy, cognitive behavioral therapy (CBT), notch therapy, and habituation training. A 2019 Cochrane review found that CBT significantly reduces tinnitus distress in the majority of patients. Many people achieve a state where tinnitus no longer affects their daily functioning.

The most common causes include: noise-induced hearing loss (responsible for ~22% of cases), age-related hearing loss, ear infections, earwax blockage, Ménière's disease, TMJ disorders, head/neck injuries, and certain medications (ototoxic drugs such as high-dose aspirin, some antibiotics, and loop diuretics). Stress and anxiety can amplify tinnitus perception even without physical changes to the ear.

Not always. Acute tinnitus (lasting less than 3 months) resolves on its own in many cases, especially if caused by temporary exposure to loud noise or an ear infection. Chronic tinnitus (lasting more than 6 months) is less likely to disappear completely, but habituation — where the brain learns to filter out the signal — makes it manageable. Studies show that 80% of chronic tinnitus patients achieve significant habituation within 12–18 months of consistent management.

Tinnitus is remarkably common. An estimated 10–15% of adults worldwide experience some form of tinnitus. In the United States alone, approximately 50 million people report tinnitus, with 20 million experiencing chronic symptoms and 2 million finding it debilitating. It is the #1 service-connected disability among U.S. military veterans, with over 2.5 million veterans receiving VA compensation for tinnitus.

Tinnitus prevalence does increase with age, primarily because age-related hearing loss (presbycusis) is a major contributing factor. However, tinnitus severity doesn't inevitably worsen. With proper management — including sound therapy, hearing protection, and stress management — many older adults report stable or improving tinnitus over time. The brain's ability to habituate persists throughout life.

Tinnitus varies widely between individuals. The most common descriptions are: ringing (most frequent), buzzing, hissing, humming, roaring, clicking, and pulsing. The pitch can range from a low rumble (~200 Hz) to a very high screech (~12,000 Hz), with most tinnitus falling in the 2,000–6,000 Hz range. Some people hear it in one ear, both ears, or perceive it as originating from inside their head.

Pulsatile tinnitus is a rhythmic sound that typically beats in sync with your heartbeat. Unlike regular tinnitus, pulsatile tinnitus often has an identifiable physical cause — usually related to blood flow changes near the ear. Causes include high blood pressure, atherosclerosis, arteriovenous malformations, or intracranial hypertension. Pulsatile tinnitus should always be evaluated by a doctor, as it may indicate a treatable vascular condition.

Stress doesn't directly cause tinnitus, but it significantly amplifies its perception. The limbic system (responsible for emotional processing) and the auditory cortex are closely connected. When stress activates the amygdala, it heightens awareness of tinnitus signals that the brain would normally filter out. Studies show that 53% of tinnitus patients report stress as their primary trigger for worsening symptoms.

Yes, you should see a doctor if: your tinnitus started suddenly without obvious cause, it's in only one ear, it's pulsatile (rhythmic), it's accompanied by hearing loss or dizziness, or it significantly impacts your sleep or concentration. An ENT specialist or audiologist can rule out treatable causes and recommend a management plan. Lushh's PDF report feature lets you share your tinnitus history and tracking data with your doctor.

Sound therapy uses external sounds to alter your perception of or reaction to tinnitus. It works through four mechanisms: masking (covering the tinnitus with another sound), distraction (redirecting attention), habituation (training the brain to classify tinnitus as unimportant), and neuromodulation (physically changing neural activity). Clinical research consistently shows that structured sound therapy reduces tinnitus severity scores by 30–50% within 3–6 months.

Notch therapy (tailor-made notched sound therapy) removes the specific frequency matching your tinnitus pitch from broadband sound or music. This creates a "notch" that triggers lateral inhibition in the auditory cortex — surrounding neurons suppress the overactive neurons responsible for tinnitus perception. Research by Okamoto et al. (2010) published in PNAS demonstrated significant tinnitus reduction after 12 months of 1–2 hours daily listening. Lushh uses frequency matching to identify your tinnitus pitch and applies real-time notch filtering to 65+ relief sounds.

The best sound depends on your tinnitus pitch and personal preference. Research shows: white noise is effective for broad masking across all frequencies; pink noise is preferred for high-pitched tinnitus as it has more low-frequency energy; brown noise is best for sleep and relaxation; nature sounds (rain, ocean) promote habituation because they're pleasant and sustainable for long listening sessions. The key is consistency — 1–2 hours daily of any appropriate sound produces measurable improvement.

Binaural beats show promising but mixed results for tinnitus. A 2022 systematic review found that delta (1–4 Hz) and alpha (8–13 Hz) frequency binaural beats may reduce tinnitus perception and associated anxiety in some patients. The effect is likely mediated through brainwave entrainment, which promotes relaxation and reduces the emotional salience of tinnitus. Lushh includes binaural beat presets specifically tuned for tinnitus relief and sleep.

Clinical guidelines recommend 1–2 hours of structured sound therapy daily for notch therapy, and 6–8 hours for general sound enrichment (including during sleep). However, even 30 minutes daily produces measurable improvement after 4–6 weeks. The most important factor is consistency — daily sessions are far more effective than sporadic long sessions. Lushh tracks your daily therapy time and reminds you to maintain your routine.

Cognitive Behavioral Therapy (CBT) for tinnitus helps change how you think about and respond to tinnitus. It doesn't reduce the volume but significantly reduces the distress, anxiety, and depression associated with tinnitus. CBT is the only treatment rated "strongly recommended" by the American Academy of Otolaryngology. A meta-analysis of 28 studies found CBT reduces tinnitus-related distress by an average of 40%. Lushh includes 7 CBT-based techniques within the app.

Habituation is the process by which the brain reclassifies tinnitus from a threatening signal to a neutral one — similar to how you stop noticing the hum of a refrigerator. This is the goal of Tinnitus Retraining Therapy (TRT), developed by Dr. Pawel Jastreboff. The process typically takes 12–24 months of consistent sound therapy and counseling. Once habituation occurs, tinnitus may still be present but no longer causes distress or interferes with daily life.

White noise is not bad for tinnitus when used correctly. At moderate volumes (below your tinnitus level), it promotes habituation by providing a sound backdrop that reduces the contrast between silence and tinnitus. However, using any sound at excessively high volumes can worsen hearing and tinnitus. The rule is: set the volume just below your tinnitus level so you can still faintly hear the ringing. Complete masking (where you can't hear tinnitus at all) is less effective for long-term habituation.

Your tinnitus frequency can be identified by matching it with a test tone. An audiologist can perform this professionally, or you can use a frequency matching tool. Lushh offers a built-in Frequency Matcher that plays a tone you adjust with a slider (20–16,000 Hz) until it matches your tinnitus pitch. Most tinnitus falls between 2,000–8,000 Hz. Knowing your exact frequency enables targeted notch therapy, which is significantly more effective than generic sound therapy.

Yes. For people with hearing loss and tinnitus, hearing aids are one of the most effective treatments. By amplifying environmental sounds, they reduce the perceived contrast between silence and tinnitus. A 2014 survey found that 60% of tinnitus patients with hearing aids reported some relief, and 22% reported significant relief. Modern hearing aids often include built-in sound generators for additional tinnitus masking.

Vertigo is the sensation that you or your surroundings are spinning or moving when neither actually is. It's caused by problems in the inner ear or brain that affect balance processing. Vertigo is distinct from dizziness or lightheadedness — it specifically involves a rotational sensation. The most common cause is benign paroxysmal positional vertigo (BPPV), which accounts for approximately 50% of all vertigo cases.

Benign Paroxysmal Positional Vertigo (BPPV) occurs when tiny calcium carbonate crystals (otoconia) become dislodged from the utricle and enter one of the semicircular canals. This causes false motion signals when you change head position. BPPV is treated with canalith repositioning maneuvers — the Epley maneuver being the most common. Studies show 80–90% resolution rate within 1–3 treatments. Lushh provides IMU-guided Epley and Cawthorne-Cooksey exercises with real-time motion tracking.

The Epley maneuver is a series of 4 specific head and body movements designed to guide displaced otoconia out of the semicircular canal and back into the utricle. Each position is held for 30–60 seconds. The maneuver was developed by Dr. John Epley in 1980 and has become the gold-standard treatment for posterior canal BPPV. It has an 80–90% success rate and can be performed at home once properly trained. Lushh uses your phone's IMU sensors to track head positioning and guide you through each step.

Cawthorne-Cooksey exercises are a series of progressive vestibular rehabilitation movements designed to improve balance and reduce dizziness. They include eye movements, head movements, sitting and standing exercises, and walking tasks. Originally developed in the 1940s, they remain widely prescribed because they promote vestibular compensation — the brain's ability to adapt to inner ear dysfunction. Lushh guides you through these exercises with visual instructions and progress tracking.

Yes. Tinnitus and vertigo frequently co-occur because both involve the inner ear. Ménière's disease is the classic condition causing both symptoms simultaneously, along with hearing loss and a feeling of fullness in the ear. Studies show that approximately 30–40% of tinnitus patients also experience some form of balance disorder. Lushh is the only iOS app designed to manage both tinnitus and vertigo in a single platform, with integrated tracking for both conditions.

Tinnitus appears louder at night because of reduced ambient noise. During the day, environmental sounds partially mask tinnitus. In a quiet bedroom, there's no competing sound, so the brain's gain increases to compensate for the silence — making tinnitus more prominent. Additionally, the transition to sleep involves heightened awareness of internal body signals. Sound enrichment during sleep (playing low-level nature sounds or white noise) is one of the most effective strategies for nighttime tinnitus.

Research on dietary triggers is mixed, but commonly reported triggers include: high-sodium foods (can increase blood pressure and worsen pulsatile tinnitus), caffeine (stimulates the central nervous system, though evidence is conflicting), alcohol (causes vasodilation and can temporarily increase tinnitus), and high-sugar foods (blood sugar spikes may trigger tinnitus in some individuals). The most effective approach is to track your own triggers — Lushh's daily journal with trigger correlation analysis can identify which foods affect your specific tinnitus.

The relationship between caffeine and tinnitus is complex. A large-scale study of 65,000 women (Nurses' Health Study II) actually found that higher caffeine intake was associated with lower tinnitus incidence. However, some individuals report caffeine as a personal trigger. The current medical consensus is that there's no reason to universally avoid caffeine for tinnitus. Instead, track your personal response — if caffeine consistently worsens your tinnitus, reduce intake gradually.

Yes. Regular aerobic exercise (30 minutes, 3–5 times per week) has been shown to reduce tinnitus severity through multiple mechanisms: improved blood circulation to the inner ear, reduced stress hormones (cortisol), improved sleep quality, and release of endorphins. A 2022 meta-analysis found that physical activity reduced tinnitus handicap scores by an average of 18%. However, avoid exercises that involve extreme neck strain or loud environments, as these can temporarily worsen symptoms.

Sleep and tinnitus have a bidirectional relationship. Poor sleep increases tinnitus perception by 40% on average, while tinnitus disrupts sleep for approximately 50% of sufferers. Studies show that getting less than 6 hours of sleep is associated with significantly higher tinnitus distress scores the following day. Sound enrichment during sleep, good sleep hygiene, and 4-7-8 breathing exercises are evidence-based strategies for breaking this cycle. Lushh tracks the correlation between your sleep hours and tinnitus scores.

Daily tracking serves three critical purposes: (1) Pattern identification — discovering which triggers (stress, caffeine, poor sleep, noise exposure) worsen your tinnitus, (2) Progress measurement — objectively seeing improvement over weeks and months (critical for motivation), and (3) Clinical communication — providing your doctor with actionable data instead of vague descriptions. Research shows that patients who self-monitor report 25% faster improvement than those who don't.

The THI is a validated 25-question self-assessment tool that measures the impact of tinnitus on daily life across three domains: functional (concentration, hearing), emotional (anxiety, frustration), and catastrophic (feeling out of control). Scores range from 0–100, classified as: 0–16 (slight), 18–36 (mild), 38–56 (moderate), 58–76 (severe), 78–100 (catastrophic). The THI is the gold standard used by audiologists and ENTs worldwide. Lushh uses a validated shortened THI for regular reassessment. You can also take a quick version at lushh.app/test.

Most patients notice initial improvements within 2–4 weeks of consistent daily sound therapy. Measurable THI score improvements typically appear at 4–8 weeks. Significant habituation (where tinnitus no longer significantly impacts daily life) usually develops over 3–12 months. Notch therapy specifically requires a minimum of 3 months of 1–2 hours daily listening for neuroplastic changes to become evident. Lushh tracks your progress with weekly reassessments to show your improvement trajectory.

Your doctor needs: onset date and circumstances, whether it's one or both ears, pitch description and matched frequency (if known), loudness pattern (constant vs. fluctuating), identified triggers, impact on sleep and concentration, THI score over time, and any treatments tried. Lushh generates a professional PDF report containing all of this data — tinnitus frequency, THI scores over time, daily tracking trends, trigger correlations, and therapy session history — in a format ENTs can immediately act on.

Lushh is an iOS app for managing tinnitus and vertigo. It combines frequency-matched notch therapy, 65+ relief sounds with an advanced mixer, pulsatile tinnitus tracking, IMU-guided vestibular exercises (Epley maneuver, Cawthorne-Cooksey), daily symptom tracking with AI-powered trigger analysis, CBT techniques, breathing exercises, sleep stories, and professional PDF reports for your doctor. It uses validated THI assessments to personalize your therapy plan from day one.

Lushh offers a generous free tier that includes: basic sound mixer with 5 relief sounds, Cawthorne-Cooksey vestibular exercises, daily habituation tracker with trend charts, 4-7-8 and box breathing techniques, and 7 CBT techniques. Lushh Premium unlocks the full library of 65+ sounds, Frequency Matcher with notch sessions, IMU-guided Epley maneuver, sleep stories, binaural presets, AI-powered trigger analysis, PDF doctor reports, and premium programs. Premium includes a 7-day free trial.

Lushh is the only app that manages both tinnitus AND vertigo. Key differentiators: (1) 65+ sounds — more than any competitor, (2) real notch therapy with frequency matching based on Okamoto et al. research, (3) IMU-guided Epley maneuver using phone motion sensors, (4) assessment-driven personalization from the first session, (5) AI-powered trigger correlation analysis, (6) professional PDF reports your ENT can actually use, (7) pulsatile tinnitus tracking, (8) emotion-aware daily adaptation.

Lushh is currently available on iOS only (iPhone and iPad). An Android version is in development. You can join the Android waitlist at lushh.app to be notified when it launches.

Yes. All 65+ sounds are stored locally on your device. Sound therapy, vestibular exercises, breathing techniques, and daily logging all work completely offline. No buffering, no interruptions. An internet connection is only needed for initial download, syncing, and PDF report generation.

No. Lushh is a wellness and management tool, not a medical device. It does not diagnose, treat, cure, or prevent any disease. The sound therapy, exercises, and tracking features are based on published clinical research but are intended for self-management, not clinical treatment. Always consult an audiologist or ENT specialist for medical evaluation and treatment of tinnitus or vertigo.

Lushh processes all health data on your device. Your tinnitus scores, daily logs, and session data are stored locally using Apple's encrypted SwiftData framework. No personal health data is sent to external servers. Analytics data (usage patterns, feature engagement) is collected via Firebase Analytics with no personally identifiable health information. Full details are in our privacy policy at lushh.app/privacy.html.

Yes. Lushh generates a professional PDF report titled "Tinnitus Clinical Progress Report" that includes your matched tinnitus frequency, THI scores over time, daily tracking trends, trigger correlations, therapy session history, and progress comparison. You can export this report via Share Sheet, AirDrop, email, or any other sharing method. The report is formatted specifically for ENT specialists and audiologists.

You can take a free 60-second tinnitus severity test at lushh.app/test. It's based on the validated THI (Tinnitus Handicap Inventory) methodology and gives you an instant severity score with personalized recommendations. No signup required. For ongoing tracking, the Lushh app includes regular reassessments to measure your improvement over time.

Lushh is available for free on the App Store. Search for "Lushh" or "Lushh Tinnitus Relief" on your iPhone or iPad. The app is free to download with optional Premium subscription that includes a 7-day free trial.