Why Do We Hear Ringing in the Ears? What Tinnitus Research Shows

Oct 16, 2026 · 4 min read · Sourced and fact-checked

The short answer: Most tinnitus has no outside sound source. A 2014 review says it is linked to changes in the brain after the inner ear loses its normal input, and that noise and age-related hearing loss are the most common causes.

A ringing, buzzing or hissing sound with no source in the room is called tinnitus. A 2014 review in the Journal of the American Academy of Audiology by Henry and colleagues explains what researchers think is going on.

Two kinds of tinnitus

The review separates objective and subjective tinnitus. Objective tinnitus is a sound made by something inside the body, such as blood vessels, muscles or breathing structures. The most common type is pulsatile tinnitus, which beats in time with the heart. The authors say the great majority of patients have subjective tinnitus, which has no identifiable sound source.

A brain that loses its input

The review says it is increasingly clear that tinnitus involves neuroplastic changes, meaning changes in how nerve cells connect and respond, in the central auditory system. These happen when the brain is deprived of its normal input because of damage in the cochlea, the hearing organ of the inner ear. The authors say the damage does not always show up on a standard hearing test, but may be found with more sensitive measures. Keeping tinnitus going over the long term likely involves a complex network that includes parts of the brain beyond hearing.

Common causes

According to the review, among young adults the most common cause is noise exposure, and among older people it is age-related hearing loss. Hearing loss in general makes chronic tinnitus more likely. Other causes listed include heart and blood vessel disease, some medicines, head and neck injury, and thyroid problems. Often no cause is found: about 40 percent of patients report no known event linked to their tinnitus onset.

Hearing tests can look normal

The review notes that someone with tinnitus can have hearing within normal limits on a standard test and still have signs of damage. In one study it cites, about a quarter of tinnitus cases (8 of 32) had normal thresholds up to 8 kHz but some impairment at higher frequencies.

Hearing it versus being bothered by it

The authors draw a line between the perception of the sound and a person's reaction to it. Reactions can include distress, poor sleep and trouble concentrating. The review says it is not currently possible to eliminate the tinnitus percept, but that a person's reactions to it can clearly be changed, with evidence-based behavioural approaches.

A note

If you hear a sound that beats with your pulse, hear it in one ear only, or have sudden hearing loss, see a doctor. This is general information, not medical advice.

Sources

Underlying mechanisms of tinnitus: review and clinical implications, Henry, Roberts, Caspary, Theodoroff and Salvi, Journal of the American Academy of Audiology, January 2014: https://pmc.ncbi.nlm.nih.gov/articles/PMC5063499/

Facts checked: October 16, 2026.