Tinnitus Masking: In-Ear Maskers

[Leila]

I think that for a hearing aid with a masker to provide any level of relief to your tinnitus you need to have some hearing loss (moderate or above...). It's not just the masking but the amplification of external sound which both together bring relief. Especially since there are different program settings on the hearing aid which on bad days I can adjust to increase amplification so that makes my ears feel less full of pressure.

I'm using a hearing aid that doubles as a masker without suffering from hearing loss and it has been a lifesaver. My ENT and other doctors were very much against me trying this version of a WNG but it helped me a lot.

I have a new and third tinnitus noise in my previously unaffected ear now and will try to get a second device or, should that fail, have the one I already have altered so it fits the other ear since the new noise is so loud it almost blocks out the buzzing noise in my other ear.

Here in Germany, if you get the WNG/hearing aid from an acoustician, you have quite a long testing period. I think I've been in and out, experimenting with different masking noises and devices for about 3/4 of a year. There was not a lot to choose from and it was rather difficult to figure out what works and what doesn't but to me it was worth the while. So, unless you are forced to buy the product whether it works for you or not, I think it is, at the very least, worth a try.

 

[Poseidon65]

If you are doing TRT and I mean with a trained therapist then he or she should know, wearing white noise generators, although possible, is not advisable when sleeping.

When I had TRT with my Hearing Therapist (who has tinnitus) she advised to use a sound machine by the bedside at night time, as advised by Jastreboff.

It's not clear why there would be a difference between "a WNG you wear in your ear" and "a WNG at your bedside," especially if they are at the same volume. Michael, do you know why that's the recommendation? Is there science behind it?

 

[Poseidon65]

I'm using a hearing aid that doubles as a masker without suffering from hearing loss and it has been a lifesaver. My ENT and other doctors were very much against me trying this version of a WNG but it helped me a lot.

Out of curiosity, did your doctors say why they are against this? Tinnitus maskers have been included in hearing aids for a decade now (as far as I understand), and I don't think the functionality is controversial.

 

[Michael Leigh]

It's not clear why there would be a difference between "a WNG you wear in your ear" and "a WNG at your bedside," especially if they are at the same volume. Michael, do you know why that's the recommendation? Is there science behind it?

I believe you have made a mistake Posidon65. It is recommended to use a sound machine by the bedside. Not a WNG.

As I have said in my post to T Toledo in a section you have quoted, whilst it's possible for a person to sleep with WNGs and some people probably do, it's advisable to give the ears a rest from having sound funnelled into them at such close proximity, after wearing them during the day for the best part of 8 to 10 hours. Furthermore, they can feel uncomfortable on the side of the head when placed against a pillow. I do not know of any science behind Jastreboff's suggestions not to wear WNGs at night. Although in his TRT book he mentions some people wear them at night. I have tried it and find them very uncomfortable.

I have expressed my views on science and tinnitus previously in this forum. Science has its place in this world and to some degree with tinnitus. Medications for example can be immensely helpful for some people and devices such as white noise generators. I am specifically referring to noise induced tinnitus. If one wants to learn about this condition and acquire more knowledge, the only way is with first hand experience. That is living with it and corresponding with people that have it. This type of tinnitus as well as tinnitus caused by an underlying medical condition, can seriously affect a person's mental and emotional wellbeing when severe. One cannot understand tinnitus reading about it from a book.

Michael

 

[Leila]

Out of curiosity, did your doctors say why they are against this? Tinnitus maskers have been included in hearing aids for a decade now (as far as I understand), and I don't think the functionality is controversial.

They argumented that most tinnitus patients couldn't get used to them and suggested I spare myself the time and energy it would take to have them properly set up and train myself to tolerate them.

I'm glad I insisted, because the device made a really big difference to me. Yes, it took some getting used to having something in my ear and it did take a really long time to get the frequency right because I have two noises in one ear and one masking noise that helped with one noise would often agitate the other, but in the end I found something that worked and I'm eternally grateful for that.

 

[Leila]

It's not clear why there would be a difference between "a WNG you wear in your ear" and "a WNG at your bedside," especially if they are at the same volume. Michael, do you know why that's the recommendation? Is there science behind it?

I was never advised to not wear my WNG at night so I initially tried wearing the device in my sleep. However, I quickly came to realise that having something in my ear became painful to the point of waking me up the moment I went from sleeping on my back to sleeping on my side. Also it really is intense having something emitting a noise right into your ear for a longer period of time, even if this noise helps you with your tinnitus noise. In the beginning, when taking out my WNG, it felt as if I had been to a rock concert without ear protection. All the noises around me sounded really remote and dull. But I got used to it and hardly need any time to adjust anymore.

So, yes, it does make a difference whether something is projecting a noise right into your head or is producing said noise somewhere in the room, just as there is a difference when listening to music via in-ear phones or playing it through your speakers, and since people are different, too, it's something you will have to try out for yourself.

 

[Jack V]

It's not clear why there would be a difference between "a WNG you wear in your ear" and "a WNG at your bedside," especially if they are at the same volume. Michael, do you know why that's the recommendation? Is there science behind it?

That's his recommendation, not "the" recommendation.

You can find authoritative sources who recommend wearing WNGs at night, just as I suppose you can find ones who don't.

It really boils down to what works best for you.

 

[T Toledo OH]

Each person is different and if you have no problems sleeping with your Widex hearing aids and playing sounds through them that's fine. However, it's something I don't advise as the auditory system needs a rest like everything else. To have a constant input of sound in such close proximity to the ear and auditory system isn't a good thing in my opinion. I have had TRT twice both treatments lasted 2 years and have used white noise generators for over 20 years.

Please think about this. If you are doing TRT and I mean with a trained therapist then he or she should know, wearing white noise generators, although possible, is not advisable when sleeping. This is documented in Professor Jastreboff's TRT book which I have. When I had TRT with my Hearing Therapist (who has tinnitus) she advised to use a sound machine by the bedside at night time, as advised by Jastreboff.

Michael

I play the tones real low. If I am having a good night I will try to sleep without them.

 

[Michael Leigh]

I play the tones real low. If I am having a good night I will try to sleep without them.

It is up to you...

 

[twa]

What does your tinnitus sound like? Mine is loud, multi tone, and oscillating, so I wonder if your hearing aid method would mask mine or if it works better for pure tone tinnitus?

Is everyone's oscillating? Mine kind of changes throughout the day.

 

[AfroSnowman]

Is everyone's oscillating? Mine kind of changes throughout the day.

Mine too.

 

[Poseidon65]

I'm curious: has anyone tried bone-conducting headphones as an alternative to in-ear maskers? I ask because my tinnitus is very high frequency, and in-ear maskers can only play up to a certain frequency (e.g. 10,000 Hz). It looks like bone-conducting headphones might go up to 20,000 Hz, while also leaving your ear canal open.

Anyone try this? If so, I'm curious to hear how you like the bone-conducting headphones vs. in-ear maskers.

 

[Poseidon65]

FWIW, I have trialed hearing aids (used as maskers) from Widex and Phonak. I tested the two models for their ability to reproduce a high-frequency white noise, as generated by the myNoise iPhone app. Specifically, I played the white noise on both models at identical loudness levels (dBA), and then measured the loudness at specific frequencies above 10,000 Hz.

My measurements show that the Phonak produces more loudness at high frequencies than the Widex. This was somewhat surprising to me, as Widex advertises a wider frequency range than Phonak does. Though this might apply to the hearing aid function, rather than to just the speaker. Note both models are receiver-in-canal (RIC) models.

I thought I'd share this info in case it's helpful.

 

[Leila]

Has anybody heard of or tried the Nuheara tinnitus masker? I came across their web page when looking for something a little more tailored to tinnitus than the hearing aid turned WNG version I'm currently using. I talked to my acoustician about the product and he told me that Siemens will be launching something similar this year but since he had only been sent a dummy product so far he couldn't say anything about its functions or special features.

They are offering an online hearing check tailored to their product which is quite different than the hearing tests I've had before since it doesn't just decreases the volume of the numbers you are told to repeat (no words here as far as I can tell) but plays a noise interference at the same time. I'm not sure if that makes a difference as far as the end result is concerned but it was something that stuck out to me because it was a lot closer to what hearing with tinnitus is like than the decrease in volume tests I've done before.

 

[Jrblovsky]

FWIW, I have trialed hearing aids (used as maskers) from Widex and Phonak. I tested the two models for their ability to reproduce a high-frequency white noise, as generated by the myNoise iPhone app. Specifically, I played the white noise on both models at identical loudness levels (dBA), and then measured the loudness at specific frequencies above 10,000 Hz.

My measurements show that the Phonak produces more loudness at high frequencies than the Widex. This was somewhat surprising to me, as Widex advertises a wider frequency range than Phonak does. Though this might apply to the hearing aid function, rather than to just the speaker. Note both models are receiver-in-canal (RIC) models.

I thought I'd share this info in case it's helpful.

I thought the Widex hearing aids sucked honestly. I also trialed the Phonak Audeo Marvel M90R model. I have an Android phone and it was annoying to me you cannot direct control the Widex. The Phonak works great. I'm going to breakdown and buy one once I get this roaring figured out.

 

[Poseidon65]

I've been using wearable WNGs for the last month. I use them all day (not when I sleep). They're very helpful.

Is there any reason I should try to wean myself off of the WNGs over time? I don't see a good reason to do so, assuming I want to wear them and that they continue to help me. But just thought I'd ask.

 

[Michael Leigh]

Is there any reason I should try to wean myself off of the WNGs over time? I don't see a good reason to do so, assuming I want to wear them and that they continue to help me. But just thought I'd ask.

I have been using white noise generators off and on for over twenty years. There is no reason to wean yourself off them if they are helpful. Used properly they will do no harm. Put them on and set the white noise slightly below the tinnitus and leave the volume alone. Out on the street you might be tempted to increase the volume because the white noise will be more difficult to hear due to traffic noise. Try not to do this. By keeping the white noise below the level of the tinnitus, the brain will habituate to it and slowly push the tinnitus further into the background. In time you will reach a point, where it won't matter whether you are wearing the generators or not.

 

[Kriszti]

I have been using white noise generators off and on for over twenty years. There is no reason to wean yourself off them if they are helpful. Used properly they will do no harm. Put them on and set the white noise slightly below the tinnitus and leave the volume alone. Out on the street you might be tempted to increase the volume because the white noise will be more difficult to hear due to traffic noise. Try not to do this. By keeping the white noise below the level of the tinnitus, the brain will habituate to it and slowly push the tinnitus further into the background. In time you will reach a point, where it doesn't matter whether you are wearing the generators or not.

What's the difference between white noise generators and listening to white noise through earphones (if the volume is strictly kept under the tinnitus volume)?

 

[Poseidon65]

What's the difference between white noise generators and listening to white noise through earphones (if the volume is strictly kept under the tinnitus volume)?

One difference is that white noise generators come in open fit models, meaning they do not block or cover up the ear canal. For this reason, it feels more natural to me than an earbud does.

 

[Michael Leigh]

What's the difference between white noise generators and listening to white noise through earphones (if the volume is strictly kept under the tinnitus volume)?

I have answered this question a few times in this forum. I do not recommend listening to white or pink noise through headphones or earbuds as a form of therapy to treat tinnitus or hyperacusis. The sound is not smooth and regulated like proper white noise generators that are made for this purpose. More often than not people that use earbuds or headphones, to listen to white or pink noise, find their tinnitus and hyperacusis increases even when the volume is kept low.

Some people question the use of white noise generators and hearing aids and believe they are the same as headphones or earbuds, this is not the case. White noise generators and hearing aids don't usually irritate the auditory system due to the volume being kept low and its frequency range remains constant, so there is no syncopation within it unlike music. In addition to this the sound is delivered through a small plastic tube that wraps 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. Headphones and earbuds use a large speaker/diaphragm in comparison to emit sound into the ear. Compared to white noise generators and hearing aids, the sound is crude, unregulated and can cause irritation.

Although white noise generators can be bought privately to treat tinnitus and hyperacusis, I don't advise anyone to do so, unless a Hearing Therapist/Audiologist has first tested their auditory system for suitability. A person must also be shown how to use these devices correctly, as improper use can make the tinnitus worse. Furthermore, they are normally used in conjunction with Tinnitus Retraining Therapy to get optimum results.

Michael

 

[Kriszti]

@Poseidon65, @Michael Leigh.

Thank you.

 

[Toby1972]

I'm using a hearing aid that doubles as a masker without suffering from hearing loss and it has been a lifesaver. My ENT and other doctors were very much against me trying this version of a WNG but it helped me a lot.

I have a new and third tinnitus noise in my previously unaffected ear now and will try to get a second device or, should that fail, have the one I already have altered so it fits the other ear since the new noise is so loud it almost blocks out the buzzing noise in my other ear.

Here in Germany, if you get the WNG/hearing aid from an acoustician, you have quite a long testing period. I think I've been in and out, experimenting with different masking noises and devices for about 3/4 of a year. There was not a lot to choose from and it was rather difficult to figure out what works and what doesn't but to me it was worth the while. So, unless you are forced to buy the product whether it works for you or not, I think it is, at the very least, worth a try.

Which model do you use? Welches Modell nutzt du?

 

[Poseidon65]

Has anybody heard of or tried the Nuheara tinnitus masker? I came across their web page when looking for something a little more tailored to tinnitus than the hearing aid turned WNG version I'm currently using. I talked to my acoustician about the product and he told me that Siemens will be launching something similar this year but since he had only been sent a dummy product so far he couldn't say anything about its functions or special features.

They are offering an online hearing check tailored to their product which is quite different than the hearing tests I've had before since it doesn't just decreases the volume of the numbers you are told to repeat (no words here as far as I can tell) but plays a noise interference at the same time. I'm not sure if that makes a difference as far as the end result is concerned but it was something that stuck out to me because it was a lot closer to what hearing with tinnitus is like than the decrease in volume tests I've done before.

FWIW for my hearing aids, rather than using the built-in masking function, I'm streaming white noise from my iPhone. This allows me to customize the noise, e.g., using the myNoise app, to dial it in just right. Basically "just right" means "masks my tinnitus reasonably well" while also "not being annoying to hear all day."

My feeling is that a customized noise gives you more flexibility than the fixed options offered by the hearing aid companies. The downside is that streaming will use more battery than a built-in masker. As a result, with a rechargeable hearing aid, you might not get a full day of streaming. The solution to this is to use a non-rechargeable model. On size 312 batteries, I get around 2 full days of streaming.

Just my 2 cents on built-in masking vs. customized.

 

[Leila]

Which model do you use? Welches Modell nutzt du?

I'm using a Starkey Livio AI 100 RIC. The amplifier it came with has been exchanged for a stronger version because the original one didn't with work well / couldn't be turned up high enough in the lower frequency spectrum.

It comes with quite a number of masking noises to choose from and it took me a long time to find something that worked for me. My tinnitus noises are on opposite sides of the scale and while the WNG is capable to cover the complete spectrum or even have two separate masking noises played at the same time, I had to call it quits when it comes to the high pitch noise because whatever masking noise we tried it only made it worse.

For a while I thought I would settle for one of the Zen options but the problem with is noise was that when it got to the very low frequency sounds there was some kind of "overdrive" (which is also the reason we experimented with a stronger amplifier) and since the melody repeats after a while, eventually, you're lying in wait for this particular sound to make an appearance. The company apparently knows about it but since most people use their product to compensate hearing loss, they aren't very inclined to work on this problem.

 

[Leila]

My feeling is that a customized noise gives you more flexibility than the fixed options offered by the hearing aid companies.

It really does, because trying to find the right masking noise is one of the hardest and time consuming things I've ever done so far and I'm so grateful my audiologist didn't run out of patience with me.

The last time we spoke he offered to upload a customised noise of my choosing to my WNG, because it was something I'd asked about before and he wasn't sure whether it could be done. But since I've gotten used to the noise I've picked and didn't want to rock the boat I refused to give it a try.

 

[Poseidon65]

A few questions about in-ear maskers:

1. The typical guidance for the level of masking volume, e.g. from a TRT program, is "slightly below the level of your tinnitus." What amount of background sound should be present for this calibration? For example, if we set the level in a completely silent room (e.g. a closet), then if we go into a normal room (e.g. one where a fan is running), the tinnitus might be completely covered in that room. Hence the question about what environment to set the volume in.

2. We can measure the volume of the masking noise by holding the WNG speaker directly up to a SPL meter. What is considered the maximum safe masking volume to use? I assume 30 dB is safe. How about 40 dB, 50 dB, 60 dB, 70 dB? Is there any info available on this?

 

[Michael Leigh]

1. The typical guidance for the level of masking volume, e.g. from a TRT program, is "slightly below the level of your tinnitus." What amount of background sound should be present for this calibration?

Background noise doesn't usually cause a problem. When using white noise generators as part of TRT or using them for sound enrichment, put them on in any room making sure the volume is set slightly below the tinnitus and leave them alone. The longer you use them, the easier you'll find setting the volume even in a noisy environment. The important thing is not to keep adjusting the volume, as this will make it more difficult for the brain to habituate to the white noise and push the tinnitus further into the background over time.

2. We can measure the volume of the masking noise by holding the WNG speaker directly up to a SPL meter. What is considered the maximum safe masking volume to use? I assume 30 dB is safe. How about 40 dB, 50 dB, 60 dB, 70 dB? Is there any info available on this?

I have been using white noise generators for over 20 years and never measured their volume. Just set the white noise slightly below the tinnitus and forget them. Problems can occur when the white noise is set too loud, particularly for people that have hyperacusis or have some oversensitivity to sound which can cause irritation.

 

[Adrifr]

I'm looking for tinnitus masking earbuds that go up to 12,000 Hz. Do you know if such high frequency devices are available?

I know that a few years ago they stopped at 10,000 Hz, but maybe the science has advanced now?

 

[Poseidon65]

@Adrifr, the Phonak Paradise I have does play some volume up to 12,000 Hz. I'm not sure they advertise this, but to really know you would need to trial the hearing aids and test them yourself (e.g. play a masking noise which goes up to 20,000 Hz through the hearing aid, and then measure the frequency response of what the hearing aid plays back). You can measure the frequency response with an iPhone app, so it's easy to do.

I did this with the Phonak Paradise and Widex Moment, and found the Phonak played higher than the Widex. I did not test any other brands.

 

[KWC]

I'm looking for tinnitus masking earbuds that go up to 12,000 Hz. Do you know if such high frequency devices are available?

I know that a few years ago they stopped at 10,000 Hz, but maybe the science has advanced now?

Signia makes hearing aids that have masking up to 12,000 Hz.