Why Tinnitus Comes and Goes: Understanding Fluctuating Ringing in the Ears
Tinnitus is commonly described as ringing, buzzing, hissing, or clicking in the ears—is a subjective auditory perception experienced without an external sound source. Many individuals notice that their tinnitus comes and goes rather than staying at a constant volume or pitch, which can be confusing and distressing.
Understanding the fluctuating nature of tinnitus involves recognizing that it is not a single condition, but a complex auditory symptom influenced by a variety of biological, neurological, and lifestyle factors.
Why Tinnitus Varies Over Time
1. Neural Variability and Central Auditory Processing
Tinnitus is strongly linked with how the brain processes sound, especially when normal auditory input is reduced. Changes in neural activity and neuroplasticity can make tinnitus louder or quieter at different times. Research shows that tinnitus loudness and annoyance ratings fluctuate significantly from moment to moment across individuals, suggesting that the brain’s internal processing of the tinnitus signal varies over time. Tinnitus intensity and distress can be higher at certain times of day (such as night and early morning). These patterns may relate to natural circadian rhythms in stress‑related hormones and alertness.
2. Stress, Sleep, and Emotional State
Emotional stress, anxiety, and poor sleep quality are strongly associated with increases in tinnitus perception. Research shows that sleep status and anxiety levels correlate with changes in tinnitus severity, meaning that when stress or fatigue rises, tinnitus may become more noticeable.
3. Peripheral and Environmental Triggers
Temporary changes in auditory input—such as exposure to loud noise, ear pressure changes, congestion, or ear infections—can alter how tinnitus presents. Even brief changes in hearing sensitivity or middle ear dynamics can influence tinnitus perception.
4. Inherent Symptom Variability
Clinical research emphasizes that tinnitus is inherently variable within individuals over time, and single measurements may not capture typical fluctuations. Some people experience pronounced ups and downs, while others have relatively stable symptoms.
What This Means for You
Because tinnitus can fluctuate, it is important to understand that temporary changes in ringing intensity are part of how tinnitus behaves, rather than always indicating a new underlying condition.
A comprehensive wellness approach which is focused on stress management, sleep quality, hearing protection, targeted nutritional support from supplements, and cardiovascular health—may help reduce the impact of tinnitus fluctuations, though individual experiences will differ.
Sources of Information:
Characteristics of tinnitus and factors influencing its severity - PMC
Tinnitus: Clinical Insights in Its Pathophysiology-A Perspective - PMC
Tinnitus: Characteristics, Causes, Mechanisms, and Treatments - PMC