Tinnitus Sound Therapy Q&A
Sound Therapy Is More Than One Method, One Device, and Select Sounds
What Is Tinnitus Sound Therapy?
Researchers and clinicians define sound therapy in several ways, but put simply, it’s the use of sound to reduce tinnitus or its impact on quality of life. When used in combination with counseling, sound can be very effective, but benefits differ among people and how the sound is used. Sound therapy shouldn’t be thought of as a single method but rather as a range of methods, each of which may change tinnitus in different ways.
Is One Sound Better Than Another?
Currently, there is no one sound to “rule them all.” The goal of the sound may be to provide relief from tinnitus through partial masking, or relaxation through the positive emotional response to the sound, or retraining to drive functional changes in the brain’s perceptual networks.
We also all have different reactions to sounds. Some sounds may be perceived as comforting by some people (e.g., rain), while in others sounds may induce fear as a result of strong negative memories (e.g., storm damage from flooding). Hissing noise sounds (“white noise”) were among the first used in tinnitus maskers. Although most people wouldn’t immediately think that this is a pleasant sound, it has been very effective in reducing tinnitus perception because it contains many frequencies of sound, is constant, and is easily ignored.
Sounds have been manipulated in many ways to try to increase their effectiveness, but most studies show similar effectiveness with unaltered sounds. We have recommended that to obtain control over tinnitus, constant noise-like sounds (including constant rain sounds) are effective in masking. For relaxation, sounds associated with positive, relaxing memories can be helpful (e.g., ocean waves).
To retrain the brain to focus on real-world sounds, dynamically changing, attention-engaging sounds with spatial localization cues are useful (e.g., natural environments with lots of different sounds to listen to), especially if these sounds are linked to training exercises in which the goal is to identify sounds being played, while not listening for the tinnitus.
Do I Need Hearing Aids, or Can I Use Headphones?
In our research, we often use headphones as low-cost tools in prototype therapies before using them in hearing aids. If you have good hearing, then using good quality headphones or earbuds is fine. These should be selected on the basis of sound quality and a design that does not block out hearing sounds around you.
Many people have difficulties comfortably hearing with headphones on and find them uncomfortable over long periods of use. Properly fitted hearing aids alone are often enough to quiet tinnitus. They also have the advantage of wirelessly receiving sounds from smartphone apps, and many feature inbuilt sounds for reducing the perception of tinnitus. Hearing aids are designed to be comfortably worn for long periods. The primary disadvantage of hearing aids over headphones is their cost.
Purpose-designed desktop sound generators, or “sound conditioners,” are an alternative to headphones. Because of their limited portability and wearability, these sound generators tend to be used at bedside as sleep aids.
Can I Manage Sound Therapy Myself or Do I Need to See an Audiologist?
Many people experiencing tinnitus will seek to reduce it in a self-help do-it-yourself “DIY” approach using headphones and music or apps downloaded to their smartphones. This approach can be helpful, and if it works, that is a great outcome.
However, individuals who experience bothersome tinnitus often have underlying hearing and stress problems that need to be managed to get the most from using sounds. We recommend that audiologists be involved in providing advice and support. The degree to which a clinician needs to be “hands-on” will vary, depending on the nature of the tinnitus and therapy approach taken. The best option may be an approach in
which you take responsibility for sound therapy but work in conjunction with evidence-based support and guidance from an audiologist.
Grant D. Searchfield obtained his PhD from the University of Auckland, New Zealand, where he is an associate professor in audiology. He is director of the university’s Hearing and Tinnitus Clinic and deputy director of the Eisdell Moore Centre for Hearing and Balance Research. He began his association with the ATA in 1995 as an attendee of the Fifth International Tinnitus Seminar in Portland, Oregon, where he first met Jack Vernon and Mary Meikle. Searchfield is a former member of the ATA Scientific Advisory Committee, and he is a past recipient of ATA research funding. His research for the last 20 years has focused on how to improve tinnitus sound therapy..