MemberThis post is intended for information only. It is based on using sound enrichment and white noise generators which I have used to help with tinnitus management. We are all different so please don't consider anything that I write to be professional medical advice. If you need help with your tinnitus and hyperacusis, please talk with your healthcare provider.
Thank you,
Michael Leigh
Thank you,
Michael Leigh
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Some people believe there hasn't been much progress in the treatment for tinnitus. Whilst we are all entitled to an opinion, I disagree with this train of thought but will say, a lot more research needs to be done if a cure for tinnitus is to be eventually found and that is something I wholeheartedly welcome.
Tinnitus has been around for centuries and dates back to the Egyptians when the first account of it was written in medical records. They used a variety of remedies that included applying infused oil, frankincense and tree sap to the external part of the ear, also known as the bewitched ear, using a reed stalk to help suppress the ringing. The Mesopotamians, a collection of cultures and considered to be one of the main cradles of civilization, wrote about tinnitus and found benefit chanting a mantra or meditating to help ease the whispering sound in the ears as it was called. Physicians believed in those remedies for that was the best treatment available to people living with tinnitus at the time.
I believe medical treatment for tinnitus has come a long way over the years to help improve the quality of people's lives, especially for those in the early stages of the condition that may have immense difficulty adjusting to the strange new noise heard in their head and ears. Although no two people will experience tinnitus the same, it should be noted that tinnitus is a very common condition and fortunately, a lot of people eventually learn to habituate to it with or without being referred to an ENT clinic and possibly Audiology, for specialist help with an audiologist trained in tinnitus management.
Having said that, there is a more serious and sobering side to tinnitus that is not often talked about beyond the realms of the tinnitus forums. Whilst tinnitus is very common and a lot of people are able to carry on with their lives doing everything that they want to, it can also be very debilitating for some people and can affect the quality of their life tremendously. Carrying out simple everyday tasks or being able to work can be incredibly challenging and may require them to regularly take prescription medication to help cope with this condition.
One of the best ways to treat tinnitus in the early stages and beyond is to use sound enrichment. This is often encouraged by audiologists and hearing therapists that work with tinnitus patients. I believe it's particularly relevant to use with noise-induced tinnitus, whether hyperacusis is present or not.
I have lived with tinnitus for 26 years and still use sound enrichment. It can be provided by a simple tabletop sound machine that plays nature sounds to fill in the background ambiance in a room during the day and placed by the bedside at night. Many sound machines are fitted with an output audio socket that enables an under pillow speaker to be attached for privacy. The idea is to have the sound machine playing continuously in the background throughout the night without drawing attention to itself unlike a radio. For this reason playing low-level music at night might not be the best choice for sound enrichment as it can draw attention to itself. Again, we are all different so some people may find music to be more pleasurable.
The purpose for using sound enrichment at night is not to induce sleep but to help prevent the brain from increasing its background activity, which is quite possible if the brain hears silence. In doing so the tinnitus will also be increased which can make it louder and more intrusive during waking hours. Sound enrichment enables the brain to suppress its background activity which can also help to lower the tinnitus and treat hyperacusis by desensitizing the auditory system. It takes at least 6 to 8 weeks to get used to using a sound machine at night, so patience is required when using this form of therapy.
One of the best devices to provide sound enrichment and treat tinnitus and hyperacusis, are wearable white noise generators, formally called maskers. I think fate had a part to play in the inception of this wonderful piece of equipment and I don't think it happened just by chance. Although at first glance this does seem to be the case.
In 1973, Jack Vernon, PhD, led a research group in the studying of tinnitus. He was travelling with a friend Dr. Charles Unice who had severe tinnitus. As they were passing an outdoor fountain, Dr. Unice stopped abruptly and was reluctant to continue. As he stood listening to the soothing sounds of the fountain, he said to Dr. Vernon, "I cannot hear my tinnitus. This is the first time I've been unable to hear that unconscionably wretched sound since it began over two years ago. This is absolutely wonderful!" Dr. Vernon was taken aback by his friend's comments, and this inspired him to research the matter further until he developed a wearable masking device, as a way of providing relief for people with tinnitus.
White noise generators are no longer called maskers by healthcare professionals, although some people still refer to them as maskers. Tinnitus should not be masked as it can make it more difficult for the brain to habituate to the tinnitus if it can't hear it. As soon as the masking sound is removed or temporarily stopped, the brain immediately latches on to the tinnitus and often, it can appear to be louder and more intrusive. A much better way and preferred method that most audiologists and hearing therapists advise tinnitus patients, is to set the volume of the white noise below the level of the tinnitus and keep it there. Some also advise the white noise can be kept at the mixing point. This enables tinnitus and white noise to blend together. I don't particularly like this method as it can cause the tinnitus and hyperacusis to spike.
I have counselled and corresponded with many people over the years that have noise-induced tinnitus because it's something I am familiar with and know how it can affect a person's mental and emotional well-being. Some have asked for my advice on how to wear white noise generators, as they seem to have difficultly wearing them after following the advice of their audiologist/hearing therapist. They tend to find their tinnitus and hyperacusis spiking and find they can no longer continue wearing the devices which is something I completely understand.
My audiologist was born with tinnitus and I found her to be a very good tinnitus therapist. 24 years ago I had very severe tinnitus and hyperacusis with pain. I began TRT with counselling and was advised to introduce the white noise generators slowly to reduce irritation and possibly spiking the tinnitus and hyperacusis. I was told to set the volume below the level of the tinnitus and wear them for just 1 or 2 hours, then remove them for the same duration, and after the elapsed time put them on again and setting the volume below the tinnitus and wear them for another 1 or 2 hours. If I noticed any irritation, I was told the wearing time should be reduced. Some experimentation was needed to see what worked best for me.
This is something I advise people to do that contact me for advice on wearing of white noise generators. Some people may only be able to wear the white noise generators for 5 or 10 minutes, then take them off for 20 minutes and put them back on. That is fine. Just take things slowly and at your own pace.
I was advised to continue doing this on day one, two and throughout the week. Then to continue this process for the second week and so on, while gradually increasing the wearing time. The goal was to achieve a total wearing time of 6 to 10 hours which I did achieve. At night the white noise generators were not worn, instead a sound machine was placed by the bedside setting the volume slightly below the tinnitus and played throughout the night until morning.
Over time the white noise generators desensitized my auditory system and the hyperacusis was completely cured and it has remained this way. The tinnitus reduced to a very low level where I could only hear it in very quiet surroundings. Unfortunately I had a second noise trauma in 2008 that increased my tinnitus but the hyperacusis did not return. It took 4 years to habituate to the tinnitus for the second time.
This treatment can take up to up to 2 years and ideally, one should have regular counselling with a tinnitus therapist. Counselling helps to demystify the negative thinking that is often attached to tinnitus and hyperacusis. Contrary to some beliefs, hyperacusis can be completely cured or reduced to very low levels using white noise generators. Similar results can be obtained using self-help that I have covered in my thread: Hyperacusis, As I See It. It all depends how severe the tinnitus and hyperacusis are and the way they affect a person's mental and emotional well-being. Counselling with a tinnitus therapist may not always be needed when wearing white noise generators but it's something I advise them to have.
Some people believe playing white or pink noise through headphones or earbuds, is the same as when played through white noise generators and hearing aids but they are not.
White noise generators and hearing aids are not the same as headphones or earbuds. White noise generators and hearing aids don't usually irritate the auditory system due to the volume being kept low and its frequency range remaining constant, which is unlike music that is constantly changing in pitch, rhythm and timber. In addition to this, the sound through white noise generators and hearing aids is delivered through a small plastic tube that goes over the back of the ear and enters the entrance to the ear canal. At the end of the tube there is a tiny aperture/hole where sound emits. Therefore these devices are not speakers.
Headphones and earbuds use a large speaker/diaphragm in comparison. When audio is played through them, they generate sound waves into the ear which can cause irritation, especially to someone that has noise-induced tinnitus with or without hyperacusis.
