Safe Noise Levels?

[Michael Leigh]

It is true that TRT doesn't repair the damages, I guess it just helps the brain to adapt to the new input it recieves.

I believe that you are someone that listens @VRZ78 and therefore would like to explain something. When TRT is properly administered following the Pawel Jasterboff protocol it can be very effective in reducing tinnitus perception in many patients and completely curing hyperacusis as in my case. Many clinics that practice TRT have adapted the treatment to their requirements but it is not True TRT.

Proper TRT is wearing (2) white noise generators for up to 10hrs per day. At night using a sound machine by the bedside. Playing sound enrichment throughout the night until morning. The sound level should be set just below the tinnitus. Similarly, the white noise generators, when worn should be set to just below the tinnitus and then left alone.
It is important that the patient has regular tinnitus counselling sessions with a Hearing Therapist trained in TRT.
The counselling helps to remove and demystify the negative thinking that people have about tinnitus.
Treatment last up to two years.

I have had TRT twice in the 20 years that I have had tinnitus with good results.
Michael

 

[Tom Cnyc]

take some time off from loud sounds. It's early stages, you'll feel a lot better soon. I had hyperacusis and constant ear pain and I barely do at all anymore. I wore, and still wear earplugs (filtered) in places most people advise is overkill. It didn't cause H. I think it allowed my ears to heal a bit actually.

After a few months go by, start introducing loud(er) places again. This time, with filtered earplugs. Bars, louder restaurants. You should have been wearign earplugs there with or without tinnitus.

 

[Candy]

Agree Ed, it becomes a minefiel.
In conclusion one theory is that the human ear was not designed to withstand such sounds that are present in modern life.
This is why we should be careful, not just careful like the plug em site suggests, but more careful because we already have T. This would preclude us from doing a lot.
The next question is what if your threshold is lower, say you are a musician or work in construction and your ears have become damaged after prolonged exposure versus someone who acquired it after acoustic trauma that did not affected the next person? In the latter case do you have to be even more careful?

We don't know...I am beginning to get the impression very little data is collected from patients. An opportunity missed IM but that's a whole different chapter...

 

[Ed209]

Agree Ed, it becomes a minefiel.
In conclusion one theory is that the human ear was not designed to withstand such sounds that are present in modern life.
This is why we should be careful, not just careful like the plug em site suggests, but more careful because we already have T. This would preclude us from doing a lot.
The next question is what if your threshold is lower, say you are a musician or work in construction and your ears have become damaged after prolonged exposure versus someone who acquired it after acoustic trauma that did not affected the next person? In the latter case do you have to be even more careful?

We don't know...I am beginning to get the impression very little data is collected from patients. An opportunity missed IM but that's a whole different chapter...

I think one of the biggest problems is that nobody actually knows what tinnitus is. It is the multifaceted nature of it, and the many different causes that makes it so intriguing.

I think there is a genetic element that makes some of us more susceptible than others, but I don't believe there is a lowered threshold per se. I really believe on a noise level that it's the big hitters that are predominantly the problem. This would be concerts, night clubs, loud factories, daily powertool usage, loud ear buds, loud headphones etc. If we all used earplugs/muffs in these situations then I believe you'd see a dramatic fall in tinnitus cases. Not all because there are other causes as we know.

I don't believe daily sounds/noises pose a problem. Nature can be just as loud, and a lot of our history is littered with loud noise, not just the modern world. No one actually knows this stuff though as there's just no real hard data on it. I just don't think you can live with any kind of sanity if you genuinely believe your ears are at risk every time there's a knock or bang nearby. The stress or fear of it getting worse can become a bigger problem if it gets out of hand.

 

[Konstadinos]

Rule of thumb is that if you need to raise your voice to be heard from about a meter/2-3 feet, you may want to limit your exposure to those noise levels or plug up. This coincides with noise levels around 70-75 db approximately. But just go with whatever feels comfortable. F. Ex. I went on a date to the movies on saturday. It was some French drama (her choice of course;-) with lots of dialogue and still, the volume was cranked all the way up so i put in my filtered earplugs. As we walk out she says 'it was so loud inside the theater, i felt very uncomfortable' and she doesn't have T/H. This overstimulation we are exposed to is NOT normal.

Voice in cinemas is extremely loud!
(her choice of course) you made me laugh

 

[Candy]

Ed, the problem for me is that I have been to 2 concerts in my life, over 15 years ago, and that is it. Not a music person never listen to it. I have been sensitive to loud noises generally as my ears blocked up occasionally when exposed to them. This is why I am talking about thresholds...it makes me feel vulnerable, I am walking on eggshells on top of having to manage the annoyance of it. I got T without drastic noise exposure...

 

[Ed209]

Ed, the problem for me is that I have been to 2 concerts in my life, over 15 years ago, and that is it. Not a music person never listen to it. I have been sensitive to loud noises generally as my ears blocked up occasionally when exposed to them. This is why I am talking about thresholds...it makes me feel vulnerable, I am walking on eggshells on top of having to manage the annoyance of it. I got T without drastic noise exposure...

Not all tinnitus is noise related though. Your tinnitus could have been caused by a multitude of things, you are assuming it's noise induced. It may well be, but there's no way of really knowing.

Have you ever had your ears checked? One of my students has a genetic ear condition which he got from his dad. Basically the cilia in his cochlear are bent and he cannot hear high frequencies. He was told as a child he would have to try and avoid loud places, and to use ear plugs if he does go somewhere loud. At school he uses a hearing aid as background sounds becoming distracting.

 

[Pleasure_Paulie]

For what it is worth, I've comprehensively quizzed 4 audiologist (2 of them with tinnitus), and 2 ENTs regarding this issue. They ALL told me to not shelter yourself in a bubble as you will develop or make worse hyperacusis worse. But be sensible, wear plugs to concerts, and loud events or when using power tools. These are specialists in the area; so I have no reason to doubt their knowledge; especially when 2 of them were also tinnitus suffers.

 

[Julien87]

The above levels are to protect against hearing loss(haircell damage)....i guess for Tinnitus(synapses loss) it is much lower. I guess we will have partially damage synapsis....so it may not take as much and as long to cause further damage.

Why? I would like to understand this. You mean noise damages synapses in addition to hair cells?

 

[Ed209]

I'd just like to make a correction to my post above. It was in fact his dad who was told to limit his exposure to clubs and gigs. But, like most people, he hasn't really taken any notice and goes to gigs quite regularly without any ear plugs. At the moment he doesn't have any tinnitus, yet his ears are genetically weaker. It just shows how random tinnitus is, and how hard it is to understand.

I only recently found out about this family condition when his son really wanted me to attend his first gig playing with his band. So, I went along armed with my ear plugs. I ended up having a chat with them about protecting their hearing and that's how I found out.

Apparently his mom has been trying to make him wear ear plugs for quite a while, but he never would because of the uncool factor. Then I suddenly rock up at his gig wearing some. I had a talk with him about what has happened to my ears playing in bands and it really registered with him. His mom said he now wants ear plugs simply because he knows I use them. As stupid as it sounds, it's kind of took away some of the uncool factor because I don't care.

 

[Ed209]

For what it is worth, I've comprehensively quizzed 4 audiologist (2 of them with tinnitus), and 2 ENTs regarding this issue. They ALL told me to not shelter yourself in a bubble as you will develop or make worse hyperacusis worse. But be sensible, wear plugs to concerts, and loud events or when using power tools. These are specialists in the area; so I have no reason to doubt their knowledge; especially when 2 of them were also tinnitus suffers.

It's the same advice I've received from my ENT and two audiologists. That is the majority professional view on the matter.

 

[maltese]

So yesterday I tried walking to my classes without my headphones, and realised I was feeling fine. Very few sounds bothered me! Great to make another step towards normal life.

But now I have aural fullness and moderate hiperacusis. Very slight increase in T. I guess it was too sudden of a change lol. I'm a bit supprised , my headphones reduce sounds by no more than 10, max 15dB.

Okay. I'm scared now but I hope both H and T will return to the baseline over next few days.

Got a GP appointment on Friday, I hope she will refer me to someone.

 

[Michael Leigh]

@maltese You have had tinnitus for a very short amount of time, try not to become too stressed about it. Use sound enrichment at night as it will help to desensitise your auditory system. Leave the headphones at home as you are only making things worse. If necessary, use noise reducing earplugs but only when environmental sounds are causing irritation.
Give it time and I advise you not to listen to audio through headphones even at low volume.
Michael

PS: It is far too early for you to be seen at ENT. Unless you have additional problems such as: ear pain, dizziness or balance problems. All ENT will do is tell you to wait. The ear is a very delicate organ, the last thing doctors want to do is to start messing around with it at this early stage. The best treatment is to leave it ALONE.

 

[3ri0w]

Well-said @Ed209 It is so easy for some people to become paranoid about sensitivity to sound (hyperacusis). They think wearing earplugs or noise-reducing earplugs daily is the right thing to do, when actually it is the worst thing a person can do, as they are likely to make their auditory system more sensitive. However, it is their choice.

I would like to end by telling a short story that is absolutely true. It might dissuade some of the hard believers out there that the overuse of earplugs to suppress normal everyday sounds is not a good idea.

A friend of mine has had tinnitus and hyperacusis for quite some time. She also has slight hearing loss. Her Hearing Therapist has repeatedly advised her to wear a hearing aid or use white noise generators to help desensitise the auditory system, which will reduce and eventually cure the hyperacusis. Instead, she won't wear either of these devices. I have given up on telling her that this is the wrong thing to do.

At every opportunity she keeps away from normal everyday sounds and is now a virtual recluse at home. The hyperacusis (or fear of sound) has got so bad, she even complains about the sound of rain falling on top of her conservatory roof, which is made of glass. The sound of the fridge, microwave, washing machine and dishwasher sends her into panic mode. Just last week, while talking to her on the phone, she complained about the sound of my electric kettle boiling up in the background.

Michael.

Wow I definitely have that.... fridge and washing machine causing almost phobia like irration..and recently when I was talking on the phone I heard that the receiver had a switched-mode power supply plugged in (whining sound)..

I can't bear the thought about using wearable white-noise generators 12 hours a day since white-noise only makes my ears ring real bad, seems like tinnitus tries to "talk" with the noise...though playing music at nights seems to help with the "irritation to sounds", nothing seems as loud when I wake up after "not sleeping in silence". BR

 

[3ri0w]

@Michael Leigh

The thing is that there seems to be different form of hyperacousis. I believe if you have pain for loud sounds or if sounds in general are too loud white noise generator works well.

But it my case for example it is only some frequencies that are really loud. For exemple a can hear a really high pitch noise in subway stations from a great distance where my friends don't hear anything. If I get closer the sounds goes really loud and into my head. The more I listen to it the louder it gets. If I listen to white noise I will hear a lot of frequencies that stand out of the white noise and it will increase my tinnitus to the roof. I had holidays and stayed one total week in the silence and after that it was better as the sounds of those frequencies were lower. My ontologist told me I should were special filters all days that only attenuate the damaged frequency. He also seems to to TRT so I guess he knows in which situations it is usefull... Again maybe he's wrong...

1) Do you hear a "repeating" sound when you listen to white noise? Or this kind of "beep...beep...beep...beep" sound?
2) Do you hear the 'damaged frequency' when listening to "regular music"
3) Where to get those kind of filters? Didn't know they even existed! Would be nice to have ear plugs that have a low pass filter at 8 khz too so no harsh sounds would be distracting

 

[Candy]

Thanks guys, basically I will too carry on with normal protection as nobody in the medical field has an answer...
Will be getting MRI results soon, guess if there is an abnormality it will be picked up.

 

[Michael Leigh]

@3ri0w I don't know whether you are being serious or having a laugh. I will assume you are having a laugh so will join in

 

[3ri0w]

@3ri0w I don't know whether you are being serious or having a laugh. I will assume you are having a laugh so will join in

Serious

 

[VRZ78]

1) Do you hear a "repeating" sound when you listen to white noise? Or this kind of "beep...beep...beep...beep" sound?
2) Do you hear the 'damaged frequency' when listening to "regular music"
3) Where to get those kind of filters? Didn't know they even existed! Would be nice to have ear plugs that have a low pass filter at 8 khz too so no harsh sounds would be distracting

1) Yes
2) sometimes but not on every song. I hear the damaged frequencies way louder so they can stand out of music sometimes
3) I got them yesterday at my audioprothesist. They basically do -30 dB above 2K. You can start the reduction at higher frequencies if you want.

I also have problems like you with fridges where a frequency from the sound of the fridge is very amplified and goes in my head if I'm too close. Same for power outlet like you I hear them from very far away. It seems to get better though as the power outlet in my room doesn't do that as much. Before I could hear it on the other side of the room and if I was at my desk it would go to my head. Now I have to be close to the power outlet to hear it. The more I'm in silence the better it gets I think.

It was already better like that once but I went to the movies with plugs and then it was bad again. Even voices of people had frequencies
standing out. Now it's gone again or happen way less often.

I don't have problem with general loudness of sound I can be in a place where loud people talk easily but if there is a sound of like 4khz then I'm dead haha

Nice thing about hose filters is that they are totally invisible. Downside is that instead of hearing the higher frequencies you hear your T. I hear it almost all day now and all the time inside whereas without the filter I would hear it only in quiet rooms. It doesn't bother me that much though

 

[Michael Leigh]

1) Do you hear a "repeating" sound when you listen to white noise? Or this kind of "beep...beep...beep...beep" sound?
2) Do you hear the 'damaged frequency' when listening to "regular music"
3) Where to get those kind of filters? Didn't know they even existed! Would be nice to have ear plugs that have a low pass filter at 8 khz too so no harsh sounds would be distracting

@3ri0w
1. When listening to white noise through my white noise generators, the sound is smooth and constant and causes no irritation to my ears.
2. I am an HI-FI enthusiast (Audiophile). Sound quality is very important to me. I hear no frequency damage when listening to music even when my tinnitus is intrusive. My tinnitus ranges from: complete silence, mild, moderate, severe and extremely severe.
3. Noise-reducing earplugs are widely available and quite affordable. They come in various values of attenuation. From 9 decibels up to 30 decibels and more. They can be bought from ebay or try Google. Many online stores have them.

If you have hyperacusis, depending on how severe it is? Certain sounds will be distorted and can cause irritation to your auditory system and even be painful. When I had hyperacusis many years ago, it was so bad I had to ask people to lower their voice when talking to me as my ears hurt so much. Listening to music was a definite no. The sound of kitchen cutlery and plates being washed had me running for cover. Road traffic noise was unbearable at times until I discovered earplugs. This was 20 years ago.

Hyperacusis can be cured as in my case with the proper treatment. It can get better naturally without treatment. In severe cases, TRT is usually the best treatment for hyperacusis, it will also treat the tinnitus at the same time. Using white noise generators, a sound machine at night for enrichment and tinnitus counselling with a Hearing Therapist.

Michael
PS: earplugs and noise-reducing earplugs should only be used in noisy surroundings and are not meant to suppress normal everyday sounds, as overuse will make your auditory system hypersensitive.

 

[Jason C]

1) Do you hear a "repeating" sound when you listen to white noise? Or this kind of "beep...beep...beep...beep" sound?
2) Do you hear the 'damaged frequency' when listening to "regular music"

1, I hear a rattle noise mixed in with white noise along with pinging noises like an electrical circuit discharging.

2, I hear a rattle when trying to listen too music, I believe this is the damaged frequency. Music sounds like it is coming from a broken speaker.

And too top off my day today. I was blasted by an ambulance siren for about 5 seconds this morning as it turned a corner and stopped right in front of me. This actually sounded louder than the alarm that I was exposed too which caused all my issues in the first place.

 

[Candy]

When I hear a siren, alarm...wherever I am I put my hands over my ears, make my kids do it too...

 

[Capricornus]

I don't know how to act around everyday "loudish" noises... I went to a restaurant with a friend the other day for approx 1,5 h, then took the bus home and my T was much louder for 15 mins before it settled. Today I went outside with earplugs for 3 hours, when I came home the same thing happened.

Worth mentioning is that I'm very new to T, and that it's mild. It would be nice to visit a restaurant without making it worse...

EDIT: I don't believe it's reactive to noise, because I can watch movies and I'll be just fine. Or maybe it's reactive to moderate noises, who knows?

 

[Michael Leigh]

@Capricornus You need to be seen at ENT and possibly referred to a hearing therapist for treatment of your hyperacusis. You could try using sound enrichment at night to help desensitize your auditory system. It is hypersensitivity that is causing your problems and wearing earplugs for long durations, as you have been doing can make the situation worse, so be careful.
Michael

 

[Capricornus]

@Capricornus You need to be seen at ENT and possibly referred to a hearing therapist for treatment of your hyperacusis. You could try using sound enrichment at night to help desensitize your auditory system. It is hypersensitivity that is causing your problems and wearing earplugs for long durations, as you have been doing can make the situation worse, so be careful.
Michael

Hyperacusis? Sounds doesn't bother me at all. It was just a bummer to come home after a nice meal and realise that my T was louder for 15 mins. I don't wear earplugs all day. Today was simply an experiment, and now I know that it's not a good idea to block out everyday sounds.

EDIT: Some seem to advocate maskers during night, while some doesn't. I sleep just fine without any background noise, getting my 8 hours. Do you mean I should introduce maskers anyway?

 

[Michael Leigh]

@Capricornus Something is causing your tinnitus to increase in intensity and if I were you I'd get it seen to. The quicker the better. Do you listen to music through headphones? If you do it's not a good idea even at low volume.
Best of luck
Michael

 

[Capricornus]

@Michael Leigh Okay, I understand what you are telling me now. I don't want my T to increase after being exposed to a certain sound, so what would you recommend for me? I don't listen to music through headphones.

 

[Michael Leigh]

@Capricornus I see on your profile picture that your tinnitus was caused by "loud noise"? exposure to loud noise is the most common cause of tinnitus. Even though you say sounds don't bother you, something is causing your tinnitus to spike? Tinnitus that was caused by loud noise exposure, hyperacusis is often present. I see you haven't had tinnitus long, therefore, there's a good chance that the tinnitus will improve or go away completely with time. It all depends what caused the "loud noise"? If it was going to night clubs? Then you need to give it a rest for a while.

I advise you to start using sound enrichment at night. Click on my profile picture and choose Started threads. In the list you will see a post called: Introduction to Tinnitus. Please read it. It explains the causes of tinnitus and how to use sound enrichment at night using a sound machine, which I strongly advise you to buy.

I still think your auditory system is hypersensitive to sound that's what's causing the increase in the tinnitus. If you act now there is a good chance that you will make a speedy recovery. Keep a way from loud sounds and only use the earplugs in noisy enviroments.
Michael

 

[Tom Cnyc]

do not buy earplugs on the internet. go to the audiologist and get fitted professionally. it's WORTH the extra money. spend the $100 extra.

 

[Tom Cnyc]

@Capricornus if you have mild T and its been a few weeks you'll probably continue to heal. Avoid loud places for a while and DON'T be afraid to wear earplugs for a bit. IT WILL NOT CAUSE HYPERACUSIS. Just buy some FILTERED earplugs that don't block out all sound. It will help a TON with the increased volume after restaurants and bars that get loud due to crowds. You won't need to do that forever. It gets better with time.