Which Custom Earplugs Should I Buy?

[Guy214]

Hello everyone,

I have moderate hyperacusis - I'm able to handle almost all noises at home, but I'm unable to go to movies, weddings and even the gym (because of the loud music), because it's far too loud (it is unbearable for me)...

I go next week to buy custom earplugs, and I wonder whether I should buy the ER-25 musician earplugs (which gives a straight attenuation of about 25 decibels) , or the regular custom ones (which gives about 30 decibels attenuation, not uniformly).

I want to buy the ER-25 because of the straight attenuation, but I'm afraid they won't attenuate enough at those loud places I mentioned above.

Here is the datasheet for each one of them:
http://adut.co.il/images/ER.pdf (ER-25)
http://adut.co.il/images/compact_flexcomfort.pdf (ML 01)

What do you think I should buy?

Thanks in advance!

 

[yonkapin]

Check out ACS customer musician's plugs: https://www.acscustom.com/

I was going to get the ER-25's myself but the ACS Pro26 plugs have much better attenuation across the frequency spectrum. They will be more than suitable enough for the situations you mentioned. They helped me greatly when I was suffering from severe hyperacusis.

 

[MichaelP]

Hi everyone,

I just got tinnitus a little over 3 weeks ago and would like some advice on which custom earplugs to buy. I have read quite a lot of other posts and some reviews, but it is always more helpful getting some direct advice/experiences.

I'm thinking I want to get some ACS Pro's as I'm yet to see a bad review of them. I emailed the only shop in New Zealand (PacificEars) that seems to distribute them and they said that they have a flatter attenuation and less occlusion than the Etymotic Research (ER) earplugs. So, if anyone can confirm that they like them, what sort of situations they use them in and what dB rated filters they use for those situations (10, 15, 17, 20, 26, 27 or 31) that would be awesome?

I think I will mostly want to use them in the odd bar, maybe a club (that isn't playing excessively loud music), and I guess any other type of event that will have a louder volume. I've seen the Pro-17 earplugs recommended quite a lot for gigs etc. and so am wondering if they will be suitable for the situations I've mentioned above? Or should I be more cautious and go with the Pro-26 (or get both for different circumstances?). I don't really have any idea how much they will actually reduce the sound in real terms, i.e. how they will make audio/voices sound and at what volume they will reduce to.
I'm open to buying a few different filters, so if anyone has any suggestions it'd be great!

I also see they sell them with and without grips (for easier removal), has anyone got them with these and do they help? I kind of want them to be as inconspicuous as possible, so I'm thinking without, but I really don't know how big the grip is and can't find any images of it. I imagine you must still be able to remove them ok, otherwise that would be a fairly big design flaw!?

Thank you for your help!
Michael

 

[MichaelP]

Was my post moved into this thread? Or did I do it accidentally somehow, as I'm pretty sure I created a new one as this one doesn't really answer my question.

Well, if anyone has any experience with the ACS Pros and what filters are best to get and for what situations you use them in it'd be most appreciated.

Thanks,
Michael.

 

[MattS]

Hello everyone,

I have moderate hyperacusis - I'm able to handle almost all noises at home, but I'm unable to go to movies, weddings and even the gym (because of the loud music), because it's far too loud (it is unbearable for me)...

I go next week to buy custom earplugs, and I wonder whether I should buy the ER-25 musician earplugs (which gives a straight attenuation of about 25 decibels) , or the regular custom ones (which gives about 30 decibels attenuation, not uniformly).

I want to buy the ER-25 because of the straight attenuation, but I'm afraid they won't attenuate enough at those loud places I mentioned above.

Here is the datasheet for each one of them:
http://adut.co.il/images/ER.pdf (ER-25)
http://adut.co.il/images/compact_flexcomfort.pdf (ML 01)

What do you think I should buy?

Thanks in advance!

I expect 25s would be more than enough for the situations you describe (except weddings). Indeed, in time I would expect you'll be able to do with less than that even.

 

[MichaelP]

I expect 25s would be more than enough for the situations you describe (except weddings). Indeed, in time I would expect you'll be able to do with less than that even.

Thanks, @MattS. Think I'll go for the 17 and 26 filters, with maybe the solid insert for any particularly loud situations I might find unavoidable.

Why do you think in time I'd be able to use less? Because my auditory system would have recovered a bit or stabilised? I'm not really sure if that's something that happens or not? I have read about people who let their guard down after their tinnitus reduced though and had relapses.

Cheers.

 

[MattS]

Thanks, @MattS. Think I'll go for the 17 and 26 filters, with maybe the solid insert for any particularly loud situations I might find unavoidable.

Why do you think in time I'd be able to use less? Because my auditory system would have recovered a bit or stabilised? I'm not really sure if that's something that happens or not? I have read about people who let their guard down after their tinnitus reduced though and had relapses.

Cheers.

How long have you had your symptoms for Michael?

I think everyone's course is a bit different, but many people find that their symptoms reduce or stabilize some over time. Those are not necessarily the people that gravitate towards this forum, and so it may not always seem that way on here, but it's the most common path. Is it because one's symptoms actually get better? Or does the person just get used to them and not get bothered by them as much? That's not entirely known; but it also may not be the most important distinction to dwell on. Either way, most people see improvement and stabilization over time.

With regard to hyperacusis, that's even more true: almost all hyperacusis is treatable, via gradual desensitization of the auditory system. And so with proper care, you can almost certainly reduce your sensitivity to loud noises. It will take time, and it will require that you be very patient and deliberate in your exposure...but it can be done.

Moreover, it *should* be done. The auditory system requires sound, or it withers. In this regard it's no different from any other body part: if you don't use it, it atrophies. That doesn't mean you should go out and blast yourself with music or anything - as I said, you'll have to be very patient and deliberate - but you should expose your system to sound, in order to desensitize it, and in order to properly stimulate it.

Tinnitus symptoms are more complicated, particularly if they are reactive to noise (like mine are). You didn't describe the severity of your tinnitus symptoms, just the hyperacusis. With tinnitus symptoms you need to be even more gradual/deliberate, because the goal is to prevent too much sound from causing a spike. But the tinnitus also serves as a good gauge of the appropriateness of the sound you're exposing yourself to: if you spike from a given noise, then your system isn't ready for that level of noise yet, and you need to start slower; if you don't spike, numerous times, to a given volume, it's likely safe (at realistically, safe levels, of course).

Yes, some people let their guard down and relapse. That's I'll advised, and not what I'm suggesting. Don't ever let your guard down and allow exposure to sounds that you haven't fully determined are safe for you. But that doesn't mean to live in a cave, or to never stop wearing plugs. There's a happy medium somewhere, where you determine what your safe levels are, and you remain vigilant outside of that range.

One super safe way to begin desensitizing is to slowly decrease the NRR of your plugs. So the fact that you are getting 25s and 17s is good. Starting at 25, and slowly graduating to the 17s, and then maybe even down from there, would be a really safe way to guide your sensitivity down, without "letting your guard down". It may take months to graduate down... but it's a nice feeling of accomplishment, and a nice regaining of some of your life blood, when you get there.

Of course only you can truly decide what is right for you. But if anything I'm saying is resonating at all, perhaps check out this posting as well, where I detail out my rehabilitation philosophy in a bit more detail:

https://www.tinnitustalk.com/threads/tinnitus-hyperacusis-a-rehabilitative-model.35846/

 

[MichaelP]

Hi @MattS

For almost 4 weeks now. My apologies though, I think I must have incorrectly described what I'm experiencing, I don't believe I have hyperacusis, well, it's possible I might have a very mild version, but I can only think of one such thing that describes what I believe hyperacusis is. When I used to play volleyball my two teammates and we were reffing they would blow the whistle loudly and it would hurt my ears, but never theirs. Ironically, I naively always put this down to perhaps my hearing being better than theirs, when I guess in reality it was probably a sign of the opposite. This is the only time I can think of it happening though and that was probably about 6 months ago (or more). I've heard whistles since, but not as close to me and it's been fine though, so I wouldn't say I have hyperacusis at all.

But the tinnitus also serves as a good gauge of the appropriateness of the sound you're exposing yourself to: if you spike from a given noise, then your system isn't ready for that level of noise yet, and you need to start slower; if you don't spike, numerous times, to a given volume, it's likely safe (at realistically, safe levels, of course).

This is interesting and something I haven't heard mentioned at all reading these forums. So, you think that as well as being susceptible to different sound levels, people actually acclimatise, or their auditory system improve over time, so that they won't be as susceptible?

My tinnitus is what I would describe as mild, well, it may have got slightly louder since last night perhaps in relation to what you have said above. I went to a bar for the first time last night since I got tinnitus (I didn't drink). I told the people I was with that I had it and we avoided all the loud bars and settled on one which I wouldn't generally have considered loud at all. I bought some Alpine Musician Pro earplugs as well, which I wore the entire night, and we also spent the majority of the time in the pub garden where it was even quieter. Nevertheless, I got back and felt an increase in the overall volume of my tinnitus, in the morning I was also experiencing quite a few louder high-pitched spikes in my right ear that lasted quite a long time, although that seems to have calmed down now. I had also been randomly getting these at times on other days as well, but in both ears and much shorter in length. Some of this increased 'activity' could potentially be put down to stress and lack of sleep though, but I still think last night, or yesterday spent around town during the day was probably the main influence.

Anyway, I guess this maybe goes to show that I'm not ready for any even comparatively quiet bars at the moment, or I need to wear even higher rated earplugs (I've just ordered the custom ACS Pros and they're 26s (with the 17s), so hopefully should serve me better, plus the foam ones, of course).

Thank you for taking the time to write that out. I'll check out that thread you linked tomorrow and see if I can find any more about desensitising in relation to tinnitus; it's very late where I am and I barely slept last night, I really should've been trying to sleep ages ago!

Cheers!

 

[MattS]

Hi @MattS

For almost 4 weeks now. My apologies though, I think I must have incorrectly described what I'm experiencing, I don't believe I have hyperacusis, well, it's possible I might have a very mild version, but I can only think of one such thing that describes what I believe hyperacusis is. When I used to play volleyball my two teammates and we were reffing they would blow the whistle loudly and it would hurt my ears, but never theirs. Ironically, I naively always put this down to perhaps my hearing being better than theirs, when I guess in reality it was probably a sign of the opposite. This is the only time I can think of it happening though and that was probably about 6 months ago (or more). I've heard whistles since, but not as close to me and it's been fine though, so I wouldn't say I have hyperacusis at all.



This is interesting and something I haven't heard mentioned at all reading these forums. So, you think that as well as being susceptible to different sound levels, people actually acclimatise, or their auditory system improve over time, so that they won't be as susceptible?

My tinnitus is what I would describe as mild, well, it may have got slightly louder since last night perhaps in relation to what you have said above. I went to a bar for the first time last night since I got tinnitus (I didn't drink). I told the people I was with that I had it and we avoided all the loud bars and settled on one which I wouldn't generally have considered loud at all. I bought some Alpine Musician Pro earplugs as well, which I wore the entire night, and we also spent the majority of the time in the pub garden where it was even quieter. Nevertheless, I got back and felt an increase in the overall volume of my tinnitus, in the morning I was also experiencing quite a few louder high-pitched spikes in my right ear that lasted quite a long time, although that seems to have calmed down now. I had also been randomly getting these at times on other days as well, but in both ears and much shorter in length. Some of this increased 'activity' could potentially be put down to stress and lack of sleep though, but I still think last night, or yesterday spent around town during the day was probably the main influence.

Anyway, I guess this maybe goes to show that I'm not ready for any even comparatively quiet bars at the moment, or I need to wear even higher rated earplugs (I've just ordered the custom ACS Pros and they're 26s (with the 17s), so hopefully should serve me better, plus the foam ones, of course).

Thank you for taking the time to write that out. I'll check out that thread you linked tomorrow and see if I can find any more about desensitising in relation to tinnitus; it's very late where I am and I barely slept last night, I really should've been trying to sleep ages ago!

Cheers!

Hi Michael,

I think, as you said, that your thread got moved in here, and that led to a bit of confusion - I was actually thinking that I was responding to the person who began this thread, not realizing that you weren't him. My apologies. The advice I've given remains mostly the same...but it is a bit more oriented towards hyperacusis than tinnitus.

But mostly the advice is the same:

* Yes, if you've only had tinnitus for three weeks, and are seeing increases in bar environments, then that's probably a sign that you may want to step back a bit.

* Yes, I believe that your system can become less reactive over time. @Michael Leigh has a quite interesting idea that the reactive spike is itself a sign of hyperacusis, and that that level of reactivity can be reduced over time by desensitizing the ears. That doesn't mean the tinnitus goes away, but perhaps the constant noise-induced spikes can.

*But these things really do take time. I'm at about 6 months right now, and still seeing slowwww progress back to normality. Many people claim to require up to 2 years to stabilize. After three weeks, you're still very, very fresh. So do be careful.

* Most people do see stabilization, but it can also become progressively worse without proper protection/care.

* As really, really broad guidelines, I would say that anything above 80dbs should be treated with caution, and anything above 90dbs should be avoided. Sadly, that removes many bar environments. Moreover, super high and super low (bass) frequencies are worse, so be particularly cautious of those. The bass is really common at bars, and even at quieter levels they can irritate tinnitus.

* But of course everyone is different, and you need to figure out what works best for you. Getting plugs seems a good idea, and will help. Just know that bars are tricky, and that the bass can get through even the best of plugs. So, as you have, you may find that you experience new/louder sounds following a night at the bar, even with protection. The question, really, is how much that bothers you. Some people just accept the ringing and live their lives; some people need to really take stock of their lifestyle and make changes. You'll need to figure that out for yourself.

Hopefully some of that was helpful.

Matt

 

[MichaelP]

Hi Matt,

Thank you for the advice, some very interesting points that I wasn't aware of previously and will have to look into more.

Temporary spikes (I have noticed I get them from exercise even if it is non-impact, e.g. yoga) I can live with; anything that might be permanently damaging I definitely will not be able to get used to easily. Unfortunately, this will mean a lot of lifestyle changes for me it seems, not that I historically frequent bars often, or festivals/clubs/events as much as I used to, but they've definitely been a big part of my life, especially as I am in a new town and currently unable to meet up with a lot of the people I've met here who are going to those environments. I feel pretty depressed right now, but know that I would regret it more if another decision I made was the cause of my tinnitus getting worse.

I'm just hoping things will stabilise over time like you say they might, although I'm unsure how I will know if that's happening if I'm avoiding bar environments? Is there anything in particular that makes you think your tinnitus is stabilising?

Are cafes or restaurants ok do you think? I guess some play loud music, but it's pretty rare they'll have the kind of speakers with loud bass that a bar would.

It was definitely a helpful post.

Thank you,
Michael

 

[MichaelP]

Hi Michael,

I think, as you said, that your thread got moved in here, and that led to a bit of confusion - I was actually thinking that I was responding to the person who began this thread, not realizing that you weren't him. My apologies. The advice I've given remains mostly the same...but it is a bit more oriented towards hyperacusis than tinnitus.

But mostly the advice is the same:

* Yes, if you've only had tinnitus for three weeks, and are seeing increases in bar environments, then that's probably a sign that you may want to step back a bit.

* Yes, I believe that your system can become less reactive over time. @Michael Leigh has a quite interesting idea that the reactive spike is itself a sign of hyperacusis, and that that level of reactivity can be reduced over time by desensitizing the ears. That doesn't mean the tinnitus goes away, but perhaps the constant noise-induced spikes can.

*But these things really do take time. I'm at about 6 months right now, and still seeing slowwww progress back to normality. Many people claim to require up to 2 years to stabilize. After three weeks, you're still very, very fresh. So do be careful.

* Most people do see stabilization, but it can also become progressively worse without proper protection/care.

* As really, really broad guidelines, I would say that anything above 80dbs should be treated with caution, and anything above 90dbs should be avoided. Sadly, that removes many bar environments. Moreover, super high and super low (bass) frequencies are worse, so be particularly cautious of those. The bass is really common at bars, and even at quieter levels they can irritate tinnitus.

* But of course everyone is different, and you need to figure out what works best for you. Getting plugs seems a good idea, and will help. Just know that bars are tricky, and that the bass can get through even the best of plugs. So, as you have, you may find that you experience new/louder sounds following a night at the bar, even with protection. The question, really, is how much that bothers you. Some people just accept the ringing and live their lives; some people need to really take stock of their lifestyle and make changes. You'll need to figure that out for yourself.

Hopefully some of that was helpful.

Matt

Hi Matt,

I realised on this forum you don't get a notification to posts below yours unless someone tags you or you quote their post. So, in case you didn't see my comment I've done just that!

Thank you for the advice, some very interesting points that I wasn't aware of previously and will have to look into more.

Temporary spikes (I have noticed I get them from exercise even if it is non-impact, e.g. yoga) I can live with; anything that might be permanently damaging I definitely will not be able to get used to easily. Unfortunately, this will mean a lot of lifestyle changes for me it seems, not that I historically frequent bars often, or festivals/clubs/events as much as I used to, but they've definitely been a big part of my life, especially as I am in a new town and currently unable to meet up with a lot of the people I've met here who are going to those environments. I feel pretty depressed right now, but know that I would regret it more if another decision I made was the cause of my tinnitus getting worse.

I'm just hoping things will stabilise over time like you say they might, although I'm unsure how I will know if that's happening if I'm avoiding bar environments? Is there anything in particular that makes you think your tinnitus is stabilising?

Are cafes or restaurants ok do you think? I guess some play loud music, but it's pretty rare they'll have the kind of speakers with loud bass that a bar would.

It was definitely a helpful post.

Thank you,
Michael

 

[MattS]

Hi Matt,

I realised on this forum you don't get a notification to posts below yours unless someone tags you or you quote their post. So, in case you didn't see my comment I've done just that!

Thank you for the advice, some very interesting points that I wasn't aware of previously and will have to look into more.

Temporary spikes (I have noticed I get them from exercise even if it is non-impact, e.g. yoga) I can live with; anything that might be permanently damaging I definitely will not be able to get used to easily. Unfortunately, this will mean a lot of lifestyle changes for me it seems, not that I historically frequent bars often, or festivals/clubs/events as much as I used to, but they've definitely been a big part of my life, especially as I am in a new town and currently unable to meet up with a lot of the people I've met here who are going to those environments. I feel pretty depressed right now, but know that I would regret it more if another decision I made was the cause of my tinnitus getting worse.

I'm just hoping things will stabilise over time like you say they might, although I'm unsure how I will know if that's happening if I'm avoiding bar environments? Is there anything in particular that makes you think your tinnitus is stabilising?

Are cafes or restaurants ok do you think? I guess some play loud music, but it's pretty rare they'll have the kind of speakers with loud bass that a bar would.

It was definitely a helpful post.

Thank you,
Michael

Yeah, sorry Michael - as you suspected, I didn't see your post until now.

Glad some of what I said was helpful.

It makes sense that you'd experience louder sounds after exercise. Nothing you can do about that unfortunately, but just know that that's always temporary, and just due to the increased blood flow/pressure to your head. I find exercises that load up my neck and traps lead to the highest volumes. But it's always temporary, so nothing to worry about. Sounds like you know that already.

Regarding bars and festivals, etc. Again, everyone has to figure out what works best for them, what they need to do to stay healthy. I'd say most people on here steer clear of those environments - but no doubt you'd find many people at the festival's who claim to have tinnitus. So who knows, right? My advice would be to be pretty cautious; but you'll know if you need to be or not.

Regarding coffee shops, cafes, etc: Yes, I think those are generally fine. But I always have my plugs with me, and do find that I often throw them in when I'm staying in a coffee shop. Not because the decibel levels are dangerous, but because I personally find the sound of dishes clanking together one of my worst triggers. Again, everyone is different: if a sound triggers you, you'll figure it out.

The dishes is a good example to make another point that I think you'll find relevant: it's very unlikely that dishes or cutlery clinking together cause *dangerous* noise levels; and yet they can trigger temporary spikes in some Tinnitus sufferers. This leads me to believe that not all sounds that cause temporary spikes are dangerous - they may just temporarily aggravate the system. I have no direct evidence for this, just my sheer conjecture; so do with that info as you wish. But I see you already making a distinction between exercise and bars re them being dangerous or not...so I thought this may be relevant for you to chew on.

Finally, you asked how I know things are stabilizing. Truthfully: I can't say*for sure* that they are. And obviously I don't know what tomorrow may bring. But that said, I do find that I'm fluctuating a bit less these days. That I can tolerate a bit more noise exposure without paying for it later. For instance, I just attended an event at my daughter's school where the entire seventh grade was whooping and cheering in the gym for 90 minutes. In the past I'd have expected some repercussions from something like that, but this time it seems my system has tolerated it well. The tinnitus continues to blare on; but any spike was very minor, if at all. So, yes, I think that the students can stabilize some over time. How stable will it get? Who knows. Will you experience the same mileage? Who knows...wish I could tell you more. But know that your life isn't over, your social life won't crumble. Yes, you may have to take it slow for a bit, ease yourself back into noise, test the waters, be cautious. But almost everyone in here has gotten their life back in order, and you will too. So don't worry: it sucks, but you'll be okay.

-Matt

 

[MichaelP]

Thanks for the quick and well written reply, Matt!

In particular I liked this paragraph, thanks for these words, hopefully it's the case!

But know that your life isn't over, your social life won't crumble. Yes, you may have to take it slow for a bit, ease yourself back into noise, test the waters, be cautious. But almost everyone in here has gotten their life back in order, and you will too. So don't worry: it sucks, but you'll be okay.

This leads me to believe that not all sounds that cause temporary spikes are dangerous - they may just temporarily aggravate the system. I have no direct evidence for this, just my sheer conjecture; so do with that info as you wish.

I imagine this is probably true, I guess there's limits to how much aggravation the system can take before more damage is produced though?

It's probably all just a result of damage the auditory system has sustained and the fact that it probably hasn't recovered that any excessive sound input can aggravate the system in the first place?

Tom wrote this to me as well, and although I have nothing really backing it up, I tend to agree with him:
"My personal take is that hyperacusis MAY be caused by the muscles of the ear being in constant tension to protect itself. Essentially the tensor tympani in constant tension. Hold a fist for a month. It'll hurt. Same thing.

For me once I calmed down, and my muscles calmed down the area, it faded."

Tight muscles, damaged auditory system and oversensitivity because of it. I guess this is maybe why stress aggravates it (increases tightness in the neck/jaw) and exercise heals it (due to increased blood flow).

I think I'm just thinking out loud and waffling a bit at the moment haha. But yeah, in summary, it makes sense to me as just aggravating an injury, but not necessarily making it worse, although obviously there's levels to that!


Glad to hear that you're having some levels of stabilisation and getting back to normal a bit! Thanks for all the information!

Cheers.