Not all tinnitus is the same. The type of sound you're hearing — ringing, hissing, buzzing, a low roar, pulsatile beating, clicking, or music — points toward different origins, different evaluation approaches, and in one case, urgent imaging that shouldn't be delayed. Dr. Layne Garrett walks through the 7 most clinically distinct tinnitus sound types: the cochlear ringing that may co-occur with hearing loss even on a normal audiogram; hissing that warrants extended high-frequency testing; buzzing that prompts a medication history review; low-frequency roar that should trigger a Meniere's workup; pulsatile tinnitus that requires CT angiography before any other treatment; clicking that is objective tinnitus, measurable in clinic; and musical tinnitus, which is an auditory deprivation phenomenon — not psychiatric. Teresa's case illustrates pulsatile tinnitus: 8 months unimaged, venous sinus stenosis found on CT angiography, resolved after neurovascular treatment. The lesson is not subtle. Any tinnitus that started suddenly alongside sudden hearing loss — especially one-sided — is a same-day medical emergency. Do not wait. Dr. Garrett holds the Au.D., CH-TM, and ABAC and practices at Timpanogos Hearing & Tinnitus, Utah's only full-time tinnitus specialty center.

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If your hearing aids still feel noisy, uncomfortable, frustrating, or not helpful enough, it can be easy to wonder whether you bought the wrong devices — or whether hearing aids just do not work for you. But many common hearing aid problems are fixable once the real cause is identified.

In this episode, Dr. Layne Garrett of Timpanogos Hearing & Tinnitus explains five of the most common reasons hearing aids do not seem to work right: background noise, poor speech clarity, whistling or feedback, strange own-voice sound, and physical discomfort. He also explains the difference between adaptation problems, mechanical problems, and fitting or technology problems.

You'll learn why consistent wear matters, why real ear measurements, also called REM, are essential for verifying hearing aid fittings, and why speech-in-noise testing can reveal problems that a basic hearing test may miss. Dr. Garrett also explains why wax, dome size, receiver wire length, programming, and changes in hearing can all affect real-world performance.

Dr. Garrett uses a medical-model approach to hearing care, combining advanced diagnostics, REM verification, speech-in-noise testing, and practical patient counseling.

For more hearing loss and tinnitus resources, visit https://utahhearingaids.com/learning-center To schedule with Timpanogos Hearing & Tinnitus in Northern Utah, visit https://utahhearingaids.com

A rhythmic whooshing or thumping sound timed to your pulse is a different clinical presentation than standard ringing tinnitus — and it deserves a different evaluation. Dr. Layne Garrett, Au.D., founder of Timpanogos Hearing & Tinnitus, breaks down what pulsatile tinnitus actually is, why most cases trace back to manageable causes like elevated blood pressure, and why idiopathic intracranial hypertension deserves more attention than it usually gets. He walks through a real patient case where the cause turned out to be blood pressure, not something more serious, and outlines the specific signs — one-sided, new or worsening, paired with headaches or vision changes — that mean an evaluation shouldn't wait. This is medical-model audiology: recognizing the pattern accurately enough to make the right referral

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More than one in three people who invest in hearing aids stop wearing them regularly. Dr. Garrett makes the case that this outcome is almost entirely predictable — and preventable — with two steps most clinics skip. The first is a pre-fitting sound preference assessment: before any device is recommended, you listen. Research from 2026 in Trends in Hearing found that up to 40% of patients have a strong, stable preference for one manufacturer's sound processing approach over another. That preference holds across environments and over time. It's not a mood. Skipping the check means the device was selected without the most important input. The second step is real ear measurement — objective verification that the device selected for preference is also delivering the amplification your prescription requires. A 2021 systematic review found a 52% difference in user preference between REM-verified and non-verified fittings. About 70% of clinics still don't do it routinely. Margaret came in after three months with a "well-regarded" device she'd stopped wearing. Her fitting was technically correct. It just wasn't right for how she hears.

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Click here to schedule an appointment in one of our Northern Utah Clinics. --- PODCAST KEYWORDS: hearing aid fitting process, real ear measurement, sound preference testing, why hearing aids don't work, hearing aid wear rate, REM verification, audiologist best practices, hearing aid selection, "why don't my hearing aids work", "hearing aids sound wrong", hearing aid fitting Utah, audiology evaluation

A 2026 study published in the Proceedings of the National Academy of Sciences identified a direct neural pathway from serotonin-producing brainstem neurons to a key auditory relay station. Activating this circuit produced tinnitus-like behavior in mice; silencing it reduced that behavior significantly. The finding explains a clinical pattern flagged in FDA adverse event data and case reports for years — but without a mechanism, too easily dismissed. Dr. Layne Garrett breaks down what the OHSU research found, what the existing clinical record has been showing for years, and how patients who have noticed a tinnitus change after starting or adjusting an SSRI can make that conversation productive with their prescribing physician. This is a mouse model finding — not yet confirmed in humans — but it provides the biologically plausible explanation that's been missing from this discussion. Key clinical takeaways: document a clear timeline (when medication changed, when tinnitus changed), bring it to your prescribing physician, ask about alternative medication classes that don't primarily work through serotonin elevation, and ensure your tinnitus assessment includes a complete medication history. The AAO-HNS guideline already recommends against antidepressants as routine tinnitus treatment. Dr. Garrett holds the Au.D., CH-TM, and FAAA and practices at Timpanogos Hearing & Tinnitus. 0:00 When Patients Link Their Antidepressant to Tinnitus 1:00 Why Tinnitus, Depression, and Anxiety Drive Each Other 2:30 The OHSU Study: Three Findings That Change the Conversation 5:00 Marcus: When the Medication Timeline Finally Mattered 6:00 What to Do If Your Tinnitus Changed With Your SSRI 7:30 What the Evidence Means Right Now Learn more in our online learning center. Schedule an appointment in one of our Northern Utah Clinics. PODCAST KEYWORDS: antidepressants tinnitus, SSRIs tinnitus, serotonin tinnitus research, tinnitus medication side effect, tinnitus and depression, tinnitus treatment, medication and tinnitus, OHSU serotonin study, "can antidepressants m

A major 7-year study just found that hearing aids significantly reduced dementia risk — but didn't improve memory test scores. This week, Dr. Garrett unpacks why those findings aren't in conflict, and what they mean for anyone living with untreated hearing loss. The research, published in Neurology in February 2026 by Monash University, followed 2,777 older adults over seven years. Hearing aid users showed similar annual cognitive test scores — but meaningfully lower dementia rates. Dr. Garrett explains why: cognitive test scores capture current function while dementia risk accumulates slowly, invisibly, through mechanisms like effortful listening load and social withdrawal. He also breaks down a Framingham Heart Study analysis that found the strongest protective effect in people under 70 — and what that means for the "I'll wait until it gets worse" approach most patients default to. If you've been watching the dementia-hearing research closely — or you're trying to figure out what to tell a parent who keeps putting this off — this episode gives you the clinical framework to make that case.

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Most tinnitus patients who also have migraines have never been told the two are related — let alone that one may be driving the other. In this episode, Dr. Layne Garrett, Au.D., FAAA, CH-TM explains the central sensitization framework and why so many patients cycle through specialists without answers. Published research places the co-occurrence of tinnitus and migraine at 26-47%. Vestibular migraine — which can present without headache — is among the strongest predictors of tinnitus distress. A 2026 literature review from UC Irvine proposed that this triad be formally recognized as otologic central sensitivity syndrome. These may not be three diagnoses. They may be three symptoms of one overreactive nervous system. Dr. Garrett breaks down the trigeminal nerve's role in connecting migraine biology to inner ear excitability, walks through a patient case that illustrates how the right question changed the clinical picture entirely, and explains what a tinnitus evaluation that includes this framework actually looks like.

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Being told you need two hearing aids instead of one can raise an honest question: is this actually necessary, or is it just an upsell? It's a fair thing to wonder, especially when hearing aids represent a real financial commitment. In this episode, Dr. Layne Garrett of Timpanogos Hearing & Tinnitus walks through why bilateral fittings are recommended so often — and it has nothing to do with moving more units.

The short version: your brain doesn't process sound from one ear the way it processes sound from two. When both ears receive input, the brain can compare signals, filter out background noise, and locate where sound is coming from — all of which lighten the mental effort of listening. Dr. Garrett unpacks how this plays out in real environments like restaurants, family dinners, and meetings, and what actually happens to the untreated ear over time when only one side gets treated.

Listeners will come away understanding the difference between "louder" and "clearer," why auditory deprivation is a real and measurable risk, and — just as important — the specific clinical situations where a single hearing aid, CROS, BiCROS, or another approach genuinely is the right call. Dr. Garrett draws on more than two decades of clinical experience in tinnitus and complex hearing loss, using REM-verified fittings and an evidence-based, whole-person approach rather than a one-size-fits-all recommendation.

Timpanogos Hearing & Tinnitus serves patients throughout Northern Utah, offering personalized hearing evaluations, diagnostics, and treatment planning in coordination with ENTs, neurologists, and mental health professionals.

For more resources, visit our online learning center. To schedule care in Northern Utah, click here.

Tinnitus can feel confusing, frustrating, and deeply isolating — especially when someone has been told to "just ignore it" or "learn to live with it." In this episode, Dr. Layne Garrett of Timpanogos Hearing & Tinnitus explains what tinnitus actually is: the perception of sound when there is no external sound source, often shaped by both the auditory system and the nervous system.

Dr. Garrett breaks down why tinnitus may begin with hearing loss, noise exposure, medication effects, ear conditions, or other disruptions in sound input, and why the brain may respond by amplifying internal sound activity. He also explains the difference between subjective, objective, and pulsatile tinnitus, including when symptoms deserve prompt medical evaluation.

Listeners will learn why tinnitus affects some people mildly while others experience major sleep, focus, and mood disruption. The episode also covers evidence-based treatment options including hearing aids, CBT, sound therapy, tinnitus retraining therapy, REM-verified hearing aid fittings, and individualized tinnitus care.

For more resources, visitour online learning center.

To schedule care in Northern Utah, click here.