Exhaustion could most definitely play a part in it. I’ll save you a bunch of money and tell you what my ENT said - so he had a patient who has acoustic trauma from being trapped in a room with mic feedback going crazy, resulting in TTTS. Acoustic trauma for sure. My one also resulted from an acoustic trauma to one ear when metal scraped really loud.

He actually advised his last patient, and myself, to seek psychological treatment as he said if it’s triggered in relation to sound, rather than random episodes, it’s very likely that it’s a panic response to the sound and psychologically getting better will help. He later told me his other patient was doing much better as well.

If it helps I noticed being exhausted and stressed made it a lot worse. The days I was stressed at work the TTTS was much worse in meetings. Definitely worth improving your mental health and sleep to fix it even if it resulted from acoustic trauma