When lying down, some individuals notice a distinct pulsing or whooshing sound in their ears, synchronized with their heartbeat. This phenomenon, called pulsatile tinnitus, is a rhythmic noise mirroring the body’s circulatory rhythm. While often unsettling, it is frequently benign. Understanding its causes can provide clarity and alleviate concern.
The Science Behind the Sound
Hearing internal body sounds, such as the heartbeat, involves the ear’s mechanics and the body’s vascular system. When lying down, changes in blood flow dynamics can make these internal sounds more noticeable. The proximity of major blood vessels, such as the carotid artery and jugular vein, to the ear allows the sound of blood flow to be perceived.
Blood flowing through vessels creates vibrations, which transmit through surrounding tissues and bone to the inner ear. Pulsatile tinnitus describes this perceived sound, whether a whooshing or thumping, aligning with the heart’s rhythm. Unlike other forms of tinnitus, which might involve constant ringing, pulsatile tinnitus often has a physical source related to blood circulation.
Common Explanations
Many factors can lead to hearing one’s heartbeat in the ear, and most are not indicative of a serious health concern. A quiet environment, especially when lying down, significantly reduces external noise, allowing the auditory system to become more attuned to internal bodily sounds. Positional changes, like lying down, can lead to a redistribution of blood flow, potentially increasing it to the head and neck, making circulation sounds more audible.
Temporary increases in blood pressure, such as after physical activity, during stress or anxiety, or pregnancy, can heighten the perception of blood flow, resulting in a more pronounced pulsatile sound. Blockages within the ear canal, such as earwax buildup, or fluid accumulation in the middle ear from conditions like a cold or allergies, can create a conductive hearing loss. This can make a person more aware of sounds originating from within their own body.
When It Signals More
While often harmless, hearing one’s heartbeat in the ear can sometimes indicate an underlying medical condition that requires attention. Systemic issues like high blood pressure (hypertension) can increase the force of blood against vessel walls, making the sound of blood flow more pronounced. Anemia, a condition characterized by a reduced number of red blood cells, can increase blood flow and contribute to pulsatile tinnitus. Thyroid disorders, particularly an overactive thyroid (hyperthyroidism), can accelerate heart rate and increase overall blood flow, leading to audible pulsations.
Vascular conditions affecting blood vessels near the ear are frequently associated with pulsatile tinnitus. Atherosclerosis, the hardening and narrowing of arteries due to plaque buildup, can cause turbulent blood flow, generating a whooshing sound as blood moves through constricted vessels. Carotid artery disease, involving the major arteries in the neck supplying blood to the brain, can also disrupt smooth blood flow. Certain vascular malformations, such as arteriovenous malformations (AVMs), abnormal tangles of blood vessels, can create turbulent flow that is perceptible as sound.
Specific ear-related conditions can also be a source of pulsatile tinnitus. Glomus tumors, typically benign growths in the middle ear or near the jugular vein, are highly vascular and can press on blood vessels, causing a pulsing sound synchronized with the heartbeat. Otosclerosis, a condition affecting the bones in the middle ear, can also sometimes be linked to pulsatile tinnitus. Increased pressure around the brain, known as idiopathic intracranial hypertension, can also manifest as pulsatile tinnitus, sometimes accompanied by headaches or vision changes.
Seeking Professional Guidance
Seek medical advice for hearing one’s heartbeat in the ear if the sensation is persistent, new, or accompanied by other symptoms. A medical evaluation is particularly important if the sound occurs in only one ear, or if there are additional concerns like dizziness, headaches, vision changes, or hearing loss. Consulting an otolaryngologist (ear, nose, and throat doctor) allows for a thorough assessment.
The diagnostic process typically begins with a detailed medical history and a physical examination of the head and neck. The doctor may use a stethoscope to listen for the sound, which can help determine if it is “objective” (audible to others) or “subjective” (audible only to the patient). Further diagnostic tests might include blood tests to check for conditions like anemia or thyroid disorders. Imaging scans, such as MRI, MRA (magnetic resonance angiography), CT scans, or CT venography, are often employed to visualize blood vessels and structures in the head and neck, helping to identify vascular abnormalities, tumors, or other underlying causes. The management of pulsatile tinnitus depends on the specific underlying cause identified through this comprehensive evaluation.