A “whooshing” sound heard in the ear, particularly when lying down, is a common and often puzzling sensation. This internal noise can be concerning, as it sometimes feels amplified or more apparent in quiet environments. Understanding its nature can alleviate worry. If persistent or bothersome, it warrants attention.
Understanding the “Whooshing” Sound
The “whooshing” sound in the ear is often rhythmic and synchronized with one’s heartbeat. This specific internal sound is medically termed “pulsatile tinnitus.” Unlike other forms of tinnitus (ringing, buzzing, or hissing), pulsatile tinnitus has a physical source within the body. It represents an amplified perception of blood flowing through vessels near or within the ear. This sound arises from the ears detecting normal or altered blood circulation, and its presence often signals that the body’s vascular system is creating audible vibrations.
Why Position Matters: Causes Linked to Lying Down
The whooshing sound often becomes more noticeable when lying down because positional changes affect blood flow and pressure in the head and neck. Shifting to a supine position redistributes blood, making vascular sounds more apparent. This altered blood flow directly influences how sound is perceived by inner ear structures.
Increased blood flow or pressure to the head is a significant factor. Lying flat can increase the force with which blood moves through vessels near the ear. Conditions like high blood pressure can cause blood to flow more forcefully. Similarly, increased overall blood volume or flow, as seen during pregnancy, severe anemia, or an overactive thyroid, can heighten this effect.
Benign intracranial hypertension (BIH), also known as idiopathic intracranial hypertension (IIH), is characterized by increased pressure within the skull. This elevated pressure often worsens when lying down, contributing to pulsatile tinnitus. The increased pressure can narrow large veins draining blood from the brain, creating turbulent flow heard as a whooshing sound. This condition is frequently associated with headaches and vision changes.
Vascular issues directly impacting blood vessel structure and flow can also become more prominent. Atherosclerosis, a hardening or narrowing of blood vessels due to plaque buildup, can cause turbulent blood flow that becomes audible. Abnormal connections between arteries and veins, such as dural arteriovenous fistulas or malformations, can also generate loud, pulsatile sounds.
Structural variations in veins, like a venous hum or a sigmoid/jugular sinus diverticulum, can cause turbulent blood flow that is more easily heard when lying flat. Tumors in the head or neck, even if benign, can press on nearby blood vessels, altering blood flow and potentially causing a whooshing sound.
Eustachian tube dysfunction, specifically a “patulous” Eustachian tube, can also play a role. In this condition, the tube, which normally remains closed, stays open, allowing internal sounds like breathing and heartbeat to be transmitted directly to the middle ear. Positional changes may alter the perception of these internal sounds.
When to Seek Medical Advice
While a whooshing sound can sometimes be benign, certain accompanying symptoms warrant prompt medical evaluation. Consult a healthcare provider if the sound is persistent, worsens, or significantly interferes with daily life or sleep.
Additional symptoms that require medical attention include:
Dizziness
Sudden changes in hearing or hearing loss
Persistent headaches
Vision changes, such as blurred or double vision
Feelings of weakness, facial numbness, or issues with balance
If the whooshing sound begins suddenly or is only present in one ear, a medical consultation is important to rule out underlying conditions.
What to Expect at the Doctor’s Office
When consulting a doctor about a whooshing sound, the visit typically begins with a detailed medical history. The doctor will ask about the sound’s duration, frequency, characteristics, and any positional triggers, along with other symptoms.
A physical examination will follow. This may include the doctor listening with a stethoscope near your ear, neck, and sometimes your chest to detect the sound. Blood pressure will likely be checked, and a neurological exam performed to assess nerve function. An examination of the ear canal and eardrum will also be conducted.
Depending on initial findings, the doctor may recommend various diagnostic tests. These can include an audiogram to assess hearing, blood tests to check for conditions like anemia or thyroid issues, and imaging studies (MRI, MRA, CT, or CTA) to visualize blood vessels and structures within the head and neck. In cases where increased brain pressure is suspected, a lumbar puncture may be performed to measure cerebrospinal fluid pressure. The management approach will then depend on the identified underlying cause, ranging from medication and lifestyle adjustments to specific interventions like surgery or stenting.