Question 1

What is tinnitus, and what actually helps?

Accepted Answer

The perception of sound with **no external source** — ringing, buzzing, hissing or humming — and the most useful thing to understand is that it is generated by the **brain rather than the ear**, which explains why treatments aimed at the ear rarely work and why the effective approaches target the response instead.

**What is thought to be happening.** Reduced input from the ear — usually from hearing loss, even mild or unnoticed loss at particular frequencies — leads the auditory system to **increase its own gain**, amplifying internal neural activity that is then perceived as sound. The analogy frequently used is a hearing system turning up its volume when the signal weakens, and hearing its own noise.

**The common causes and associations:** age-related hearing loss, noise exposure, ear wax, ear infection, Ménière's disease, head injury, some medications, and stress — which does not cause it but reliably worsens the perception.

**Why distress does not track loudness.** Two people with identical tinnitus can be entirely unbothered or severely distressed. **The perceived threat and the attention paid to it predict distress far better than the sound itself**, which is the basis of every effective treatment.

**What actually has evidence behind it:**

**Hearing aids**, where hearing loss is present — restoring input reduces the gain and frequently reduces tinnitus substantially. **This is the most under-used effective intervention.**

**Cognitive behavioural therapy**, which has the strongest evidence of any treatment. It does not reduce the sound; it reduces the distress, which is what people actually want.

**Sound enrichment** — background sound so the tinnitus is less prominent, particularly at night when silence makes it dominant.

**Tinnitus retraining**, combining counselling and sound therapy.

**Treating any underlying cause**, including wax removal.

**Addressing sleep and anxiety**, which form a genuine feedback loop.

**What does not work**: most supplements marketed for it, and there is no established cure.

**When to seek urgent assessment:** tinnitus in one ear only, pulsatile tinnitus that beats with your heart, sudden onset, or tinnitus with sudden hearing loss or dizziness.

General information, not medical advice.

Question 2

Why does hearing decline with age?

Accepted Answer

Mostly because the hair cells in the inner ear are damaged over a lifetime and do not regenerate in humans — a cumulative, largely irreversible loss that begins far earlier than most people realise.

Question 3

What is sleep apnoea, and why does it matter?

Accepted Answer

Repeated interruption of breathing during sleep, lasting seconds at a time and occurring anywhere from a few to hundreds of times a night — and it matters because the person affected is usually

Question 4

Why does stress cause physical symptoms?

Accepted Answer

Because the stress response is a whole-body physiological state evolved for physical emergencies, and running it continuously produces real effects in tissues that have nothing to do with

Question 5

Why do we get motion sickness?

Accepted Answer

The leading explanation is sensory conflict — your balance system and your eyes reporting different things about whether you are moving. How balance normally works. The vestibular system in the inner

Question 6

What are common triggers for migraines and how can I avoid them?

Accepted Answer

Common migraine triggers include stress, dietary factors, hormonal changes, sleep patterns, and environmental stimuli. Identifying and managing these can help prevent migraines.

Question 7

What is delirium, and how is it different from dementia?

Accepted Answer

Delirium is an acute, fluctuating disturbance of attention and awareness, usually caused by an underlying physical problem — and distinguishing it from dementia matters enormously, because delirium

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