Understanding Tinnitus Sound Therapy: Effectiveness and Treatment Options
Tinnitus, a common hearing problem, affects approximately 15% of adults. It manifests as a consistent hissing, ringing, buzzing, or other unpleasant sounds in the ears, even without external sound sources. It’s often most disruptive at night.
For two decades, sound therapy and other tinnitus treatment options (such as Tinnitus Retraining Therapy - TRT) have been introduced to help individuals living with tinnitus hear better and experience lasting relief. We’ve helped many Raleigh residents find relief from the constant ringing and buzzing of tinnitus. If you’re experiencing this challenging condition, we encourage you to contact us for an appointment. As the leading ear, nose, throat and allergy doctors in Raleigh, we’re pleased to offer this effective treatment at our many locations throughout the area.
In this article, we will discuss the most important things you need to know about sound therapy.
How Does Sound Therapy Work?
According to the American Tinnitus Association (ATA), “Sound therapy means the use of external noise in order to alter a patient’s perception of, or reaction to, tinnitus.” The ATA notes that sound therapy is not a “cure” for tinnitus-tinnitus is a symptom, not a specific disease (like how a fever is a symptom, not a disease)-but they “may significantly lower the perceived burden and intensity of tinnitus.”
Sound therapy works in several different ways. Depending on the devices or techniques being used, therapy can minimize the sounds of tinnitus, distract the individual living with tinnitus, make the sounds associated with tinnitus easier to ignore or control the “hyperactivity” causing the tinnitus to be present in the first place.
Does Sound Therapy Treat Tinnitus?
Can sound therapy completely cure tinnitus? Unfortunately, no-there is no cure for tinnitus. In most cases, sound therapy combined with Tinnitus Retraining Therapy (TRT) can effectively treat tinnitus. Sound therapy is most effective when directed by an audiologist with specific training in and experience with tinnitus. Not all audiologists have been trained to treat tinnitus, hyperacusis, and misophonia, and that professional will have the biggest impact on a patient’s success. As we mentioned earlier, sound therapy is most effective when tailored to meet the specific needs of the patient. This is why working with an audiologist is important to get the relief you need. Individuals who receive sound therapy in conjunction with TRT (counseling and education), report strong levels of relief, suggesting that sound therapy is one of the most effective tinnitus treatments currently available.
Before your audiologist suggests a specific tinnitus treatment, they will first want to identify what is causing you to experience tinnitus in the first place. Sometimes, tinnitus may be caused by an underlying health condition. Tinnitus has many possible underlying causes including exposure to loud noises, age-related hearing loss, various diseases, and several others. While the results of sound therapy cannot be guaranteed, these evidence-based, FDA-approved treatment options have provided lasting relief to people all around the world.
The Goals of Sound Therapy
The goals of sound therapy - whether using hearing aids alone or combination devices - are to alter tinnitus perception and reduce the negative emotional reactions associated with tinnitus. The underlying rationales for device application are to promote tinnitus masking or habituation. Either way, clinical benefit is derived when a patient’s quality of life is improved by reducing the psychosocial consequences of tinnitus, which include frustration, anxiety, irritation, depression, loss of control, and sleep disturbance.
Evaluating the clinical effectiveness of sound therapy in the management of patients with bothersome tinnitus has been one line of investigation in our Audiology Research Laboratory. We are currently focused on the application of hearing aids or combination devices (hearing aids and sound generators housed in the same unit) as a management tool to provide relief for patients with both hearing loss and distressing tinnitus.
Types of Sound Therapy
Sound therapy is a somewhat broad term. Essentially, any program that relies on sound in order to help improve an individual’s hearing experience (or decrease the effects of tinnitus) can be loosely categorized as sound therapy. While DIY options exist for sound therapy for tinnitus, personalization is essential to effective treatment.
However, most sound therapy treatment options can fall into one of four general categories: masking, distraction, habituation, and neuromodulation.
- Masking: Describes treatment options that use devices (known as sound maskers) that play noises loud enough to cover up-or “mask”-your tinnitus. Usually, the noises being created by these devices are categorized as “white noise.” These are not as effective in providing long-term benefits.
- Distraction: Describes treatments that are designed to direct the patient’s attention away from their active tinnitus and towards some other noise. You can use calming and pleasant sounds to draw your attention away from the tinnitus noise. Despite what you’ve heard about multitasking, the brain can only effectively focus on one thing at a time. Usually, these are pleasant noises, such as fractal tones or nature sounds. A simple internet search will reveal dozens of sites with various types of sounds, ranging from white noise to a purring cat.
- Habituation: Also known as tinnitus retraining therapy, this process trains your brain to become more accustomed to tinnitus. Describes practices that seek to train the brain to eventually ignore tinnitus and block out these noises altogether. Here, you listen to noise similar to your tinnitus sound for long periods. Eventually your brain ignores the tone, along with the tinnitus sound. It's similar to how you eventually don't think about how glasses feel on your nose. After living in a house for several years, your brain may completely tune out the hum of the refrigerator-habituation treatments attempt to do the same thing, but with the tinnitus sounds you are hearing.
- Neuromodulation: Describes sound therapy that seeks to “rewire” the components of the brain that are causing the tinnitus to begin with. Neuromodulation treatments are limited to subjective tinnitus (the most common form of tinnitus).
While each of these treatment options will have a similar underlying goal, recognizing the differences between them will still be important. Depending on your specific tinnitus experience-the causes, intensity, duration, sound type, etc.-your audiologist may recommend a mix of treatment options that are specific to your needs.
Sound Therapy Devices
Until recently, clinically available ear-level sound generators only incorporated a broadband white noise, which many patients found unacceptable. Several manufacturers now offer combination devices that generate a variety of different sound stimuli.
Hearing aids with sound masking built in; A lot of people with tinnitus also have hearing loss. Hearing aids can be used to mask tinnitus by turning up the volume on outside noises.
Clinical Study: Hearing Aids vs. Combination Devices
We undertook an investigation to explore whether the sound generator feature of a combination device afforded significant relief over and above what a hearing aid alone provided in a group of patients with hearing loss and distressing tinnitus. Thirty-seven adults completed a 6-month study that tracked benefits derived from contemporary hearing aids and combination devices offered by the same manufacturer (Oticon).
Judgments in clinical benefit over time were based on responses to the Tinnitus Functional Index (TFI),1 a “gold-standard” quality-of-life outcome questionnaire.
The sound generator circuitry of the combination devices used included stationary filtered broadband sounds as well as three ocean (nature) sound options. Figure 1 displays the magnitude transfer functions of the filters used for the white, pink and red broadband sound options. Figure 2 illustrates an example of an ocean sound, based on proprietary variations of modulation patterns that mimic rhythms of the ocean.
| Device Type | Description |
|---|---|
| Hearing Aids Only | Contemporary hearing aids used to amplify external sounds and potentially mask tinnitus. |
| Combination Devices | Hearing aids with integrated sound generators offering broadband sounds (white, pink, red noise) and ocean sound options. |
The TFI scores at each visit over the 6-month interval for the hearing aid only (n = 20) and combination device groups (n = 17) are summarized in Figure 3. For both groups, there was a clinically significant reduction (> 13 point TFI difference) in perceived tinnitus distress between baseline and each post-fitting visit. Further, there were no statistically significant differences between treatment groups, suggesting that both forms of sound therapy are effective in reducing activity limitation and participation restriction for patents with hearing loss and bothersome tinnitus.
Our findings are consistent with the recommendations of the AAO-HNS clinical practice guidelines for tinnitus, which support the use of hearing aids and sound generators in the management of patients with persistent, bothersome tinnitus. The integration of ongoing counseling, however, remains a critical component of the treatment plan regardless of the specific form of sound therapy used; in fact, this may serve as the mediating factor in overall patient success.
Best Sound Therapy Treatment Options
Hearing centers such as Sound Relief offer many different sound therapy treatments. These treatments are designed to specifically address the symptoms of tinnitus. Oticon Tinnitus SoundSupport, for example, is a program that uses personalized sound simulation as part of the sound therapy process for tinnitus treatment.
Widex Zen Tinnitus Treatment uses random, yet predictable musical notes in order to create a relaxing, stimulating environment where the effects of tinnitus can be properly managed. With the Widex Zen Program, audiologists will have the ability to adjust the tempo and pitch of the musical notes according to a patient’s hearing profile and preferences.
The ReSound LiNX Quattro Tinnitus Relief App is also an excellent option for individuals who want to receive sound therapy using a customizable app to create unique soundscapes that are soothing.
Other Treatment Options for Tinnitus
In addition to the options mentioned above, there are a few other treatment options that your audiologist might recommend. If your tinnitus is caused by excessive earwax production, a simple ear cleaning could be your best option. If your tinnitus is connected to permanent hearing loss - whether conductive, sensorineural, or any combination thereof - hearing aids may be recommended in conjunction with sound therapy.
Counseling (especially if you have tinnitus-linked depression), relaxation exercises, and specific medications may also be appropriate. Musculoskeletal factors like Jaw clenching, tooth grinding, prior injury, or muscle tension in the neck can sometimes make tinnitus more noticeable. Tinnitus can be a side effect of many medications, especially when taken at higher doses, like aspirin and other nonsteroidal anti-inflammatory drugs and certain antidepressants. Negative thinking. Underlying health conditions.
Because tinnitus is experienced so differently by each individual, it will be crucial to speak with a specifically trained and experienced audiologist to obtain a qualified recommendation. We recognize and respect the role of individualized medicine, and this is a vital part of tinnitus relief.