Pulsatile tinnitus causes pulsing noises in your ears to sync with your heart rate, which may naturally cause some distress and anxiety. Research confirms that the conditions are strongly linked.

Pulsatile tinnitus is characterized by a pulsing, ringing, or another rhythmic noise in the ears that often syncs up with your heartbeat. Unlike other forms of tinnitus, it’s caused by vascular issues amplifying the sound of blood flow near your ears.

Understandably, this can be frustrating, stressful, or anxiety-inducing. Though the link between pulsatile tinnitus and anxiety isn’t well understood, the two conditions often go hand-in-hand.

Here’s what to know.

Tinnitus, in general, is strongly linked to stress and anxiety. However, researchers still don’t know whether anxiety is the cause, the effect, or both the cause and effect of tinnitus.

According to a large 2020 research review involving over 22,500 participants, those with anxiety disorder were much more likely than those without it to develop tinnitus over time.

In a smaller 2018 study, researchers found that of 180 tinnitus patients, 65% had stress symptoms. Since symptoms of stress and anxiety are virtually the same, this could also suggest a strong link between anxiety and tinnitus.

Keep in mind that, according to a 2023 study, anxiety and depression symptoms aren’t more severe in patients with pulsatile tinnitus compared to non-pulsatile tinnitus patients. That said, patients with pulsatile tinnitus reported experiencing a greater day-to-day handicap than the non-pulsatile tinnitus patients.

Though there’s currently no research on the link between anxiety and pulsatile tinnitus in particular, there are many potential hypotheses about how these conditions affect each other. Since stress and anxiety may cause the heart rate to increase, for instance, this could potentially seem to worsen the sound or intensity of tinnitus in the eardrums.

There’s also a correlation between high blood pressure and anxiety, and high blood pressure is one of the causes of pulsatile tinnitus.

Based on the evidence, the relationship is likely bidirectional in the case of pulsatile tinnitus — meaning that the condition causes or worsens anxiety and vice versa. However, researchers still can’t say for sure.

Most of the time, pulsatile tinnitus does not indicate an emergency issue. But since pulsatile tinnitus is linked to cardiovascular issues, it’s a good idea to call 911 if your symptoms are accompanied by any signs of a heart attack, including:

  • sudden chest pain, pressure, or squeezing (especially in the center or left side of the chest)
  • pain in the jaw, neck, or back
  • feeling lightheaded, dizzy, or fatigued
  • sweating
  • pain in the arms or shoulders (both or one)
  • difficulty breathing
  • nausea or vomiting (especially in females)

It’s also recommended to visit the emergency room for tinnitus if it starts after you experience a head injury or if you also experience:

  • dizziness
  • facial muscle weakness
  • sudden hearing loss

Reducing anxiety may minimize tinnitus symptoms as well as improve your overall health and day-to-day quality of life.

As a result, many techniques recommended to treat tinnitus — such as therapy or exercise — are likewise recommended to treat anxiety, including:

Other techniques that may reduce anxiety include:

What kind of doctor should I see for pulsatile tinnitus?

If possible, visit an ear, nose, and throat (ENT) doctor for an initial evaluation. An ENT can:

  • examine your ears
  • test your hearing
  • order imaging tests

These measures can help determine whether you have pulsatile tinnitus or another condition. From there, the doctor may need to refer you to another professional, such as an interventional radiologist.

Was this helpful?

Tinnitus and anxiety often go hand-in-hand, with both conditions believed to influence the other. The rhythmic ringing of pulsatile tinnitus can understandably be distressing, but anxiety-reducing techniques can help manage it.

If you experience pulsatile tinnitus, it’s a good idea to visit a medical professional like an ENT for a formal diagnosis. Since the condition is often linked to vascular conditions, a doctor can help assess any potential underlying conditions.

If you experience sudden chest pain alongside pulsatile tinnitus symptoms, call your local emergency number.