Updated 4 October 2026
At a glance
- The National Institute on Deafness and Other Communication Disorders says the sound may be soft or loud and may be low or high pitched, and the NHS says tinnitus sounds may come and go, or you might hear them all the time.
- A table with four columns turns a short spike into one dated row: the hour, the situation, your response and how it looked one hour later.
- Steps to fill it, a comparison of spike days and steady days, questions for the audiology visit and a checklist follow.
- Tinnitus Journey keeps loudness, pitch or sound quality, annoyance, sleep, stress and visit notes in one dated history, so each spike row has the days around it.
A spike can rise in a few minutes and be gone before you could say what was going on. By the evening you remember that it was loud, and little else. At a visit, the question is when it happens, what is going on around it and how long it lasts, and a memory of a bad afternoon does not answer any of them.
This guide gives you one table with four columns, steps to fill it during and after a spike, a way to compare spike days with steady days, questions for the audiology visit and a checklist of what to bring. It offers no explanation for why a spike happens and no suggestions for managing the sound, because the sources cited here give none.
Why can tinnitus loudness vary, and why note the hour of a spike?
Why volume and spike hour matter
Tinnitus Journey reviewed what the cited sources say about a varying sound.
The cited sources describe a sound that varies. The National Institute on Deafness and Other Communication Disorders says that the sound may be soft or loud and may be low or high pitched. The NHS adds that tinnitus sounds may come and go, or you might hear them all the time. A sound that comes and goes has moments when it rises, and a moment can only be described by when it happened.
The sources do not say what makes the sound rise or fall, and this guide does not guess. That is why the hour is a note and not an explanation: it records when the spike was noticed, so that a clinician looking at several rows can see whether they cluster. A single row says very little. Several rows kept the same way across a few weeks say more.
The other three columns give the row its context. The situation says what was around you, the response says what you did, and the last column says how the sound looked one hour later. Together they turn a vague bad afternoon into something a clinician can read in a few seconds.
Does a spike need an explanation before I write it down?
No. Write the row first. If a pattern shows up across several rows, a clinician can help you read it.
Is the hour a measurement?
No. It is the moment you noticed the spike, in your own words, such as mid-morning or after dinner.
The Daily check-in is a guided daily pass with loudness, pitch or sound quality, annoyance, sleep, stress and concentration among its fields. In Tinnitus Journey (by Health Journey Labs), the days between spikes are written in the same answers, so a spike row is read against an ordinary day.
The four-column tinnitus spike table: hour, situation, response and one hour later
Each spike is one row. The four columns are the same every time, so rows from different days can be compared.
Four-column spike table, by Tinnitus Journey
| Hour | Situation | Response | One hour later |
|---|---|---|---|
| Mid-morning | At a desk, a meeting just ended | Wrote the loudness mark and kept working | Same mark, annoyance lower |
| Late afternoon | Walking home, busy street | Sat down for a few minutes and wrote the mark | Lower mark, still audible |
| After dinner | Quiet room, lights low | Wrote the mark and a line about the evening | Mark unchanged |
| Bedtime | In bed, about to sleep | Wrote the mark and a line about falling asleep | Asleep, no entry |
The grid measures a spike from its start to one hour later. The loudness mark is a number or word of your own choosing, used the same way each time. The last column matters most for a clinician, because it shows whether a spike settled, stayed or changed. A blank last column is acceptable and can be filled in the evening.
Free-text and voice notes go in the Daily Journal, including what the sound limited and sleep context. With Tinnitus Journey, the response column can be spoken when your hands are busy and read back later with the loudness marks.
4 steps to fill the record during and after a tinnitus spike
The steps split the work in two: a minute during the spike and a minute an hour later.
Spike record steps, by Tinnitus Journey
- Write the hour. As soon as you notice the spike, write when it was, in your own words.
- Write the situation. Put down where you were and what was going on, in a few words, without a guess about why.
- Write the response. Put down what you did, in a few words, and add a loudness mark.
- Write one hour later. After about an hour, add the new mark and a word for how it looked.
The steps keep the entry short enough to complete in the middle of a spike. Step two is the one to guard, because an explanation written on the spot tends to fix an interpretation before anyone has seen a pattern. If the fourth step is missed, write it with the evening entry and say it was late.
A day clearly worse than a usual week can be flagged in the Flare Tracker, for example a rise in loudness or annoyance, a night of broken sleep or a day when focus collapsed. Tinnitus Journey then shows whether it was a one-off or repeats across weeks.
Spike days versus steady days: a side-by-side comparison
A spike row means more when it is read against an ordinary day. The comparison below lists what to write on each kind of day.
Spike day table, by Tinnitus Journey
| What to write | A steady day | A spike day |
|---|---|---|
| Loudness mark | Inside your usual range | Above your usual range, with the hour |
| Annoyance | Your usual level | Higher than usual, even if the loudness mark did not change |
| Sleep | A usual night | A night that was broken or short |
| Concentration | Work or reading went as usual | Focus dropped, with what you were doing |
| One hour later | Nothing to add | Lower, same or higher than at the start |
Annoyance has its own row because it can move without the loudness mark moving. From Tinnitus Journey, we recommend keeping the two as separate marks, so that a clinician can see which one changed. How to read labs and hearing tests alongside loudness weeks is described in how to track labs and hearing tests alongside loudness weeks.
Weekly Goals records one small aim for the week and whether it held. In Tinnitus Journey, the aim can be to fill the last column on most spike days, and the real check-ins show whether it held.
Questions to take to the audiology visit about your spikes
The Mayo Clinic notes that you also may need to work with a hearing expert, also known as an audiologist. The American Tinnitus Association says that if no underlying medical issues are found, a person should see an audiologist for a hearing assessment and evaluation of tinnitus treatment options. The questions below are written so the clinician decides.
Questions about tinnitus spikes
Tinnitus Journey ties these audiology questions to the spike rows and the one-hour-later column.
Is a hearing assessment the right next step for me?
Ask the clinician, and write the answer and the date in the log the same day.
Is it worth reviewing my spike rows together?
Show the rows and the one-hour-later column, and ask whether they suggest anything to the clinician.
Which details in the table are the most useful?
Ask which columns the clinician would like to see more of, and write exactly those for the next few weeks.
Which tests are planned, and when will I hear the results?
Ask for the name of each test, and write the name and the date in the log.
Who do I contact between visits if something changes?
Ask whom to contact, and write the name of the person or the office in the log.
The questions ask for a review of the record. None of them asks you to read a result, and the clinician decides what the record means.
My Care Team lists clinicians and keeps short notes before, during and after a visit. In Tinnitus Journey, the questions of this section are written once and stay with the notes of the visit and the review afterward.
Checklist of what to bring to the visit
Six lines cover what to have on paper or on a screen when you arrive.
Visit checklist, by Tinnitus Journey
- The spike table, with the rows from the last few weeks.
- The number of spike days and the number of steady days in the same weeks.
- The loudness and annoyance marks, with the sleep and concentration notes from the spike days.
- The dates of any hearing test or other ENT workup.
- The names of the medicines you use and the date of any change a clinician made.
- Up to three questions, the most important first.
The checklist measures readiness. Each line is ready or missing, and a missing line is a reason to fill it the evening before. The page should stay short (Tinnitus Journey checklist), since a clinician reading it has only a few minutes. A related guide on a short appointment is how to prepare for a short ENT visit with tinnitus notes.
The Doctor Report is a one-page summary exported from the logged history, with dates, loudness and annoyance marks, sleep, stress or noise context and how you functioned. With Tinnitus Journey, the page for the visit is built from entries you already made.
Tinnitus spikes: what one spike cannot show, and when to get urgent help
List of spike limits and urgent care
Tinnitus Journey lists limits on spikes and signs that need urgent care.
One row records an event, and some things need several rows or a clinician:
- What a spike means: one row gives no reason for it.
- Whether things are getting better or worse: that needs rows from several weeks.
- What to do about the sound: the table records the day and gives no instructions.
- Any medical decision: that stays with the clinician.
Two changes are signals to seek attention and not entries for the table. Cleveland Clinic says: If you hear your heartbeat in your ears, contact your primary care doctor. For hearing that drops suddenly, the NIDCD says that you should consider sudden deafness symptoms a medical emergency and visit a doctor immediately. For an emergency, use the local emergency number.
Starting the log from scratch is described in how to start tracking tinnitus without building ten systems.
AI companions already see the logged history and are used for visit wording, a calm partner script about quiet space or a listening ear after a loud night. In Tinnitus Journey, they help word a question, and the log supplies the facts behind it.
How Tinnitus Journey can help
A notebook page with four columns is enough to start. When you would rather keep the table on a phone, Best Tinnitus Apps 2026 sets out what a tinnitus tracker can hold before you choose one.
Tinnitus Journey is a personal tinnitus tracker from Health Journey Labs on the App Store and Google Play. It lets you keep loudness, annoyance, sleep, stress and visit notes in one dated history, so each spike is recorded with the days around it. Across weeks, the history shows whether a rise in loudness or annoyance was a one-off or repeats, and the Doctor Report turns the dates into one page for the clinician. Below is what you can use and how each part helps.
- Daily check-in — A guided daily pass for physical symptoms, emotional state, sleep and outside factors, with loudness, pitch or sound quality, annoyance, stress and concentration among its fields.
- Daily Journal — Free-text and voice notes for what the sound limited, sleep context, partner or quiet-space lines, visit debriefs and leftover fear after a loud night.
- Flare Tracker — Flags a day clearly worse than a usual week, such as a rise in loudness or annoyance, a night of broken sleep or a day when focus collapsed.
- Weekly Goals — One small aim for the week and whether it held, read against the real check-ins.
- My Meds — Medicine names and medication entries, including options your clinician already cleared for sleep or anxiety, read with sleep and the rest of the tracked history.
- AI companions — Clara for general chat and specialist companions that already see the logged history, used for visit wording, a calm partner script about quiet space or a listening ear after a loud night.
- Doctor Report — A one-page summary exported from the logged history, with dates, loudness and annoyance marks, sleep, stress or noise context and how you functioned.
- My Care Team — Lists clinicians and keeps short notes before, during and after a visit, so what to ask and bring stays with the history.
- My Labs — Result dates for hearing tests, imaging and other ENT-related workups, read with loudness, sleep and function.
- Learn — Short education topics and prompts on sleep, stress stacks, visit prep and why annoyance still belongs in the log, read with your own logged weeks.
- My Assessments — Structured check-ins beyond the daily scores, plus life and social context from onboarding, read with the ongoing history.
- Food Tracker — Meal or drink lines, read with sleep and energy.
- Weight Tracker — Scale or body notes, read with the rest of the logged history.
- Period Tracker — Start and stop dates, flow and how heavy or light bleeding felt, read with sleep, stress and everything else logged.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Tinnitus Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- National Institute on Deafness and Other Communication Disorders — Tinnitus
- National Health Service — Tinnitus
- Cleveland Clinic — Tinnitus
- National Institute on Deafness and Other Communication Disorders — Sudden deafness
- Mayo Clinic — Tinnitus: diagnosis and treatment
- American Tinnitus Association — Who should I see for help?
FAQ
The answers below draw on the sources cited in this guide, and the app they mention is Tinnitus Journey (by Health Journey Labs).
Why write the hour of a spike?
Because a sound that comes and goes needs a moment to be described. The hour lets a clinician see whether several rows fall at similar times, and it takes only a few words, such as mid-morning or after dinner, in your own language.
Custom symptoms in Tinnitus Journey let you add your own labels to one dated history, so a spike can have its own row and be counted over the weeks like any other symptom you log.
Is it usual for the sound to change?
The cited pages describe a sound that varies in loudness and pitch and that may come and go, so a change from one hour to the next is a reason to write it down. The pages give no reason for the change, and this guide offers none either.
Insights and correlations in Tinnitus Journey strengthen as the shared history grows, so a few weeks of spike rows give the app more to read than a single bad day, with no extra writing from you.
How do I mark loudness?
Use a number or a word that you choose, and use it the same way each time. A scale from zero to ten is enough for many people, and the exact scale matters less than keeping it fixed, because the rows are compared with one another.
The guided daily form in Tinnitus Journey carries loudness, pitch or sound quality and annoyance as ready fields, so the mark you chose is entered in the same place on each day without having to rebuild the layout.
What counts as a situation?
Where you were, what you were doing and who was around, in a few words. Leave out any guess about why the spike happened, because the point of the column is to describe, and the reading of the pattern belongs to a clinician.
Voice entry in the Daily Journal of Tinnitus Journey lets you speak the situation when your hands are busy, and the note stays in the dated history so you can read it back at the end of the week.
What do I write in the response column?
What you did, in a few words and without a verdict. The column is a record and gives no advice about what to do, so a plain line such as sat down or kept working is the right size, and it is the same for a good result or a poor one.
Tinnitus Journey keeps the response lines in the same history as the loudness marks and the sleep notes, so a clinician can see in one place what the day held and how the sound looked an hour after your response.
What if I forget the one-hour-later column?
Fill it in the evening and say that it was late, for example by writing the word late with the mark. A late mark is still useful, and a blank column is acceptable too. A table that is kept most of the time beats one that is perfect for a week.
The calendar view and the weekly and monthly views in Tinnitus Journey color days by intensity, so a day with a late or blank mark is still visible among the other days when you look back over the month.
Should sleep go into the table?
Sleep belongs to the daily entry rather than to a spike row. A short sentence on how the night went is enough, and the clinician can read it alongside the spike rows of the following day without the table becoming crowded.
My Assessments in Tinnitus Journey adds structured check-ins beyond the daily scores, read with the ongoing history, so sleep and stress are captured in a form that is the same each time and sits in the same history as the spike rows.
What if the annoyance is greater than the loudness?
Write both as separate marks. Annoyance can rise when the loudness mark does not, and a clinician can only see that if the two are written apart. It is a real part of the day and belongs in the record even when the sound itself seems unchanged.
Learn in Tinnitus Journey has short topics on why annoyance still belongs in the log, read with your own logged weeks, so the second mark has a reason you can point to when someone asks.
What do I do if my hearing drops suddenly?
Use the local emergency number or seek care at once, and do not wait for the next visit or for the one-hour column. Sudden hearing loss calls for contacting someone, and the table has no row for it. Say how quickly it came on and which ear is affected when you reach someone.
A day that is clearly worse can be marked in the Flare Tracker of Tinnitus Journey afterward, which gives a clinician a dated record of the change and shows how it compares with the weeks before.
What if the sound beats with my heartbeat?
Contact your primary care doctor and say what you hear, without waiting for the visit. A sound that follows the pulse is a signal to seek attention. Write the date you noticed it and tell the clinician when you first heard it.
The Daily Journal in Tinnitus Journey takes a short note for what the sound limited and a look-fine mismatch line, which leaves a dated description of the change that you can read aloud at the appointment without relying on memory.
What do I bring to the audiology visit?
The table with the last few weeks of rows, the count of spike days, the dates of any hearing test, the names of the medicines you use and up to three questions with the most important first. A written question is more likely to be asked.
My Care Team in Tinnitus Journey lists clinicians and keeps short notes before, during and after the visit, so the questions stay with what was said during the visit and are easy to find again afterward in the same history.
Can the table fit on one page?
It can, if you keep the counts and the strongest rows and leave the long notes in the log. A page with the spike days, the number of steady days and a few rows reads in a minute and invites the clinician to ask about the details.
The Doctor Report in Tinnitus Journey exports a one-page summary from the history you already logged, so the dated count is on a single page and nothing is retyped for the appointment or copied from old notes.
How do I explain a spike to someone nearby?
Say that you are writing down when it rises and what is going on, so a clinician can read it. They can help by noting the hour they noticed you go quiet, without being asked to judge how loud it was or what is behind it.
The AI companions in Tinnitus Journey already see the logged history and are used for a calm partner script about quiet space, so the words for that conversation are ready well before the next spike.
Is a paper table enough?
A paper table with four columns and a row for each spike holds the same information. Choose the format that you will fill in on a busy day, because a table with gaps is harder to read than a short one that was kept steadily over a month.
Tinnitus Journey keeps all entries as one shared history on the phone, with guided forms that carry the key questions, so the table, the daily marks and the visit notes are read together instead of in separate places.
How much privacy does my symptom record need?
Notes on ringing, sleep and mood can be sensitive, especially when hearing affects work or noise exposure claims. Use a screen lock, keep the log on your own device, and share the dated summary only with the hearing clinician or the office that requested it.
Entries you make in Tinnitus Journey are your own health notes, and the app's privacy policy describes how data is stored and handled. This article offers general information and is not medical advice.