I think being dehydrated can also amplify it.
As for the theory that is always there, but you can tune it out…. I don’t think it’s always there for me. In fact, I have often experienced occasions where it came on suddenly as a result of yawning, swallowing, stretching, blowing my nose or a change in altitude..
I can tune it out more or less by distracting myself - just as I can with anything.. but to say it’s always there is just wrong - at least in my case.
I think being dehydrated can also amplify it.
Good point.