Question

I am a middle-aged diabetic. Sometimes when I fall asleep in a chair I will awake suddenly with a horrible ringing in my ears that almost makes me deaf. It goes away with time, but sometimes it lasts for hours. Is this something serious? It doesn't happen when I sleep lying down in bed.

Answer

We call any noise in the ear 'tinnitus'. There are two types of tinnitus - a constant noise, and a pulsating, or heartbeat, noise. The constant type is usually due to a hearing loss, even if the person is not aware a loss of hearing is present. The pulsating type is due to the ear hearing noise being made by an abnormal amount of blood flow through a vessel near the ear.

Nearly always, the reasons for tinnitus are more annoying than serious. However, very rarely a constant-type tinnitus can be due to a tumor along the hearing (auditory) nerve. A pulsating tinnitus may be due to a blood vessel partially closing down, or a tumor near the ear that has a rich blood supply.

Another problem that can cause tinnitus and the feeling of a hearing loss has nothing to directly do with the ear. It is the TemporoMandibular Joint (TMJ) syndrome. The TMJ is the joint attaching the lower jaw, situated just in front of the ear. Many people grind their teeth when they begin falling asleep. This can cause irritation of one or both the TMJs, resulting in considerable pain, tinnitus, and the perception of a hearing loss. When you begin to fall asleep in your chair (but not when you go to bed) you may grind your teeth unconsciously, causing you to awaken with tinnitus and the feeling of a hearing loss. A dentist would be best able to evaluate you for possible TMJ syndrome, while an otorhinologist (an ear, nose and throat physician) can deal with any possible ear problem.