Annoyance is a Factor of Loudness

[Neenie]

Hi,
I know you're about to tell me I'm wrong, but I really do think that people that suffer with tinnitus compared to people that dont have a difference in the LOUDNESS of their tinnitus. I know that study, where normal people were placed in a sound proof room and 94% of them had tinnitus. This I can understand. Sure, if you listen hard enough and you think there's a sound then there will be a sound, but thats not tinnitus. That is just normal bodily functioning. I feel that real tinnitus is when you here it so loudly that you can hear it over any daily sounds. Its like blood pressure. Everyone has a blood pressure but only some people have elevated blood pressure for which there are medication. If you take the medication is doesnt mean you get no blood pressure, it just brings you back to normal. And this is what I hope that a tinnitus cure would do. Not eradicate the tinnitus sensation but just bring it back to a normal level. I read your other post about there not being a cure and I understand that you're saying that you cant eradicate something that is a normal function but surely there will exist a treatment that can get it back into the normal range?

 

[Dr. Nagler]

Hi @Neenie -

Thank you for your excellent question.

There are two ways to look at tinnitus loudness: the tinnitus loudness match and the tinnitus loudness rating. The loudness match (i.e., how many dbSL it takes for a tone introduced into the audiology booth at the tinnitus frequency to sound to the tinnitus sufferer as loud as his or her tinnitus sounds) is remarkably constant. It can be affected by external noise and by certain medications (like high doses of aspirin), but other than that it really doesn't change much. So on a "good ear day" and on a "bad ear day" the loudness match will pretty much be the same. The loudness match is felt to reflect the strength of the tinnitus signal itself. The loudness rating, on the other hand, can vary due to any number of factors, annoyance, stress, and fatigue among them. Indeed, the loudness rating can vary for no apparent reason at all! The loudness rating is how loud your tinnitus sounds to you (on, say, a 1 to 10 scale) at any given point in time, and it is felt to reflect the overall effect of auditory processing on the tinnitus signal. Moreover, some people with a loudness rating of 9 are just fine while some people with a loudness rating of 2 are all but incapacitated.

Now obviously to a tinnitus sufferer the only loudness that matters is the loudness rating, but the fact that there is so much individual variability makes it difficult to even define what "the normal range" is, no less come up with a treatment that will lastingly achieve it.

As I see things, anyway.

Dr. Stephen Nagler