Audiologist who woke to tinnitus urges UK shift to holistic, patient-centered care

An audiologist who developed tinnitus says the condition demands a radical shift in UK care. Dr. Gladys Sanda began experiencing a constant buzzing in her head on March 16, 2020, a moment she says changed her understanding of tinnitus. The episode followed years spent diagnosing and treating patients with the condition and occurred amid a stressful period during the COVID-19 outbreak, when she found herself furloughed and with more time to dwell on the sound.

Even as an expert, Sanda says tinnitus left her overwhelmed and afraid. "My knowledge didn’t stop me feeling overwhelmed and afraid," she recalled, describing nights when the noise kept her awake. The noise affected her confidence and led to anxiety about being alone with the sound; at times she needed to play acoustic guitar for hours to calm down. She notes that stress can trigger or worsen tinnitus, releasing hormones such as cortisol and adrenaline that can change how the brain processes sound. This personal experience, she says, has become a teaching tool as she now helps others cope rather than simply endure.

Sanda has since developed what she calls a three-step program designed to reduce the emotional toll of tinnitus by addressing three interconnected systems: the auditory pathway, the limbic system which governs emotions, and the brain’s attentional network that determines what we focus on. She argues that successful management hinges on more than correcting hearing loss; it requires addressing how people think and react to the sounds they hear.

The first step in her approach is a physical assessment of the ear to rule out obstructions such as infections or wax. If that does not resolve the tinnitus, the second step is a questionnaire to gauge anxiety and stress and to determine how much the tinnitus intrudes on a person’s life. The third step is what she calls tinnitus coaching, a form of talking therapy grounded in cognitive behavioral therapy and mindfulness. The goal is not to eradicate tinnitus—which, at present, cannot be cured—but to rewire the brain’s threat response so that the noise becomes less of an emotional trigger.

Her coaching emphasizes that the brain’s prefrontal cortex acts as a decision-maker for attention and that fear-based processing can amplify tinnitus, creating a cycle of distress. By reframing thoughts and developing coping strategies, patients can regain control over how they respond to the sound. Sanda notes that some patients improve after just a couple of sessions, while others require longer, ongoing work; progress depends on what fuels the distress and how ready a person is to shift from a cure mindset to a living-well-with-tinnitus mindset.

Sanda’s stance reflects a broader critique of current UK practice. She argues that much of tinnitus care in the NHS and private clinics emphasizes symptom management rather than addressing underlying distress. While many people with tinnitus also have some degree of hearing loss—roughly 90 percent in this group—hearing aids alone do not always relieve the problem. In addition to hearing aids, retraining therapies that use sound to retrain the brain and cognitive behavioral therapy are used, but access and effectiveness vary.

UK health-sector data and advocacy groups echo concerns about access and consistency. A Tinnitus UK report titled Ringing the Alarm found that NHS patients face long waits for ENT appointments—up to three years in some cases—and delays for hearing-aid funding, psychology services or CBT referrals. Even in private practice, a sizable share of clinicians report that tinnitus care remains a low priority. Against that backdrop, Sanda says she has actively expanded training, teaching 50 healthcare professionals—within the NHS and the private sector—since April of the prior year.

Her work is rooted in clinical experience and patient stories. She recalls a 36-year-old woman who cried during her first consultation; the patient felt her life had shut down—unable to travel, start a family, or pursue writing. Through tinnitus coaching, the woman confronted fear, learned to manage reactions to the sounds, and gradually resumed life, eventually planning a holiday and completing a book. Sanda stresses that individual trajectories vary; while some improved quickly, others needed a year or more of work. Her message to patients and providers is clear: many people can live well with tinnitus if care is comprehensive, consistent and centered on the person rather than the symptom.

In addition to advocating for systemic changes, Sanda underscores the need for vigilance about warning signs that may accompany tinnitus. Four patterns warrant prompt medical attention: tinnitus in one ear or asymmetrical tinnitus, which could signal a benign growth on the auditory nerve; sudden hearing loss with tinnitus, treated as a medical emergency; and pulsatile tinnitus, which may indicate a vascular issue. She also advises seeking medical advice if tinnitus worsens with physical activity.

If implemented more broadly, Sanda’s holistic, patient-centered model could reshape how tinnitus is managed in the United Kingdom, moving beyond mere coping strategies toward a framework that treats the ear, the mind and the attention system together. As she notes, the ultimate goal is to help people live with tinnitus without letting it define their daily lives, a shift she believes is both achievable and overdue.