(SHL) is defined as greater than 30 d B hearing reduction, over at least three contiguous frequencies, occurring over 72 hours or less. It occurs most frequently in the 30 to 60 year age group and affects males and females equally. Although called sudden, it seems unlikely that hearing loss is abrupt but rather it probably evolves over a few hours. SHL is usually unilateral (that is, it affects only one ear); and is often accompanied by tinnitus, aural fullness, vertigo, or any combination. The amount of hearing loss may vary from mild to severe, and may involve different parts of the hearing frequency range. About one third of people with SHL awaken in the morning with a hearing loss. A discussion of sudden bilateral hearing loss is found here. SHL also should be "sensorineural" meaning that it is not caused by a mechanical process such as ear wax (which causes a "conductive" loss). 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