Tinnitus Masking: In-Ear Maskers

[cjbhab]

I'm a bit confused about the difference between masking and TRT. I went to see an audiologist today asking about TRT. She gave me a Oticon Real hearing aid and "shaped" the white noise it generated to my tinnitus. She increased the decibels around my tinnitus frequency (4 kHz). I tried to ask about TRT but she just seemed focused on selling me these hearing aids with maskers.

It really helped mask the tinnitus. But my goal with the TRT was to habituate to the sound, not to mask it. I don't want to become dependent on hearing aids.

Can someone help me understand how I should be using a device like this as part of TRT?

The protocol when doing TRT is to set the masking noise just below the level of your tinnitus.

 

[gameover]

I'm a bit confused about the difference between masking and TRT. I went to see an audiologist today asking about TRT. She gave me a Oticon Real hearing aid and "shaped" the white noise it generated to my tinnitus. She increased the decibels around my tinnitus frequency (4 kHz). I tried to ask about TRT but she just seemed focused on selling me these hearing aids with maskers.

It really helped mask the tinnitus. But my goal with the TRT was to habituate to the sound, not to mask it. I don't want to become dependent on hearing aids.

Can someone help me understand how I should be using a device like this as part of TRT?

Careful with sticking anything sound producing into your ears. Hearing aids with "masking" massively set me back a month ago only after using them (quietly) for an hour! I am finally recovering, it seems.

Besides, you are only 1 month in? Give your ears a rest, protect but do not overprotect, relax, sleep and eat well, and try to focus your mind on other things (I know, way harder said than done). Time might heal you, maybe sooner than you think.

 

[Michael Leigh]

Can someone help me understand how I should be using a device like this as part of TRT?

HI @withintention.

The advice I am about to give to you is not absolute and I ask that you use it for guidance only.

In order to answer your question and give you my best advice in going forward, I perused some of your previous posts in order to determine the type of tinnitus you have and how long you have been affected by it. On your profile it states tinnitus since 10/2023, but I note from your posts, you have been managing tinnitus for quite a few years, albeit at a lower level which was caused by attending loud concerts.

I understand the way that you feel at the moment. Coupled with the fact that you have been given hearing aids with white noise, that has been tuned by your audiologist to mask your tinnitus can cause some confusion, as you are not sure the correct way to use them as part of TRT which is the treatment you seek.

You have also tried HBOT and are now looking into trying LLLT (low-level laser treatment) for tinnitus.

I think you have too many irons in the fire and need to slow things right down. Recovering from noise-induced tinnitus, which is what I believe you have, takes time and cannot be rushed. So it's important to stick to one treatment for tinnitus instead of trying multiple therapies.

Although an ear infection can cause tinnitus as mentioned on your profile, it usually goes away once the infection has been treated. Since you have had manageable tinnitus for quite some time, it is my belief continued exposure to loud noise has made your tinnitus more noticeable, to the point it is now interfering with the quality of your life.

Your Oticon hearing aids with white noise might be the type I also use. However, I do not have hearing loss, so my audiologist disabled the hearing aids via computer when I was being fitted with them. My hearing aids operate purely as white noise generators. I can select three different sounds which were adjusted to my needs. I can select white or pink noise and sea waves. The hearing aid part of your hearing aids may also be switched off to make them operate purely as sound generators.

Tinnitus should not be masked, the white noise should always be kept slightly lower than the tinnitus. If the tinnitus cannot be heard, then the brain will find it very difficult to habituate to it. White noise needs to be introduced to the ear and auditory system slowly which I have covered in my posts on this thread.

I have also covered the correct way to use white noise generators in my TRT posts which you will find on my started threads. I believe your audiologist is just that, an audiologist, and also dispenses and adjusts hearing aids with or without white noise generators, for patients and those affected with tinnitus. However, she is not a TRT therapist which is the reason she was focused purely on selling you the hearing aids with white noise generators.

I was last seen in clinic by two audiologists. One was born with tinnitus and treats tinnitus patients with TRT and CBT, the other doesn't. She told me she knows nothing about tinnitus, having never experienced it.

Most but not all audiologists that treat tinnitus patients with TRT or CBT, were either born with tinnitus or acquired it at some time in their life. Tinnitus cannot be learnt from a book or at medical school in any great depth. To give high quality counselling, which is an essential part of TRT/CBT, one must understand how tinnitus can affect a person's mental and emotional well-being and their quality of life. In my opinion, this knowledge can only be acquired if the therapist has experience living with tinnitus, preferably having experience of it being mild, moderate and severe.

Since you are new to tinnitus, by this I mean it has become more noticeable, I think you will benefit from reading the following posts on my started threads: New to Tinnitus, What to Do? The Habituation Process, How to Habituate to Tinnitus, Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, Hyperacusis, As I See It.

I wish you well,
Michael

 

[Nick47]

I'm a bit confused about the difference between masking and TRT. I went to see an audiologist today asking about TRT. She gave me a Oticon Real hearing aid and "shaped" the white noise it generated to my tinnitus. She increased the decibels around my tinnitus frequency (4 kHz). I tried to ask about TRT but she just seemed focused on selling me these hearing aids with maskers.

It really helped mask the tinnitus. But my goal with the TRT was to habituate to the sound, not to mask it. I don't want to become dependent on hearing aids.

Can someone help me understand how I should be using a device like this as part of TRT?

In the UK I was told by an audiologist that they do not recommend masking. She also mentioned TRT lacks evidence. This is through the NHS. Privately they will offer it of course as it can empty your bank account.

They only recommend CBT and hearing aids.

 

[Michael Leigh]

In the UK I was told by an audiologist that they do not recommend masking. She also mentioned TRT lacks evidence. This is through the NHS

I suspect @Nick47 thatyour audiologist is just that, an audiologist, and knows nothing about tinnitus as mentioned in my post to @withintention.

When I was last in clinic for the fitting of my new Oticon white noise generators, my audiologist, who was born with tinnitus, said TRT, CBT and other treatments for tinnitus patients is still practiced at my NHS hospital.

I agree with you; one has to be careful when seeking private treatment for tinnitus, as the emphasis can be focused on purely making money. This is very unfortunate but often true.

Michael

 

[withintention]

HI @withintention.

The advice I am about to give to you is not absolute and I ask that you use it for guidance only.

In order to answer your question and give you my best advice in going forward, I perused some of your previous posts in order to determine the type of tinnitus you have and how long you have been affected by it. On your profile it states tinnitus since 10/2023, but I note from your posts, you have been managing tinnitus for quite a few years, albeit at a lower level which was caused by attending loud concerts.

I understand the way that you feel at the moment. Coupled with the fact that you have been given hearing aids with white noise, that has been tuned by your audiologist to mask your tinnitus can cause some confusion, as you are not sure the correct way to use them as part of TRT which is the treatment you seek.

You have also tried HBOT and are now looking into trying LLLT (low-level laser treatment) for tinnitus.

I think you have too many irons in the fire and need to slow things right down. Recovering from noise-induced tinnitus, which is what I believe you have, takes time and cannot be rushed. So it's important to stick to one treatment for tinnitus instead of trying multiple therapies.

Although an ear infection can cause tinnitus as mentioned on your profile, it usually goes away once the infection has been treated. Since you have had manageable tinnitus for quite some time, it is my belief continued exposure to loud noise has made your tinnitus more noticeable, to the point it is now interfering with the quality of your life.

Your Oticon hearing aids with white noise might be the type I also use. However, I do not have hearing loss, so my audiologist disabled the hearing aids via computer when I was being fitted with them. My hearing aids operate purely as white noise generators. I can select three different sounds which were adjusted to my needs. I can select white or pink noise and sea waves. The hearing aid part of your hearing aids may also be switched off to make them operate purely as sound generators.

Tinnitus should not be masked, the white noise should always be kept slightly lower than the tinnitus. If the tinnitus cannot be heard, then the brain will find it very difficult to habituate to it. White noise needs to be introduced to the ear and auditory system slowly which I have covered in my posts on this thread.

I have also covered the correct way to use white noise generators in my TRT posts which you will find on my started threads. I believe your audiologist is just that, an audiologist, and also dispenses and adjusts hearing aids with or without white noise generators, for patients and those affected with tinnitus. However, she is not a TRT therapist which is the reason she was focused purely on selling you the hearing aids with white noise generators.

I was last seen in clinic by two audiologists. One was born with tinnitus and treats tinnitus patients with TRT and CBT, the other doesn't. She told me she knows nothing about tinnitus, having never experienced it.

Most but not all audiologists that treat tinnitus patients with TRT or CBT, were either born with tinnitus or acquired it at some time in their life. Tinnitus cannot be learnt from a book or at medical school in any great depth. To give high quality counselling, which is an essential part of TRT/CBT, one must understand how tinnitus can affect a person's mental and emotional well-being and their quality of life. In my opinion, this knowledge can only be acquired if the therapist has experience living with tinnitus, preferably having experience of it being mild, moderate and severe.

Since you are new to tinnitus, by this I mean it has become more noticeable, I think you will benefit from reading the following posts on my started threads: New to Tinnitus, What to Do? The Habituation Process, How to Habituate to Tinnitus, Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, Hyperacusis, As I See It.

I wish you well,
Michael

Hi @Michael Leigh, thanks very much for the detailed response.

Yes, I had barely noticeable tinnitus which just recently became constant and loud because of a loud concert (I think the ear infection was a red herring).

I'm pursuing HBOT and LLLT right now because those are time sensitive. It's a good point that maybe I don't need to be also adding TRT to it... but I don't have high hopes for HBOT and LLLT, to be honest. I'm eager to get started on TRT because I have a lot more faith in it.

You are right, I think my audiologist is not the right person to go to for TRT. Unfortunately, my area doesn't seem to have anyone qualified. I will keep looking.

I am still unclear though whether TRT proposes you wear a noise generating device for life? Or whether you eventually stop using it?

 

[Michael Leigh]

I am still unclear though whether TRT proposes you wear a noise generating device for life? Or whether you eventually stop using it?

Hi @withintention,

If you want my honest opinion, I don't think you should be trying any tinnitus treatment at this time, including TRT and wearing white noise generators. There is a good reason for this which is explained in my threads: Tinnitus, a Personal View and New to Tinnitus, What to Do?

Please print the articles that I have mentioned in my previous post and the ones on TRT in the links below. Take your time and read them instead of reading on your phone or computer screen. This way you will absorb and retain the information better.

Take care and wishing you all the best,
Michael

What Is TRT and When Should It Be Started? | Tinnitus Talk Support Forum
TRT, As I See It | Tinnitus Talk Support Forum

 

[withintention]

If you want my honest opinion, I don't think you should be trying any tinnitus treatment at this time, including TRT and wearing white noise generators. There is a good reason for this which is explained in my threads: Tinnitus, a Personal View and New to Tinnitus, What to Do?

Hi @Michael Leigh, I read your articles, thanks very much for putting those together! I see where you say you don't recommend starting TRT until 6 months after onset, but I did not see where you say why. Maybe I missed it, can you point me to where you talk about what the harm might be of starting earlier?

 

[Michael Leigh]

Hi @Michael Leigh, I read your articles, thanks very much for putting those together! I see where you say you don't recommend starting TRT until 6 months after onset, but I did not see where you say why. Maybe I missed it, can you point me to where you talk about what the harm might be of starting earlier?

Thank you for your kind words @withintention.

Please click on the link below and read my thread: Is It Possible to Habituate to Tinnitus?

Someone that is new to tinnitus needs some time to adjust to it and this is the reason most ENT doctors do not recommend starting tinnitus treatments too soon, unless there are additional medical problems causing the tinnitus. By adjustment I do not mean habituate, although many people do habituate to tinnitus within 6 to 12 months. It is all do do with a person's mental and emotional well-being which I cover in my thread below. Starting treatment too soon can cause additional anxiety and stress which often leads to unrealistic expectations, and when these are not realised, it can cause a host of problems. It is best to take things slowly.

All the best,
Michael

Is Habituation Possible? | Tinnitus Talk Support Forum