If one ear suddenly sounds like it’s under a pillow—or goes quiet altogether—don’t wait it out. Sudden hearing loss can be a true ear emergency. The faster you act, the better your odds of getting hearing back. This guide explains what it is, how to spot it, what happens at the clinic, and how to protect your future hearing.
First: Why this is urgent (and different from a clog)
Not all sudden muffling is earwax or congestion. There’s a condition called sudden sensorineural hearing loss (SSNHL) where the inner ear or hearing nerve abruptly stops working—often in one ear. It can happen upon waking, during a phone call when one side suddenly goes “dead,” or after a small “pop” with ear fullness and ringing.
Common clues it could be SSNHL rather than a simple blockage:
- It’s one-sided and you can’t hear the phone or whispers on that ear.
- Tinnitus (ringing, buzzing, roaring) appears at the same time.
- Ear feels full but there’s no obvious cold or heavy congestion, and gently swallowing doesn’t clear it.
- Vertigo or imbalance may accompany it.
- No pain (earwax and infections often cause discomfort; SSNHL often does not).
SSNHL is time-sensitive because early treatment can improve recovery. While some people spontaneously recover, waiting to see “if it goes away” can cost precious hearing.
Know the clock: Hours and days matter
Studies and clinical guidelines emphasize a tight window. Starting appropriate treatment as soon as possible—ideally within the first few days—can improve the odds of regaining hearing. Many clinicians aim to initiate therapy within days and strongly prefer not to miss the first two weeks.
Good news: even if you’re outside that early window, it’s still worth getting evaluated. Some people improve later, and there are “salvage” options your care team may discuss.
Do this now: A simple action plan for Day 0–3
- Call an ear, nose, and throat (ENT) clinic or audiology practice immediately. Say “I think I have sudden hearing loss in one ear.” Many offices will fast-track you.
- If you can’t get same-day ENT/audiology, go to urgent care or an ER (especially if you also have severe vertigo, a new severe headache, facial weakness, trouble speaking, or other neurologic symptoms).
- Skip cotton swabs, ear candling, or poking around. You can push wax deeper and delay proper testing.
- Make a quick note: exact time it started, any trigger (shower, flight, loud sound, illness), ear fullness, tinnitus, vertigo, infections, recent new medications, autoimmune conditions, and whether sound is distorted.
- Protect the better ear from loud noise for now—use hearing protection if you’ll be around power tools, concerts, or stadiums.
What the clinic will do (so you’re not surprised)
1) Rule out a blockage or middle-ear problem
The clinician will examine your ear canal and eardrum (otoscopy) and may do quick checks to differentiate a mechanical issue (conductive loss) from an inner-ear one (sensorineural). If wax or fluid is causing a conductive loss, treatment is usually straightforward.
2) Get an urgent hearing test
An audiogram maps the amount and pattern of hearing loss across pitches. For SSNHL, there’s often a sudden drop in the affected ear compared to the other.
3) Start treatment promptly if SSNHL is likely
Because time matters, clinicians often begin therapy when SSNHL is suspected. Options include:
- Oral corticosteroids prescribed for a limited time.
- Intratympanic steroid injections: a tiny amount of steroid is placed through the eardrum to bathe the inner ear directly. This can be used as initial therapy or as "salvage" if recovery is incomplete after oral medication, or if oral steroids aren’t a good fit for you.
Your provider will weigh your health history, potential side effects, and preferences. Don’t start leftover medications on your own—dosage and timing are specific, and you need guidance.
4) Imaging or additional tests
An MRI of the internal auditory canals may be recommended to rule out rare causes such as a benign tumor on the hearing nerve (vestibular schwannoma). Blood tests are not routine for everyone but may be ordered if your history suggests an autoimmune, infectious, or metabolic contributor.
What causes SSNHL?
In many cases, there’s no clear single cause—doctors call it “idiopathic.” Theories include viral inflammation, immune-related processes, microvascular (tiny blood flow) issues, or inner-ear membrane rupture. While you can’t always pinpoint why it happened, you can act quickly to support the best outcome.
How recovery works (and what’s realistic)
Recovery is a spectrum. Some people notice rapid improvement over days, others gain hearing back gradually over weeks, and some have partial or no return. Earlier treatment and milder initial hearing drops generally correlate with better outcomes.
Expect follow-ups:
- Repeat audiograms to track changes.
- Adjustments to treatment if hearing plateaus or tinnitus is intrusive.
- Discussion of rehabilitation if there’s lasting asymmetry.
If tinnitus lingers, simple strategies like low-level background sound (a fan, soft music, nature sounds) can ease the contrast while your brain recalibrates. Many audiologists also offer tinnitus counseling and sound therapy.
If hearing doesn’t bounce back: practical solutions that work
Life doesn’t wait for perfect hearing—and neither should you. If a lasting difference remains between ears, the right tech can dramatically improve day-to-day communication and safety.
- Conventional hearing aids for partial losses can boost clarity and reduce listening effort.
- CROS/BiCROS systems send sound from the weaker ear side to the stronger ear, restoring awareness of voices and traffic on your “quiet” side.
- Bone-anchored solutions can transmit sound from the affected side through bone conduction to the better ear.
- Assistive listening devices (remote microphones, TV streamers) help in meetings, classrooms, and living rooms.
Working with an audiologist is key—they can simulate options in the clinic so you can feel the difference before committing. If you’re considering surgery-based solutions, they’ll coordinate with an ENT.
Protect the ear you have (and the one you love)
While SSNHL isn’t usually caused by everyday noise, it’s wise to prevent additional injury:
- Use hearing protection at concerts, in loud venues, and with tools or machinery.
- Manage cardiovascular health (blood pressure, lipids, blood sugar) with your primary care provider—healthy vessels are good for inner ears, too.
- Review medications with clinicians if you’re on known ototoxic drugs; never stop meds without medical advice.
- Sleep and stress: support recovery with rest, movement, and calming routines—you’re helping your nervous system stabilize.
How to tell wax vs. sudden loss (a quick self-check)
This is not a diagnosis, but a quick at-home clue: hum out loud. With a simple humming note, if the sound seems louder in the bad ear, that can sometimes point to a blockage. If it seems louder in the good ear, that can hint at inner-ear loss. Either way, if your hearing dropped suddenly, you should still seek urgent care.
Emotional side: it’s okay to feel rattled
Going quiet on one side can be scary. You’re not overreacting—acting fast is wise. Many people recover fully or partially, and those who don’t still live rich, connected lives with smart hearing strategies. Lean on your support system, loop in your care team, and give yourself permission to pace your day while your brain adapts.
When to go straight to emergency care
- Sudden hearing loss with severe vertigo or inability to walk straight.
- Sudden hearing loss with stroke-like symptoms (face droop, arm weakness, speech difficulty, vision changes, new severe headache).
- Trauma to the head or ear.
If you’re unsure, err on the side of being seen. Quick evaluation can make all the difference.
Your next step
If your ear suddenly went muffled or quiet, call an audiologist or ENT now. If you’re reading this for a friend, help them make the call. The sooner you’re in, the more options you have—and the more confident you’ll feel about the path forward.
Further Reading
- Sudden Hearing Loss, Fast Action: Your First 48 Hours (Hearing Loss) - Sudden Hearing Loss? Don’t Wait—The 72‑Hour Window That Can Save Your Hearing (Hearing Loss) - When Sound Disappears Overnight: Sudden Hearing Loss Needs Fast Action (Hearing Loss) - When Sound Fades Overnight: The Hearing Emergency You Should Never Ignore (Hearing Loss)Frequently Asked Questions
How can I tell if it’s just earwax or sudden sensorineural hearing loss?
Earwax usually causes a gradual muffled feeling, often with a history of Q-tip use or a recent swim/shower, and you may feel pressure or mild discomfort. SSNHL often appears out of nowhere, commonly with tinnitus and sometimes imbalance, and it doesn’t clear with swallowing or yawning. The only way to know is to get your ear examined and an urgent hearing test—don’t wait if the change was sudden.
Do decongestants or antibiotics help sudden hearing loss?
Not typically for SSNHL. Decongestants and antibiotics target middle-ear congestion or infection, which are different problems. SSNHL involves the inner ear or hearing nerve and is often treated with steroids started promptly after evaluation. Avoid starting any medication without seeing a clinician.
It started after a flight or elevator ride—should I still worry?
Ear pressure changes can cause temporary conductive hearing issues (barotrauma), which often come with ear pain and usually improve as the Eustachian tube opens. However, if one ear stays significantly muffled or quiet, especially with new tinnitus or dizziness, seek urgent evaluation to rule out SSNHL.
I’m past the first two weeks—Is it too late to be seen?
Still go. Some treatments are considered beyond the earliest window, and your clinician can assess recovery, discuss salvage options, and help with rehabilitation to improve daily communication and reduce tinnitus. Even if hearing doesn’t fully return, there are excellent solutions to keep you connected.
