For those who don’t suffer from tinnitus, there aren’t many conditions more difficult to understand. That’s because unless you’re afflicted with tinnitus, you won’t see, feel or hear the symptoms in the same way you might other ailments.

But for the nearly 50 million Americans who suffer from some form of tinnitus, the problem is very real and is often very difficult to manage. Tinnitus is best classified as ringing in the ears, but according to the American Tinnitus Association, it can present sufferers with clicking, whistling, hissing, swooshing, and buzzing. Maybe the most frustrating part of tinnitus is that these sounds aren’t detectable by others, which can lead to confusion, disorientation, depression and delayed diagnosis.

While that 50 million number is huge, it’s even more staggering when put in the context that it means about 15 percent of the overall public struggles with tinnitus. A report released by the U.S. Center for Disease Control says that 2 million of those people experience symptoms that are debilitating and severe while another 20 million have what’s known as burdensome and chronic tinnitus.

There’s a common link between hearing loss and tinnitus, which is why people frequently turn to hearing aids to enhance their hearing and to drown out the ringing. While a hearing aid has proven to be an effective method of lessening the symptoms associated with tinnitus, there are behavioral changes you can make to decrease the ringing.

If you have tinnitus here are 10 things to avoid:

• Alcohol; There’s a common adage that says drinking a small amount of wine daily can have a positive influence on heart health and cholesterol levels, and that might be true; however, you absolutely can have too much of a good thing when it comes to alcohol and tinnitus. For some people drinking too much alcohol makes tinnitus symptoms more evident because it tends to increase your blood pressure.
• Loud sounds; This one probably seems obvious, but it bears reiterating that loud noises can worsen the sounds you’re already hearing internally. If a scenario happens where you will be exposed to loud noises, be mindful. This can include concerts, loud restaurants, and construction sites. If you can’t abstain from loud settings, think about using earplugs to shield you from some of the noise. People who work at loud jobs are especially benefited by ear plugs.
• Unsafe blood pressure levels; If you want to keep your tinnitus at bay you should keep track of your blood pressure which can also help protect you from other illnesses. It’s important to note that both high and low blood pressure levels can make your tinnitus worse, so you should be persistent about regularly checking your blood pressure.
• Caffeine; Here’s another influencer of blood pressure that can cause a surge in levels. You will most likely notice a change in sleeping habits if you drink too much caffeine.
• Smoking; Smoking is another habit that can increase your blood pressure. Also, it can make the tinnitus worse by shrinking the blood vessels to the ears.
• Excess earwax; There’s no doubt that earwax is helpful in the grand scheme of how your ears work. But actually dirt is trapped and our ears are protected by this gunk that we hate. That being said, too much accumulation can cause tinnitus to get worse. To make sure it doesn’t build up to a dangerous amount, your doctor can clear some of it out and help with prevention.
• Jaw issues; If you’re having jaw pain, you should already be visiting a doctor, but particularly if you also suffer from tinnitus. Because the jaw and ears share components like nerves and ligaments, minimizing jaw pain may have an impact on your tinnitus.
• Specific medicines; Over-the-counter medications including aspirin and other non-steroidal anti-inflammatory drugs can be quite effective at soothing pain, but they may actually increase your tinnitus symptoms. There are other prescription medications including cancer drugs and antibiotics that can also have an impact on tinnitus. But before you quit taking a medication that was prescribed by your doctor, you should get a consultation.
• Poor sleeping habits; When mom said you need to get your eight hours of sleep each night, she wasn’t kidding. Sleep is another essential aspect of healthy living that offers a wide range of benefits, including helping to avoid triggers of tinnitus.
• Infections; Since a lingering cold can quickly turn into a sinus infection there has always been commentary about the need to find a cure for it. Infections in both the ears and sinus have been known to worsen tinnitus, so be sure you’re doing everything you can to reduce your exposure to infections.

Even though there’s no established cure for tinnitus, there are ways to manage the symptoms and take back your life. You may be surprised in the changes in your general health and your tinnitus symptoms if you try these 10 recommendations. If these don’t help, set up an appointment with a hearing specialist.