Pulsatile Tinnitus and ADHD: Symptoms, Triggers, and Relief

Having a steady noise in one’s ear can be a strange and isolating experience; but when that steady noise matches your heartbeat, it is called Pulsatile Tinnitus. The sounds you may hear are described as a whooshing, rushing, or thumping noise, which always seem to beat in sync with your heart rate, like an internal drum beating in time with your heart.

Pulsatile Tinnitus and Attention Deficit Hyperactivity Disorder (ADHD) have a common thread; they both affect how we pay attention, stay focused and manage impulses. For example, if you tend to jump from task to task, forget about time passing, or get the sensation that your mind is racing you may find yourself struggling to cope with these aspects of your Pulsatile Tinnitus and ADHD. Having to deal with all of this on top of hearing an internal drumbeat while trying to go about your daily routine can make things even more challenging for you.

When Pulsatile Tinnitus and ADHD occur at the same time, daily living can be difficult due to the fact that the internal drumbeat may distract you, raise your levels of anxiety, and disrupt your ability to sleep. The purpose of this article is to help you identify symptoms and possible causes of your Pulsatile Tinnitus and ADHD, including medications used to treat your ADHD, and to provide some relatively simple ways to relieve your discomfort, giving you hope that you are not alone in this.

What Is Pulsatile Tinnitus and How Can It Affect ADHD Symptoms?

Tinnitus that “pulses” (or beats) with your heart rate is called “pulsatile tinnitus”. For most individuals, it’s described as either a “whooshing”, “thumping”, or gentle “whishing” type sound. Most people report hearing this noise in only one ear, however; occasionally it occurs bilaterally (in both ears).

On the other hand, typical tinnitus is generally reported to be a constant, steady “ringing”, “buzzing”, or “hissing” sound. The key difference between regular tinnitus and pulsatile tinnitus is that regular tinnitus does not have an audible rhythmic quality to it, whereas pulsatile tinnitus has an audible rhythmic quality that may resemble listening to a drumline or very slow bass beat. In addition, when someone is living with pulsatile tinnitus and also ADHD; it may only take seconds for the “noise” to draw their attention away from whatever they are doing.

In terms of ADHD, it already makes it much harder for the individual to ignore distracting sounds and distractions. The ADHD brain will process each distraction (and many others) as if they were all important. When the individual is exposed to additional internal stimuli such as the “heartbeat” of pulsatile tinnitus, the combination of pulsatile tinnitus and ADHD will likely create increased levels of stress, confusion, and mental exhaustion.

Pulsatile Tinnitus vs Regular Tinnitus: The Key Differences

Tinnitus is most often described as a continuous ring or buzz. It can be loud, soft, steady, or variable. It doesn’t have to sync up with your heartbeat. Tinnitus is like static in the background.

On the other hand, pulsatile tinnitus will sound like there’s a drum in your ear. The pulsatile tinnitus will be synchronized with your pulse (whoosh-whoosh, thump-thump, rush-rush). For someone with pulsatile tinnitus and ADHD, the steady beat will cut through all the rest of the noise, making it difficult for them to stop thinking about the noise and its pulsing pattern.

The pulsating nature of the tinnitus, when combined with ADHD, may make you more conscious of your body. You will become more conscious of your heart beating, and may start to feel more anxiety, which will cause you to concentrate on the pulsing of the tinnitus. This creates a loop that makes the pulsing of the tinnitus appear to grow louder, and possibly more distressing, over time.

How Noise in Your Ears Can Make ADHD Feel Worse

If you already suffer from ADHD, then your brain will spend additional energy on separating the important signals from the unimportant ones. When you add a constant ear noise as another signal for your brain to fight against; the constant ear noise can:

• Cause you to lose your focus when reading or working.
• Force you to hear the noise in your head over and over.
• Make you keep switching between hearing the sound and thinking about the task and back again.

It’s here that pulsatile tinnitus and ADHD can become a loop of frustration, causing both to be exhausting. The ear noise is added to the difficulty of focusing due to ADHD and the rising level of stress causes an increase in physical tension. Some individuals may find their tinnitus feels louder because of this increased tension.

In general, the combination of tinnitus and ADHD tends to worsen in environments with little to no background noise. This is true for exam situations, meeting situations, or late at night when the ambient noise is low. The quieter the environment, the louder that internal drum beats.

Common Symptoms When You Have Pulsatile Tinnitus and ADHD Together

Symptoms caused by the combination of living with a condition like pulsatile tinnitus and having ADHD may become confusing as they are often interrelated. Symptoms may appear as being related to either the tinnitus or the ADHD; alternatively, as symptoms caused by a stressful environment. Common examples of symptoms include:

• Trouble tracking conversations in loud environments,

• Difficulty staying engaged in task-oriented activities, as the distracting noise draws your focus,

• Feeling restless, agitated, or irritable,

• Avoiding quiet areas where the noise seems louder than in other areas.

In addition to these symptoms, it is possible you will experience feelings of guilt, shame and low self-esteem regarding your inability to keep pace with others. For example, I may feel ashamed for yelling at my family members, when all I am trying to do is cope with an overwhelming amount of sound. Recognizing this pattern of behavior may enable you to treat yourself with more compassion and understanding.

The combined effects of pulsatile tinnitus and ADHD can eventually lead to exhaustion, both physically and mentally, and result in doubts about one’s capabilities.

Mental and Emotional Symptoms You Might Notice

Filtering out the constant noise of tinnitus, and also dealing with ADHD simultaneously, means a lot more work from your brain. The additional workload may be seen in the way you feel and the way you think about things.

You may experience:

• Dreaded feelings of being anxious or worried that there’s something wrong with your brain
• Feeling irritable and angry quickly over little things
• Being full of racing thoughts that won’t slow down
• Feeling mentally exhausted-even after doing nothing all day

The pressure on your brain, constantly “on” to manage both pulsatile tinnitus and ADHD can lead to burnout. Your mental exhaustion could cause you to shut down, spend hours scrolling through social media, or completely abandon tasks due to feeling spent before you’ve ever even started.

What Can Trigger Pulsatile Tinnitus and ADHD Flare Ups?

Both conditions may be triggered by many of the same things. The same thing that would cause an increase in your ADHD symptoms may, at the very same time, cause your ear noise to grow louder and/or worse.

Some common everyday triggers for both pulsatile tinnitus and ADHD are:

• Stress/Anxiety
• Sleep Disturbance (not enough sleep; irregular sleeping)
• Noise/Loud or Repetitive Sounds
• Food/Skipping Meals or Blood Sugar Swings
• Medication Changes

There could be other medical causes for pulsatile tinnitus, including vascular changes, hypertension or hearing-related disorders. This is why it is so vital to get this evaluated. However, there are some things you do, eat, and experience that can help determine the level of intensity of your pulsatile tinnitus and ADHD. For example, I noticed that my symptoms worsened when I didn’t eat, or when I didn’t get a full night’s rest.

Stress, Anxiety, and Sensory Overload

The effect of stress on your entire body is the reason that your muscles tighten; your breathing changes, and your heart beats faster. When this occurs it typically increases how much you perceive the pulsating sensation in your ears.

Most people with ADHD have a brain that reacts very severely to stress. The reaction is so severe that you will probably feel overwhelmed by every sound, every task, and every message at one time. A condition called sensory overload is when many stimuli, such as sights, sounds, smells, and requests are felt simultaneously and become overwhelming. As a result, your system automatically goes into “alarm” mode.

As a result of these two conditions, both pulsatile tinnitus and ADHD can be exacerbated by each other. Therefore, if you experience stress and anxiety the sound you hear becomes louder; your ability to focus diminishes; and your patience decreases. If you get stressed out and feel overwhelmed, you may yell at someone or quickly leave a job/task; then later regret yelling at someone or leaving a task/job.

Sleep, Caffeine, and Lifestyle Habits

When sleep, food and movement are unbalanced, both conditions (ADHD & Tinnitus) will be harder to deal with.

Here are some things that could cause you to experience more symptoms on certain days:

• Lying awake late at night watching screens
• Drinking lots of coffee/energy drinks
• Not eating breakfast, or skipping meals for hours
• Wearing headphones to listen to loud music for extended times
• Dehydration from drinking too little water

Caffeine increases heart rate and anxiety, which could make the pulsating of tinnitus more obvious. Sleep has an impact on both increasing the intensity of ADHD symptoms and decreasing one’s ability to cope with the constant background noise of tinnitus. Making small changes in daily routine can reduce how much both pulsatile tinnitus and ADHD seem to intensify.

Pulsatile Tinnitus ADHD Medication Links and Side Effects

Certain types of ADHD medications can increase heart rate, blood pressure, or blood flow. For a few individuals these increased physiological responses may be associated with an increased awareness of pulsatile tinnitus. Discussions have used the term “pulsatile tinnitus ADHD medication” to describe this association between tinnitus and medication use.

In addition to ADHD medications, other types of medications (such as certain antidepressants and antihypertensive medications) can also cause tinnitus. In no way does this suggest that the medication you are taking is poor quality, nor should you discontinue the medication without discussing discontinuation options with your prescribing physician. When treated appropriately for ADHD at the correct dosage at the optimal time, many individuals report that their tinnitus symptoms become less bothersome due to decreased levels of anxiety and chaos.

Always consult with your doctor/prescriber prior to making any changes to your current medication regimen. It is possible to provide your doctor/prescriber with information regarding when your tinnitus first appeared, how it sounds, and if the perceived severity has changed based upon the amount of medication you take. The open communication with your doctor/prescriber will enable you to develop a treatment plan which is both safe and acceptable to you.

How to Get Help for Pulsatile Tinnitus and ADHD: Diagnosis and Safety

You don’t need to go through this alone. If you hear a heartbeat sound in your ear, or a change in your concentration, or both, you owe it to yourself to get that to a doctor. Both pulsatile tinnitus and ADHD are legitimate medical conditions and you deserve help for each.

Don’t wait when pulsatile tinnitus starts to occur. Even if it comes on quickly or is only in one ear, it’s better to get checked as soon as possible so serious causes may be ruled out and you can find some peace of mind. The combination of being nervous but relieved after seeking assistance is common.

When dealing with pulsatile tinnitus and ADHD you will likely work with multiple people:

• Your Primary Care Doctor to begin the process
• ENT (Ear, Nose, Throat) Doctor
• An Audiologist to test your hearing
• A Neurologist to evaluate the function of your brain and nerves
• A Mental Health Provider or an ADHD Specialist

Together, they can help you understand how pulsatile tinnitus and ADHD show up in your life and what steps make sense next.

Tests and Evaluations You Might Go Through

The first time you visit a physician, he/she will likely recommend multiple examinations to assist in determining what your body is doing and why the sounds are occurring.

Some of the most common examinations include:

• Hearing assessments with beeps and tones (the ability to hear)
• Blood Pressure measurements (sometimes done at two or three separate times of the day)
• Blood samples (to assess other potential conditions affecting blood flow)
• Imaging studies (MRI or CT scan) of blood vessels and surrounding structures
• Questionnaires/evaluations regarding ADHD (Attention Deficit Hyperactivity Disorder), concentration, memory, etc.

The physician asks you numerous questions about when your symptoms began, when they occur, when they improve or worsen, and how often they impact your daily routine. This information may help you find out why you have your symptoms and which treatment options would work best for you.

Relief Strategies for Pulsatile Tinnitus and ADHD You Can Start Today

While waiting for answers or appointments, you can also start with small, easy-to-try things. While none of these ideas will “fix” either condition, many can help reduce the total load on both your body and mind.

Lifestyle changes, some type of sound tool, support for focus, and emotional care are common components of good plans for managing both pulsatile tinnitus and ADHD. It doesn’t take a lot to make progress — I may not be able to silence the sound, but I can at least minimize its impact on my daily life.

Keep in mind that as you test these strategies that both pulsatile tinnitus and ADHD can fluctuate by day, so what works today may not work tomorrow.

Sound Strategies: Background Noise, Apps, and Safe Headphone Use

Background sound, even if it’s soft, can distract from the pulsation of tinnitus. But, it doesn’t have to add more stress. The most important thing is to select calming sounds for you, rather than stimulating sounds.

Some things you might want to try:

• An air purifier or a fan in your bedroom.
• Instrumental soft music.
• One of many apps available which will play rain, ocean, or brown noise (white noise is usually too loud).

Brown noise has lower frequencies than white noise, therefore tends to be less harsh on the ear. Brown noise may also assist individuals with ADHD with their ability to focus, as it provides the brain with a steady, unobtrusive sound that does not compete for attention.

Focus and Routine Tips That Calm Your Brain

Simple tools that help structure the day can also make living with pulsatile tinnitus less of a struggle. Your structure doesn’t need to be “by the book”; it simply needs to offer some support.

Some simple tools you could consider include:

• Making an extremely short to-do list (only 3 to 5 things) for each day
• Using a timer to create separate blocks of time for work. For example, you could use a 20-minute timer, then do a very short break (and repeat).
• Working with a “body double” – using either a video conferencing platform, or working in the same physical location as another individual – while you both complete tasks
• Scheduling daily periods of quiet time (with one primary focus) and avoiding multiple-tasking

When you reduce the level of chaos in your life and reduce your decision fatigue, your nervous system has fewer battles to fight. The noise from the pulsatile tinnitus will likely continue to exist, but your brain won’t have to fight as many battles at the same time. With time, the amount of mental real estate taken up by your tinnitus and ADHD will decrease.

Stress, Body Care, and Mindset Shifts

When you take good care of your body and treat it with kindness and respect, you will find that it is much easier to manage both the loud, constant, “pulsating” noise and the symptoms of your ADHD.

Here are some tips that may help:

• Breathing exercises – breathe slowly and deeply (such as inhale for 4 seconds and exhale for 6)
• Stretching – stretch gently, either first thing in the morning or right before bed
• Taking short walks – just go for a walk for 5-10 minutes to get fresh air
• Mindfulness – take a quick moment to notice what you can see, hear, and feel in the present moment (“What am I seeing? What do I hear? What do I feel?”).

These are not magic fixes, but they send your body a message that it is safe to relax. Less tension often means the sound feels less explosive and your ADHD reactions feel softer.

All of these are NOT going to cure your problem, BUT they will let your body know that you are trying to relax and that you want to feel safe and calm. The less tension there is in your body, the less explosive the sound will feel, and the fewer and less intense your ADHD reactions will be.

Conclusion

Feeling overwhelmed with a “beat” in your head and racing thoughts feels like it’s just too much. Once you see how ADHD and Pulsatile Tinnitus affect each other; you will begin to identify some patterns, you will name your symptoms, and you will establish ways to create habits that will help you. There are many people searching for things like “pulsatile tinnitus and adhd” because there is so much hunger for clearly honest information about these conditions, and you deserve that same honesty.

You have identified how these two conditions are feeding into each other, the symptoms that may be occurring, and the triggers that may lead to an increase in symptoms, as well as a few of the small relief strategies to provide temporary comfort. You don’t have to carry this burdenof Pulsatile Tinnitus and ADHD by yourself. You have medical doctors, therapists and support groups available to support you through this journey.

Most importantly, you can be your own advocate. I can learn to work with my brain and my ears, rather than fighting against them. Begin by identifying your symptoms, making an appointment with your doctor, and creating one new habit today. A single small adjustment could lead to a smoother and steadier path of managing Pulsatile Tinnitus and ADHD.