MANAGING TINNITUS WITH SOUND
Reducing Your Attention to the Tinnitus
Most people find that they are more aware of their tinnitus sounds when they are in a quiet place. For instance, the tinnitus can be particularly noticeable at night, when external sounds drop away, and can seem very intrusive when you wake in the quiet of the night. The contrast between the tinnitus and silence draws your attention to the tinnitus because it is the dominant ‘sound’ present. This is similar to the way in which our eyes are drawn to a candle burning in a dark room whereas we might not notice a candle flame in a well-lit room.
To reduce attention to the tinnitus sounds, it is recommended that people with tinnitus avoid silence. The aim is to reduce the contrast between the ambient quiet and the loud tinnitus sounds. This can mean having the radio, TV or low music playing, or using sources of low level, neutral sound, e.g. fan noise, running water. The purpose is not to mask the tinnitus sounds but just to reduce the contrast between the quiet background and the tinnitus.
Some people find that they can successfully ‘mask’ the tinnitus with other noise, that is, cover up the tinnitus sounds so that they cannot wear them. Music or the TV might achieve this, or other continuous sounds such as the air conditioner. Using external noise to try and mask the tinnitus sound is not always effective, however, as some people may require quite high sound levels to achieve effective masking. Also, masking the tinnitus can delay habituation (tuning it out) because the attention system cannot learn to ignore a sound it cannot perceive.
Introducing low-level, neutral sound is preferable to masking and can help in several ways:
- Having low level sounds around you can lessen the contrast between your tinnitus sound and the ambient sound environment. If it’s silent, the tinnitus sounds will dominate. If there’s some other sound present, the tinnitus may be less apparent.
- The auditory system is used to having a job to do - it expects to be actively processing sounds. If the auditory system does not receive input, it can sometimes create ‘junk sounds’ for itself (the tinnitus perceptions). If it has ‘real sound’ to process, however, this can divert it from the junk sounds.
- The attention system learns to habituate to (tune out) constant sounds, so low levels of ambient sound which do not demand attention can hasten this process.
- External sounds also draw your attention outside the body so that attention to your internal sound perceptions is diminished. Many people with tinnitus AND hearing loss find that they are less aware of the tinnitus perceptions while they are wearing their hearing instruments, because these increase the loudness of ambient sounds.
SOUND SOURCES
- Domestic equipment - such as ceiling fans and heater or air conditioner fans - can provide suitable low level sound
- Recordings of natural sounds - such as a waterfall, rain or crashing surf – offer a pleasant, neutral backdrop to your day-to-day activities, without intruding too much
- Try the real thing – a table-top fountain next to the bed makes a low splashing or trickling sound, or install a fountain or wind chime outside your bedroom window
- Low level music – particularly light classics, ambient electronic music or Gregorian chant – can be very calming
- Tune your radio to the FM band, between stations, to hear the ‘hash’ sound. This is a ‘white noise’ which some people find very soothing and a gentle distraction from the tinnitus
- Special recordings of neutral sound (e.g. white noise) which have been modified to match or mask common tinnitus sounds such as hissing
- Noise generator software programs can be downloaded from the Internet. You can then choose suitable sounds to mix with or mask your tinnitus and play them through your computer or MP3 player, or record them on CD
- Wearable noise generators, which look a bit like hearing instruments, create a white noise at a level which just mixes with the tinnitus and provide a ‘safety net’ of low level, neutral sound wherever you are. Such noise generators are used within the context of Tinnitus Retraining Therapy.
- Neuromonics individual sound device delivers music and neutral sound through small earphones.
Tinnitus Therapies Which Use Sound
1 Tinnitus Retraining Therapy (TRT)
TRT uses a combination of wearable noise generators or hearing instruments, counselling, attention control techniques and relaxation to encourage habituation to tinnitus.
Alliance Tinnitus and Hearing Center www.tinn.com
International Tinnitus and Hyperacusis Society under review
Tinnitus and Hyperacusis Centre, Emory University www.tinnitus-pjj.com
2 Neuromonics Acoustic Desensitisation Protocol
Uses a wearable sound device, programmed to your own hearing levels, to deliver neutral sound and music to each ear. This is combined with counselling.
Neuromonics www.neuromonics.com
3 Sound Therapy International
Sound Therapy is a portable self-help program that uses specially recorded analogue audio- tapes of highly filtered classical music to “rehabilitate the ear and recharge the brain”. Sound Therapy presents constantly alternating sounds of high and low tone. This, it is claimed, “exercises the middle ear muscles and stimulates the receptor cells in the inner ear”.
Joudry R. (2001) Triumph Over Tinnitus. Sound Therapy International, Sydney.
www.soundtherapyinternational.com/info_sheets/tinnitus.htm