Understanding musical ear syndrome

Most of us have experienced getting a catchy tune stuck in our heads, but what if you could hear music that wasn’t actually playing?

This unusual phenomenon is known as musical ear syndrome (MES). Unlike when you’re replaying a song in your mind, MES involves the false sensation of actually hearing music or sounds that seem as though they are coming from an outside source. Though the condition and its causes are not completely understood, it is often linked to hearing loss.

Hearing music that's not there

People with MES perceive music that's not there. The songs people with the condition report hearing can range from simple melodies or instrumental music to more complex tunes with lyrics such as pop songs or Christmas carols, and they often repeat in a loop. Many can identify the direction the song is coming from and don't realize it's an auditory hallucination at first.

In one documented case, an 87-year-old woman was annoyed at hearing what sounded like a concert coming from next door. Only after realizing that her relatives were not hearing the persistent music did she become concerned and seek medical attention.

What causes musical ear syndrome?

MES is not widely understood, however it does seem to be mostly associated with auditory deprivation caused by severe or profound hearing loss.

It's sometimes been compared to the condition Charles Bonnet syndrome, which causes people with very poor vision to experience visual hallucinations. Researchers theorize that the brain starts to compensate by generating phantom sounds, including music, when severe hearing loss is present.

Other potential causes include:

• Tinnitus: Alongside experiencing a ringing or buzzing in the ears, some people with tinnitus can experience more complex sounds like music.
• Age-related changes: As people age, changes in the auditory system or brain may lead to MES, especially in conjunction with hearing loss.
• Neurological conditions: Conditions affecting the brain like epilepsy, dementia, or brain tumors, may cause auditory hallucinations.
• Medications: Medications, especially those affecting the central nervous system, may trigger MES as a side effect.
• Cochlear implants: There have been rare reports of people with cochlear implants experiencing musical hallucinations.

Research has also found that more women than men report musical hallucinations and that social isolation is a risk factor.

Is musical ear syndrome psychological?

Psychiatric disorders such as schizophrenia can produce auditory hallucinations, including, potentially music. However, musical ear syndrome is not considered psychiatric in nature.

In general, people experiencing auditory hallucinations due to mental illness will experience other signs, such as delusions, disorganized thinking or erratic behavior. They may also experience auditory hallucinations that are not musical, such as hearing voices. Also, antipsychotic medications used to treat hallucinations would likely not be effective for a person whose musical hallucinations are due primarily to hearing loss.

It's important to note that a person can have both MES and a mental health disorder simultaneously, which might require a combination of treatments to manage the symptoms.

How common is MES?

It's unknown how common MES is among people with hearing loss. Dr. Neil Bauman, director of the Center for Hearing Loss Help, and the person credited with naming musical ear syndrome, suggests that upwards of 10% of people with hearing loss experience some degree of musical hallucinations.

However, there is little research on the frequency of MES, and is generally considered to be a rare condition, with one study noting it was present in just 0.16% of general hospital populations.

Healthy Hearing sent a quick survey to a small number of experts from our hearing directory about MES. Only half of those who responded indicated that they were familiar with musical ear syndrome and even fewer had experience treating a patient with the condition.

Treatment options

Treating hearing loss may help to reduce symptoms of musical ear syndrome. In the case of the 87-year-old woman mentioned earlier, hearing aids combined with having regular ambient sounds (like white noise) playing in the background helped her find relief. To that end, common treatments include:

• Hearing aids: Amplifying sounds with hearing aids can help reduce the brain’s need to "fill in" missing auditory input, and decrease the occurrence of MES in those with hearing loss.
• Cochlear implants: For more severe cases, cochlear implants may be more helpful in restoring auditory input and reducing symptoms.
• Sound therapy: Playing background noise or white noise can help mask the music you are hearing, making it less noticeable and helping the brain focus on other sounds.
• Tinnitus retraining therapy: This technique retrains your brain to habituate to tinnitus sounds and can be used for MES as well.
• Cognitive behavioral therapy (CBT): Though MES is not psychological, CBT therapy can help patients manage any emotional stress that's caused by MES, which can then change the way the brain responds to it.
• Medications: Additionally, medications that can help anxiety and depression may also lessen the psychological impact of MES.
• Stress reduction: MES symptoms can be worsened by stress. Relaxation techniques like mindfulness, meditation, or deep breathing exercises may help minimize symptoms.
• Change triggering medications, when possible: One of our providers who had treated MES mentioned going through the patients medication list and when they noticed a certain medication could damage hearing, recommended the patient ask their physician for an alternative.

It's important to rule out other neurological or health conditions that might be contributing to MES. If you or a loved one are experiencing musical hallucinations, visit a medical provider right away to help determine the cause and find what treatment options are right for you.

Getting help for your hearing 

In most people, the signs of hearing loss are more subtle and far less jarring than hearing music that isn't there. Instead, it's more common to find yourself turning up the TV or radio louder than you used to, or having conversations where you feel like you can hear but not understand. 

Any hearing changes should be evaluated by a local hearing provider to determine the cause and help find effective treatment to keep you hearing your best.