When Elliot Gerberg wakes up, he often hears a single tone in his head. The tone — a ceaseless, monotone ringing in his ears that Gerberg finds exhausting — is a sign of tinnitus, a condition without an apparent cause that affects around 25 million American adults.
Gerberg, who is almost 70, has lived with the condition for 20 years. He says he should have noticed first warning signs in college, where he played saxophone and flute in a jazz-rock band.
"That was the era when they had a wall of amplifiers. I would go home every night after a performance and the ears would be ringing," he says. "I'd wake up the next morning and the ears would still be ringing."
With time, his condition seemed to go away. Or rather, become dormant, until Gerberg took a job that involved frequent flying. Triggered by the sounds of jet engines, the buzzing in Gerberg's ears came back stronger than before.
"I didn't sleep for two or three weeks," he says. "I didn't know what it was, but it was terrifying, because it wouldn't leave me."
Dr. Brian Fligor, audiologist and tinnitus expert at Tobias & Battite Hearing Wellness in Boston, is treating Gerberg's condition. He says there are more than 100 causes that trigger tinnitus in patients.
"The most common would just be lifetime wear and tear," Fligor says. "As we get a little older, our hearing gets down a little bit. The brain accidentally turns down its own inhibition and hears its own circuit noise."
Fligor says everything from behavioral therapy to white noise machines can be used to bring relief to patients. But each case is unique and requires a tailored approach — while Gerberg's tinnitus is just a single sound in his head, others might experience different noises and sounds at varying volumes.
One solution that seems to be working — and received FDA approval this year — is a non-invasive device called Lenire. Co-developed at the University of Minnesota, the device combines sound therapy through headphones and tactile stimulation on a patient's tongue.
"The two come together in the brain and cause a retraining," Fligor says, "where the intrusiveness of [tinnitus] is brought down over the course of weeks."
The concept of two stimuli working together is called bimodal neuromodulation. Fligor says the duality allows the brain to be absolutely focused on one task, effectively distracting the patient from the sounds in their heads.
"It's an effect where you get totally distracted from the tinnitus, and you actually start relaxing," Gerberg says. " Soon, you don't even hear the tinnitus. It's there, but you're just hearing the sounds from the headphones."
Yet Fligor warns that bimodal neuromodulation is not a universal solution for tinnitus.
"This is one tool in the tool chest," he says, adding that it might not work for everybody.
Fligor says people experiencing ringing in their ears should talk to an audiologist before purchasing the device or proceeding with any other kinds of self-treatment. Diagnosing the condition requires extensive medical testing that can not be performed at home.
But when used under a doctor's supervision, Lenire has been a saving grace for many, including Gerberg. For 12 weeks, he spent an hour a day wearing the device. He says it helped him to stop hearing his tinnitus.
"When I wake up in the morning, sometimes if I slept funny, I hear a little tinnitus," he said. "And then I sit up and I fix my neck and it's gone again."
This segment aired on August 30, 2023.