Dizziness is a large-scale health issue, particularly among the older population. In a sample of people aged 65-75, one-third reported that dizziness and imbalance degraded the quality of their lives,32 while balance-related falls account for more than one-half of the accidental deaths in the elderly. According to the NIH (National Institute of Health) in the US, 347,000 hospital days are incurred each year in the general population because of balance disorders.
Dizziness and vertigo relief through Sound Therapy
John Clancy, a music teacher, and founder of the Gippsland Chamber Opera Company, woke up one morning feeling dizzy. He also had a sense of liquid fl ooding the inside of his head and dry, sore eyes. Th ese peculiar symptoms plagued him for eight months during which time he consulted no less than six general practitioners, two ear specialists, a physician, a neurologist, a chiropractor, an acupuncturist, a shiatsu masseur, a naturopath and a Chinese medical practitioner. None of them was able to help. While eye drops fi xed the dry eyes, the ear problems proved a mystery because the doctors who examined him could fi nd no problem with his ears – the organ of balance.
After a year, the dizzy sensations changed and he felt as though he was being pulled to the left. “It was on a trip to South America that I began to notice a few persistent patterns,” said Clancy, describing
32 ‘A Report of the Task Force on the National Strategic Research Plan,’ National Institute on Deafness and other Communication Disorders, National Institutes of Health, Bethesda, Maryland, April 1989, p.74.
Sound Therapy ~ Music to Recharge Your Brain
how journeys by boat always produced attacks of imbalance. “A two hour crossing by boat from Colonia in Uruguay to Buenos Aires produced a severe attack which lasted for about three days.”
However he was puzzled that on a trek on the Inca Trail, at an altitude of about twelve thousand feet, the condition seemed to disappear.
Th e fact that this condition was alleviated at high altitude points clearly to a relationship between balance and air pressure. A reduction in air pressure at high altitude will also reduce the air pressure in the middle ear and may, in turn, impact the fl uid pressure in the inner ear.
Clancy eventually decided to try Sound Th erapy, since nothing else had given any promise of relief. Th is is what he had to say about Sound Th erapy:
“For the fi rst two or three weeks, I did not feel that any change was taking place. Then gradually I began to notice an improvement. The pull to the left side of my head seemed to be waning. My feelings of imbalance began to improve. I persisted with the therapy, confi dent now that things were under repair.
I continued the Sound Therapy for the required three months.
My sense of balance has now virtually returned to normal.”
How our sense of balance works
Th e role of the vestibular apparatus, (the semicircular canals in the inner ear) is to communicate to the brain, via the vestibular branch of the auditory nerve, that there is sudden movement of the head.
When this sensation persists in the absence of real movement, it gives the patient the feeling that the world is spinning or falling away beneath them, as in a Meniere’s attack.
Th ere are several diagnoses which may be given for ear-related balance problems, including Meniere’s syndrome, vestibular infl ammation (neuronitis or labyrinthitis) or BPPV (Benign Paroxysmal Positional Vertigo.) If it is not ear-related, dizziness could be due to low blood
Part 3: Chapter 3 ~ What Sound Therapy Can Do For You
pressure or a series of strokes aff ecting the parts of the brain which process our sense of balance.
Sound Th erapy has proved helpful in many types of balance disorders and this could be for a number of reasons. Most notably:
Getting the middle ear muscles to relax may help to reduce 1.
excess pressure, fl uid imbalances and infl ammation of the inner ear mechanisms.33
Th e positive stimulation of the auditory pathways in the 2.
brain may help sensory integration and improve the way the brain provides our sense of balance through its interpretation of signals received from the eyes, ears and joint receptors.34
Meniere’s
Meniere’s syndrome is a diagnosis given to a set of symptoms which includes sudden dizzy attacks, low frequency tinnitus, a feeling of fullness in the ear, and progressive hearing loss. While the cause is unknown, there is evidence that the condition is related to too much pressure on one of the fl uids in the inner ear. Th is fl uid is called endolymph, and it is held in part of the cochlear spiral, called the scala media, as well as in the semi-circular canals which give us our sense of balance. Th e processes that occur in the inner ear are extremely complex and much of its workings are still not fully understood.
However several clinicians have observed that levels of fl uid pressure in the whole body aff ect the pressure in the ear. For some women, dizzy attacks are more prevalent during the half of their
33 Klockhoff, I., ‘Impedance fl uctuation and a “tensor tympani” syndrome,’ in: Proceedings of 4th International Symposium on Acoustic Impedance Measurements, edited by Penha and Pizarro,Universidade Nove de Lisboa, 1981, pp.69-76. Facsimile on www.
tinnitus.org
Hazel, J., ‘Things that go Bump in the Night,’ from ITHS Newsletter, 5 Jan 2003.
Golz A; Fradis M; Martzu D; Netzer A; and Joachims HZ., ‘Stapedius muscle myoclonus,’ Ann. Otol. Rhinol. Laryngol., 112(6) 2003, pp.522-4. Cited on:
http://www.dizziness-and-balance.com/disorders/hearing/tinnitus.htm
34 Jones, E. G; and Powell, T. P. S., ‘An Anatomical Study of Converging Sensory Pathways Within The Cerebral Cortex of the Monkey,’ Brain 93, 1970, pp.793-820.
Sound Therapy ~ Music to Recharge Your Brain
menstrual cycle prior to menstruation (from ovulation through the menstrual bleed). When fl uid retention is relieved from the body after menstruation, it appears that this also reduces the pressure on the ear.35
Symptom management is typically achieved through the drug Serc.
While this has been a life-saver for many people, it can have side eff ects with prolonged use. Meniere’s is also often managed via the practice of reducing salt intake, to reduce fl uid retention in the body, and this is found to help alleviate the dizziness.
However we need salt to help the body perform a variety of essential functions. Salt helps maintain the fl uid in our blood cells and is used to transmit information in our nerves and muscles. It is also used in the uptake of certain nutrients from our small intestines.
Th e body cannot make salt and so we are reliant on food to ensure that we get the required intake. Th erefore it may be preferable to fi nd another solution to Meniere’s, rather than permanently going without an important mineral.
While we know that reducing fl uid retention by cutting out salt does help to manage the symptoms of Meniere’s, this does not explain why the dizzy attacks are typically so sudden. Dr. Tomatis has proposed that Menieres’s vertigo is due to an anomaly in the tension of the stirrup muscle in the middle ear.36 Th is muscle may be subject to involuntary twitches or spasms, like any other muscle in the body. Such twitching would radically alter the fl uid pressure in the inner ear chambers, thus causing havoc with the balance mechanism.
It may be due to the re-toning of the stirrup muscle achieved by Sound Th erapy that listening helps to reduce or eliminate the dizzy attacks for some people. Research is needed in this area to determine how this mechanism occurs, and to clarify its relationship to Sound Th erapy.
35 Morse, Dr. Gwen, ‘Changes in Meniere’s Disease Responses as a Function of the Menstrual Cycle,’ cited on 9th August 2009, http://oto2.wustl.edu/men/mn8.htm 36 Tomatis, A.A., The Conscious Ear, Ibid.
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In order to maintain good ear health and pressure regulation, we recommend that Meniere’s suff erers continue long-term Sound Th erapy listening. Th ough we do not fully understand the mechanism or progression of Meniere’s, the improvement that some listeners have had with their dizziness shows that Sound Th erapy increases healthy ear function, so we can surmise that long-term input may increase the chances of reducing degeneration.
Here is what one listener said about Meniere’s:
“I’ve had Meniere’s on and off for about ten years, I used to get so giddy I would have to call a doctor. It had become progressively worse, and I’d have an attack about once a fortnight. My attacks made me nauseous, and I’d get diarrhoea with it. If an attack happened at night, my husband had to take me to hospital for a shot of stematil or maxilon. I tried SERC, multi B forte and changed my diet, with little improvement.
I started listening to Sound Therapy for three hours a day, and it was about eight weeks before I noticed a difference. I became able go up to three months without an attack or feeling giddy, and I’ve only had to have one shot in the last year, when I cut back to two hours listening a day. I’m back up to three hours a day listening now and I can’t speak highly enough of it, Sound Therapy is a miracle for me, to change such a debilitating thing.”
Name withheld.
Another said:
“So far the therapy has completely eliminated my attacks of Meniere’s Syndrome. – a miracle.”
Rupert Francis, Lower Templeston.
Another listener, Shirley Cowburn, shared her story on balance recovery in our very fi rst edition of this book. Recently (i.e. now in 2009) she made contact again and wrote:
Sound Therapy ~ Music to Recharge Your Brain
“I went to work, shopped, did housework and cooking at home and generally ‘lived’ with the earphones in my ears (a strange sight for a middle-aged woman in 1984!!) I only listened with the music in the background, not loudly at all. After about three months or so my balance, which had been awful for many years had gone back to normal. That was 25 years ago and I’m still the same today.”
BPPV (Benign Paroxysmal Positional Vertigo)
Benign Paroxysmal Positional Vertigo (BPPV) is sometimes mistaken for Meniere’s Disease and some people may receive both diagnoses from diff erent practitioners. BPPV is generally typifi ed by dizziness that comes on as a result of a particular movement:
for example rolling over in bed, or bending to do up your shoes. BPPV can have many causes, and not all of them are well understood at this time. A popular current theory is that BPPV is usually caused by free-fl oating calcium crystals in the posterior semicircular canal, one of the three canals of the vestibular system.37 Th ere is a treatment, called the Epley manoeuvre, or canolith repositioning, in which the head is tilted in a certain procedure, by a trained practitioner, in order to dislodge the crystals from the canal.
Th is may be eff ective temporarily or permanently. Th e audiologist or hearing clinic will help you to fi nd a practitioner who knows how to do this manoeuvre. While it is usually done by a practitioner who has been trained in the procedure, it is easy enough so that doctors often teach it to BPPV suff erers and their families.
Because BPPV is a complex condition, possibly also involving the integration of sensory pathways in the brain, canolith repositioning may or may not provide a permanent solution. Some of those diagnosed with BPPV have also benefi ted from Sound Th erapy,
37 Froehling DA; Bowen JM; et al., ‘The canalith repositioning procedure for the treatment of benign paroxysmal positional vertigo: a randomized controlled trial,’ Mayo Clinic Proceedings, 75(7) 2000, pp.695-700. Cited on 9th August 2009, from Vertigo: Its Causes and Treatment, Huai Y. Cheng, M.D.,
http://www.thedoctorwillseeyounow.com/articles/other/vertigo_17/
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perhaps because it seems to improve the pressure balance in the ear and the transmission of signals between the ear and the brain.
Dizziness and the brain
We cannot separate ear function from the auditory pathways in the brain, because the way the brain processes sensory information from the eyes, joints and ears also creates our sense of balance. When this process is not occurring correctly, chronic vestibular integration disorder may result.
An example of a person suff ering from a chronic vestibular integration disorder was Jeanette McKay, who lived constantly with a sense that the earth was moving beneath her feet. She had a lot of car sickness and other balance problems, and found this made everything in the way of learning much more diffi cult. In her own words, “I always felt the ground was moving, as if I was walking on a waterbed or something unstable. I didn’t know that other people didn’t experience this. Riding in a car I would have to watch the road all the time, even as a passenger. If anyone took a sharp turn or changed directions quickly while driving, it would really throw me out and make me feel ill, so I realised that I must have a problem with my vestibular system.”
After she started using Sound Th erapy Jeanette said, “I felt as though the earth was stable for the fi rst time in my life.” She added that,
“after Sound Th erapy, when that sense of constant motion stopped, I straight away felt more confi dent because I was more secure in my own body. It was the most amazing feeling. It also changed my peripheral vision and I believe part of that was the vestibular system settling down. I noticed that I had better depth perception, so instead of seeing everything as fl at, I could see in 3D – depth was added to my world!”
By off ering an integrated approach for the ear and brain pathways, Sound Th erapy presents a totally diff erent approach to the treatment of balance diffi culties than any previously available.
Sound Therapy ~ Music to Recharge Your Brain
Drug treatment for dizziness
Some doctors prescribe drugs called vestibular suppressants. Th ese drugs can have unwanted side eff ects, such as lethargy and impaired balance, and the elderly are particularly sensitive to these side eff ects.
For this reason they are given sparingly and only for more severe and long-lasting attacks.38
In contrast, Sound Th erapy aims at enhancing connections between the vestibular system and sensory processing in the brain, potentially giving a natural and more permanent solution.
It is always better to solve these problems by addressing the cause within the body rather than by trying to control it with medication.
Th ere is evidence now, from the fi eld of learning diffi culties and sensory integration dysfunction, that some recovery is possible from sensory integration disorders, if we are just able to give the right stimulus to the brain, providing input via the muscles and sensory systems.39
If Sound Th erapy can in fact produce improved balance, as some of our listeners have testifi ed, it may be very benefi cial for it to be used more widely, not just for suff erers of Meniere’s or other specifi c balance disorders, but for the older population where a slight improvement to balance can make the diff erence between falling or not falling. An improvement in balance could potentially save a lot of injury and loss of independence for those living alone.