How to Cope with Sudden Hearing Loss

It's unexpected and it's not necessarily permanent, but sudden hearing loss can bring serious changes to the lives of people who are affected.

Nancy Cipriani, 71, of Pueblo, Colorado, suddenly lost her hearing in January.

"Our hearing is one of the most important things in our life," she says. "It changes everything, especially your independence. It hits you no matter how healthy you think you are."

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"Sudden sensorineural (inner ear) hearing loss is the sudden loss of hearing all at once or over a few days," says Dr. Michael Hoa, an otolaryngology surgeon scientist at the National Institute on Deafness and Other Communication Disorders, National Institutes of Health in Bethesda, Maryland.

This type of hearing loss, known as SSHL or SSNHL, is also called sudden deafness, unexplained sudden hearing loss, single-sided deafness or unilateral hearing loss.

"Something is wrong with the sensory part of the inner ear or the cochlea, often only in one ear, occasionally in both. It happens but there is a lot that we don't know about it," Hoa says.

Hoa says an estimated five to 27 people per 100,000 members of the population are affected each year, which amounts to about 66,000 people.

Unlike many diseases, there seems to be no bias based on gender, race, geography or diet. Although SSHL can attack anyone, people who are between 40 and 60 are most often the ones affected.

About one-third of those individuals with SSHL have their hearing completely or almost completely returned, one-third have their hearing partially returned, and the other third are left with permanent hearing loss.

There are suspected causes, including infections, head trauma, stress, autoimmune diseases, reactions to medications, neoplasm (tumors), metabolic diseases, blood circulation problems, neurological disorders such as multiple sclerosis, and disorders of the inner ear.

So far, the best treatment is oral steroids and sometimes steroid injections into the inner ear. "That's less painful than it sounds," says Hoa, adding that steroids can reduce the inflammation in the inner ear.

Unlike age-related gradual hearing loss, with SSHL, people simply go to sleep one night and wake up deaf in one ear (or sometimes two) the next morning. According to the Hearing Loss Association of America, patients may attribute it to allergies, earwax buildup and blockage, or a sinus infection, thus delaying medical attention.

"It is scary," says Lee Davison, 53, of Scotia, New York. He was headed toward a family outing in July 2021 when he first had symptoms of SSHL.

"I was alarmed, as it was not anything that I had experienced before. I had no clue what it really was or even anything to do with hearing or deafness," he says. "I was very dizzy. I thought I had low blood sugar and maybe was a bit dehydrated, as I was just coming from the gym."

According to Davison, the condition was isolating.

"While my family and sons listened to me and my grief, no one really gets the pain, the absolute grief and sadness. It took months for me to even really go out, other than for work and the grocery store," Davison says. "But I eventually did it. I spoke with relatives and really got an inkling that this is not a death sentence, but life has changed forever."

Davison says he has occasional tinnitus, which is ringing in the ears, and hyperacusis, which affects his sound perception.

"It is very painful at certain times and with certain sound frequencies," he explains.

In researching the internet, the first advice seems to be a visit to the emergency room.

According to Hoa, "It's important to see an ENT (ear, nose and throat doctor or otolaryngologist) or primary care physician. If [a patient] can't get an appointment that day, at least ask for an oral steroid prescription to start taking immediately. There is a time limit after which [steroids] aren't effective." That time frame can be as long as two weeks, but the sooner the patient starts taking steroids, the better, he says.

Testing to confirm the diagnosis starts with a pure tone audiometry test, then maybe blood work, MRI, and balance tests.

Hoa also suggests that everyone over 40 have a baseline hearing test when they feel fine, so they have a good barometer if their hearing changes.

Along with the hearing loss, Barbara Kelley, executive director of the Hearing Loss Association of America, says there are other problems associated with SSHL.

"There's a comorbidity," she says, "because you're cut off from people when you can't hear them. Or you can hear them, but not understand them. A loss of hearing on the job can feel threatening unless you tell them about your loss and ask your co-workers to look at you when they talk, to talk more slowly and clearly, but not yell."

Kelley adds that the same is true with friends and family. Background noise can be a problem and sometimes painful. Eating in a restaurant can become unpleasant. She also says it's important to wear hearing protection, whether it's a head set or even earmuffs in the winter.

The HLAA has chapters or associations across the United States where people can meet others with hearing loss who will give peer-to-peer support and offer methods to make life more tolerable. The website also lists suggestions for equipment that will make life easier.

Another issue with SSHL is the possibility of dizziness or vertigo that makes it difficult to walk. That's when physical therapy might be necessary. People may fear driving and, particularly if they live alone, also be hesitant about asking friends and neighbors for help running errands and attending to medical appointments.

Davison and others have found support through a Facebook page for My Hearing Loss Story, created by Carly Sygrove. Members compare notes, discuss current therapies, and help convince others that they aren't alone.

For Cipriani, adjusting to the tinnitus has been difficult.

"It is really hard to concentrate," she says. "Nothing has helped except acceptance and moving on with my life. I try to stay busy. I volunteer at our local rescue shelter, also am a foster home for the shelter, and exercise four times a week for an hour each class."

Cipriani says she has bought ear plugs but masking the sounds hasn't helped.

"I'm trying to take this a day at a time. SSHL isn't terminal or physically debilitating, so I consider myself lucky in that respect," she says.

Julie Hickinbotham, 53, of Menasha, Wisconsin also suffers from SSHL.

"I've stopped taking potentially ototoxic drugs (ibuprofen, naproxen)," she says, adding that she's also purchased ear protection for air travel. "I avoid loud environments if possible and I use captioning on the television."

Herman "Harry" Lee's SSHL symptoms started in November, 2021. The 73-year-old from Arlington, Massachusetts was tested and has completed an evaluation for a cochlear implant.

In the meantime, Lee says he "spends less time on my headphones. I have five different pairs. I haven't been to a concert, although I avoided them during the pandemic anyway."

Hoa's bad news is that "single-sided deafness changes one's life. Nothing we have now is a complete fix, even the implant doesn't give back what [the patient] had before. They have to learn in a new way, even learning to hear with the implant takes time."

But there is also good news. "There are more options for patients who don't recover, including a hearing aid that sends sounds to the good ear," says Hoa. "Also, cochlea implant for single-sided deafness has been approved by the FDA, so there should be some restoration to that ear."

According to Hoa, gene therapy clinical trials, although not accepting participants at the moment, are also working to see if hearing loss can be corrected.