Navigating tinnitus at work

Table of contents

1. Overly quiet workplaces  
2. Noisy workplaces  
3. Managing acute tinnitus distress at work  
4. Federal worker protections for employees with tinnitus  
5. Requesting accommodations from your employer

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When you suffer from bothersome tinnitus, there are few environments more challenging to navigate than the workplace. Fortunately, a number of strategies can make it manageable.

For many tinnitus sufferers, showing up for work can start to feel like stepping into a kind of psychological battleground. The constant ringing in your ears heightens anxiety and stress levels, and endlessly competes with the need to stay focused, productive, and calm.

From environments that are either too quiet or too loud, to difficult coworkers, stressful meetings, and the fear of losing your job, tinnitus sufferers often face a unique set of obstacles at work. Over time, it can start to become increasingly difficult to ignore the sound of your tinnitus and focus on even the simplest of tasks.

There are countless strategies and coping tools that can help patients to ignore their tinnitus so they can be calmer and more productive at work. There are also employment laws in place (at least in the US) that protect tinnitus patients against discrimination and reprisals.

Let's take a look at the many challenges that tinnitus sufferers often face in the workplace, as well as the most effective solutions that can quickly help patients to be more productive at work.

 

1. Overly quiet workplaces

Tinnitus sound masking (also known as sound therapy) is the practice of using various types of background noise to cover some of the volume of your tinnitus and reduce its perceived intensity. Quiet environments are often more difficult for tinnitus patients because the lack of environmental noise means you can hear your tinnitus much more clearly and loudly.

When used correctly, sound masking can be a powerful coping tool that can make a huge difference in your ability to focus and be productive at work. The challenge is finding the right sound masking strategy that offers the most relief while allowing you to still work effectively.

Sound masking tips

• Always use safe volume levels when listening to masking sounds and make sure the volume of your masking sounds is set lower than the volume of your tinnitus. You want to make sure you can hear your tinnitus a little bit through the masking, as partial masking helps to promote habituation and will not trigger a spike when turning the masking off.
• Any sounds can work well for masking but nature soundscapes and broadband sounds (like white noise) work best for most tinnitus patients.
• Try to find a few different sound masking options that work well, so you can rotate if one becomes less effective over time. There are countless sound therapy apps in the app store for both iOS and Android to explore.

Selecting the best listening device

There are many ways to listen to sound masking, each with pros and cons, and choosing the right option will depend on the type of work environment, the nature of your job, the noise level, and your communication needs.

Hearing aids
Best for tinnitus patients with hearing loss

If you have hearing loss in addition to tinnitus, hearing aids are a highly effective option for sound therapy. Most modern hearing aids are Bluetooth-enabled and often come with tinnitus masking features built in. They can be programmed to emit white noise or other masking sounds that help to reduce the perceived volume of your tinnitus.

Hearing aids offer a discreet way to use sound masking and still allow you to maintain environmental awareness. The only real downsides are that hearing aids are the most expensive masking option by far, and the sound quality cannot compete with headphones or external speakers.

Open-ear headphones
Best for masking while retaining situational awareness and open communication

Open-ear headphones are a relatively new technology that play sound directionally into the ear, without covering or blocking the ear canal. They allow you to listen to masking sounds, music, or anything else you want to listen to while still being able to hear what's going on around you.

These are a great option for tinnitus masking in office settings where you need to be attentive to conversations or meetings. It’s also great option for people who work in communal spaces.

• Best premium option: Bose Ultra Open Earbuds ($299)
• Best inexpensive option: Q7 Open Ear Headphones ($39)

Bone conduction headphones
Best for masking while wearing earplugs or when full environmental awareness is needed

Bone conduction headphones are another great option for tinnitus sufferers who need to remain aware of their surroundings while working. These headphones transmit sound through the bones of your skull directly to the inner ear, leaving your ears open to hear ambient sounds around you. Like with open-ear headphones, this is perfect for listening to sound masking in work environments where situational awareness is important. Sound quality is generally very good, though not quite as good as traditional headphones or open ear headphones.

Pro tip for loud environments: In loud, noisy work environments where hearing protection is necessary, bone conduction headphones are the only sound masking option that can be used while wearing earplugs.

• Best premium option: Shokz Open Run Pro ($179)
• Best inexpensive option: Shokz Open Move ($79)

Bluetooth speaker
Best for masking in private spaces, closed door offices, or remote work

If you work in a private or controlled environment, such as in a personal office with door, a Bluetooth speaker is a highly effective option to play masking sounds or calming music. Many Bluetooth speakers are portable and can be brought from room to room as well, which is helpful.

Noise cancelling headphones
Best for masking in noisy communal workspaces

In noisy environments, such as crowded offices or communal workspaces, noise cancelling headphones can be an effective solution that blocks out loud external sounds while allowing you to listen to masking sounds clearly at lower volume levels. The downside is that you may have to frequently take them off to communicate with others.

 

2. Noisy workplaces

At the other end of the spectrum, noisy and loud workplace environments can be problematic for tinnitus patients as well.

Hearing protection is important for everyone, but it’s especially important for tinnitus patients. Loud noise exposure can make tinnitus worse in both the short and long term. 40-50% of tinnitus patients also experience sound sensitivity (or hyperacusis), and there are often uncomfortable noises in the workplace that can make it even harder to focus and be productive.

Fortunately, proper hearing protection can help to mitigate the impact of loud or triggering environments, allowing you to be more far comfortable while working with tinnitus.

You just need to select the right hearing protection, for the right environment and work situation. Here is a short guide to help you select the right hearing protection:

Hearing protection options

The first step in choosing the right hearing protection is to measure the volume of your work environment. There are many decibel meter apps for both android and iOS that work well. This can help you understand if you are actually at risk for hearing damage and what level of decibel reduction you will need to protect your hearing accordingly.

High fidelity earplugs for maintaining clear communication

High-fidelity earplugs, also known as musician’s earplugs, are designed to reduce the decibel level of your environment evenly across all frequencies, so that you can still hear everything clearly, just at a lower volume level. This allows you to still communicate with others as well as hear music clearly. Depending on the set, high fidelity earplugs generally offer decibel reductions of 11-26 db.

There are many off-the-shelf options available, some of which even allow you to change the decibel reduction level with a switch. You can also purchase a custom set molded to your ears from an audiologist, which are much more comfortable for all day wear.

Foam earplugs for loud environments

Foam earplugs are inexpensive, disposable, and widely available in different shapes and sizes. When inserted correctly, foam earplugs offer up to 33db of sound reduction and can protect you in very loud environments where you need maximum noise reduction, such as when operating heavy machinery or during loud events. The downside is that sound clarity is reduced greatly, especially compared to high fidelity earplugs.

Silicone earplugs for loud environments

Silicone earplugs are reusable and can be more comfortable than foam earplugs for many people. They are also generally much easier to insert and take out. Silicone earplugs provide a good seal in the ear and are suitable for varying levels of loud or noisy environments, though much like foam earplugs sound clarity is not preserved with silicone earplugs.

Earmuff hearing protectors for loud environments

Earmuff-style hearing protectors provide significant noise reduction and are much easier to put on and take off compared to earplugs. They are a great option for work environments with loud intermittent noises, such as construction sites, manufacturing, or factory environments. They cover the entire ear and are effective at blocking out high levels of noise. Earmuffs can also be combined with earplugs for little bit of extra protection in the loudest environments.

 

3. Managing acute tinnitus distress at work

Of all the ways tinnitus can make the workplace difficult, for most sufferers, the biggest challenge is managing acute tinnitus distress.

Stress and anxiety are some of the most common tinnitus triggers among patients and both can make it more difficult to cope. Acute stress or anxiety can lead to temporary increases in tinnitus intensity too, which in turn raises stress levels even further in a vicious cycle that makes it much harder to focus and be productive.

Even if you have your dream job and you love every aspect of what you do for work, your ability to manage stress will be diminished by bothersome tinnitus.

So when acute anxiety and tinnitus distress is making it difficult to focus, the best thing you can do is take a few minutes to calm your nervous system before trying to go back to work.

Pushing through the anxiety and just trying to ignore your tinnitus (especially when ignoring it isn’t working), generally will only lead to more anxiety.

Stress-fighting strategies

Take a break and go for a walk

When you are experiencing a lot of tinnitus anxiety and having a hard time focusing on work, one of the best things you can do is to take a break and go for a short walk. Even 10-15 minutes can be beneficial as walking can help clear your mind and reduce stress. Ideally, as you walk, put on sound masking, or even better, listen to music or a podcast. Also whenever possible, try to walk outside to get some fresh air and a change of scenery as well.

The 4-7-8 breathing technique

Breathing exercises such as the 4-7-8 technique can quickly trigger a relaxation response in the nervous system that reduces anxiety and provides temporary relief from tinnitus related stress.

1. Inhale deeply: Breathe in slowly through your nose for a count of four, allowing your abdomen to rise as your lungs fill with air.
2. Hold your breath: Hold the breath for a count of seven.
3. Exhale slowly: Breathe out slowly through your mouth for a count of eight, letting your body relax with the exhale.
4. Repeat: Repeat this cycle a minimum of 4 times, though you can continue practicing until you start to become more relaxed.

5-4-3-2-1 technique

The 5-4-3-2-1 technique is a powerful emotional grounding exercise that can help you to quickly manage anxiety by bringing your focus into the body, the senses, and the present moment. You can repeat this exercise as many times as needed.

1. Acknowledge 5 things you see: Look around your workspace and notice five things you can see. Try to make it as specific as possible, such as the pattern of dust on your computer screen, or the glossy green of the leaves of the plant in the corner.
2. Acknowledge 4 things you can touch: Focus on four things you can physically feel, and reach out and touch them, one by one. Again, try to make it specific, such as the texture of the wood grain of your desk, the fabric of your clothes, or the warmth of your coffee mug.
3. Acknowledge 3 things you can hear: Listen for three distinct sounds, one by one, and do this without judgement. Your tinnitus can be one of the sounds.
4. Acknowledge 2 things you can smell: Notice two things you can smell. If you can’t identify any smells immediately, you can try to smell the fragrance of your skin, or the subtle smell of the air.
5. Acknowledge 1 thing you can taste: Pay attention to one thing you can taste. If there is nothing to taste, notice the lingering flavor of whatever you last ate or drank on your tongue.

 

4. Federal protections for employees with tinnitus

The Americans with Disabilities Act (ADA) is a US federal law that prevents discrimination against qualified employees with disabilities of all types (at companies with 15 or more employees) and ensures that employees are entitled to reasonable accommodations in the workplace.

The text of the ADA guidelines for hearing impairments does not mention tinnitus, but its language is very broad, and tinnitus is mentioned specifically by the U.S. Equal Employment Opportunity Commission (EEOC), which enforces the employment provisions of the ADA.

Here is the most important bit, as written by the EEOC in a post titled Hearing Disabilities in the Workplace and the Americans with Disabilities Act:

“The ADA provides that individuals with disabilities include those who have “a physical or mental impairment that substantially limits one or more major life activities...,” have a record (or history) of a substantially limiting impairment, or are regarded as having such an impairment. This document uses ADA statutory terminology for its legal meaning and to refer inclusively to individuals who are deaf or hard of hearing, as well as those who have other hearing conditions, such as tinnitus and sensitivity to noise.”

Despite this, in my work as a tinnitus coach, my clients often tell me that they feel hesitant to discuss their tinnitus with their employer. Usually, it’s out of fear of being treated differently or worse–being let go. But if you are struggling with tinnitus at work, you have a right to request reasonable accommodations.

 

5. Requesting accommodations from your employer

So the question is, what exactly are reasonable accommodations for a person affected by tinnitus? The short answer is that it varies greatly on a case-by-case basis, depending on the person’s specific needs and the nature of both their job and work environment.

For example, if you are working in an environment that is too loud, and the noise is affecting your tinnitus, you might ask to be relocated to a quieter area, or to be provided or allowed to wear hearing protection or noise cancelling headphones. If your environment is too quiet, you can request to be allowed to play white noise from a Bluetooth speaker, or to be allowed to wear headphones while you work.

The key to obtaining better accommodations at work starts with effective communication with your employer. It’s important to document both how your tinnitus is affecting your work performance, as well as what workplace accommodations you believe would be most helpful. You might also consider asking your doctor to write a note recommending the workplace accommodations you are seeking.

It’s important to document both how your tinnitus is affecting your work performance, as well as what workplace accommodations you believe would be most helpful.

Once you are ready to make your case, schedule a meeting with either your supervisor or HR to discuss your situation, including your needs and the potential solutions you have identified. Be ready to engage in a dialogue with your employer and do your best to actively participate in the process of finding reasonable accommodations.

It may feel overwhelming to bring all this to your employer, but it’s important to remember that you have rights as an employee with tinnitus. And by advocating for the accommodations you need, you can create a better work environment that enables you to succeed despite the challenges of living with tinnitus.

Note: If disputes ever arise, or you feel you are being discriminated against, you can contact the EEOC or other legal professionals who specialize in ADA cases.

Final thoughts

Regardless of what you do for work, or what your workplace environment looks like, bothersome tinnitus can make your job incredibly difficult.

But you are not alone on this journey. Many people are able to successfully manage their tinnitus at work, and lead fulfilling, productive careers – myself included. With the right tools, the right strategy, and the right accommodations (when necessary), you can start to navigate the challenges of tinnitus in the workplace much more effectively, too.