Tinnitus is very common and affects over 50 million people worldwide. Tinnitus is when you perceive to hear a sound, whether it is ringing, buzzing, hissing, or roaring, without the presence of a physical auditory stimulus within your environment. Tinnitus can be in one or both ears and can fluctuate in both pitch and volume.
A large portion of the population who experience tinnitus are not bothered by it. They can complete all of their tasks during their day without noticing their tinnitus. Approximately 2 million people experience tinnitus so seriously that they fall within the debilitating category of tinnitus. This means the tinnitus is constantly present and bothersome and interferes with daily activities, their job, and their relationships.
When you have bothersome tinnitus there are many different forms of treatment that can be used to reduce the effects it has on your life.
Understanding the Root of Tinnitus
In order to talk about tinnitus treatment, we should first discuss where tinnitus is generated. Pawel Jastreboff, the founder of Tinnitus Retraining Therapy, created the neurophysiological model behind tinnitus. Neurophysiological, meaning that it involves our central nervous system.
Tinnitus does not originate within our ears, although it is often associated with sensorineural hearing loss and damage to our cochlea. Tinnitus is generated within our limbic system located in our central nervous system. The limbic system is very deep within our brain and responsible for our fight or flight response and our emotional responses.
Jastreboff’s Neurophysiological model states that when tinnitus is present, our fight or flight response is activated and causes our whole body to become activated and tense. This then creates a negative emotional response (annoyance, frustration, anger) which becomes associated with tension and tinnitus. This all starts a chain reaction, like a reflex.
Think about when you are cooking something on the stovetop. If you place your hand on the hot stove, you immediately pull your hand off before it gets third-degree burns. This is not something you have to think about or tell yourself to do. It is done automatically by our brain because it is a reflex. This is what happens for tinnitus but in a negative way.
Our brain tells us the tinnitus is new and scary, activates our need to escape the situation, and creates a negative emotional tie saying we hate the tinnitus. This cycle will continue unless we actively work on breaking it. This is where sound therapy often comes into play.
How Sound Therapy Helps With Tinnitus
Sound therapy is one common form of treatment option used for tinnitus. Sound therapy works by providing therapeutic sound directly to the ears, teaching the brain and the limbic system that it has access to sound and that sound is beneficial. Not all sound is harmful, and we need to remind the brain of this.
Sound therapy allows our brain to focus on sounds that are pleasant and start to learn to ignore the tinnitus. We often refer to elevator music to help explain this concept. When you walk into an elevator, you may immediately notice the soft tune playing in the background. It is not loud or the number one song played on the radio. Instead, it is often soft and relaxing and will quickly fade into the background. This is how we want to treat tinnitus, as elevator music. Sound therapy helps teach our brain to fade the tinnitus into the background.
How Sound Therapy Works
Sound therapy works by introducing noise directly into your ears, whether that be through headphones, your phone, or hearing aids. The goal is to blend this noise with the tinnitus, allowing your sound to still be audible but overall, less bothersome. The goal is not to completely block out your tinnitus with masking, as this has no long-term validity in terms of treatment success.
Often people ask why adding more sound is beneficial because they believe all sounds will be as bothersome as their own tinnitus. I use an orchestra to explain this. If you attended a concert and only a single violin was playing every piece, you may start to become annoyed by the violin. If we add in other instruments, then they all start to blend together to form a beautiful sound. Your tinnitus is the violin. It is bothersome, annoying, and a single sound. By adding another sound through sound therapy, we are adding in the rest of the orchestra. For sound therapy, specific noise is used as well. The most common are either low-level steady-state noise or fractal noise. Steady-state noise is white noise, or what people often think of as static noise. Fractal sounds follow no identifiable pattern and examples include nature and water sounds. This therapeutic sound can be present throughout the entire day, or only when your tinnitus becomes bothersome.
Often many patients with tinnitus will start and end their day with sound therapy as their tinnitus becomes most bothersome when they first wake up and when they are trying to fall asleep at night. Overall, the goal of sound therapy is to teach our brain and limbic system that sound is good and to start filtering out the bothersome tinnitus.
Personalizing Sound Therapy
As I mentioned earlier, sound therapy should not be bothersome or annoying. The noise used should create neutral reactions from your limbic system, and you are always in full control.
Along with your audiologist, you will set the volume of the sound therapy. It should be loud enough to be consistently heard throughout your day, but not mask your tinnitus sound completely. It should not interfere with your daily activities or communication, and if streamed directly into your ears should not be audible to those around you.
What Is Widex Zen Therapy?
Another form of sound therapy is called Widex Zen. This therapy can be used with Widex hearing aids or by downloading their Zen app onto your phone. This hearing aid manufacturer created six different combinations of fractal Zen tones that aim to relax our body and limbic system.
These are more representative of music, as each have a specific melody, timbre, and tempo. If you are bothered by the traditional static noise or nature sounds, this may be a better option for you if pursuing sound therapy.
The Link Between Tinnitus, Hearing Loss, and Sound Therapy
As stated earlier, tinnitus is often associated with hearing loss. When we have hearing loss, our brain is being sound deprived. This sound deprivation causes our brain to overstimulate our auditory system, creating its own sound (your tinnitus).
Currently, both hearing loss and tinnitus have no cure, but both can be managed. Hearing loss is treated with amplification that is fit specifically to one’s ear anatomy and severity of hearing loss. Although sound therapy uses therapeutic sound and is beneficial to our ears and brain, this does not manage hearing loss. For patients, who have both conditions though, you may only need to focus on one form of intervention. For 60% of patients with both tinnitus and hearing loss, both conditions are effectively treated by consistently using hearing aids.
Wearing well-fit hearing aids enriches the listener’s environment with sounds, allowing the brain more auditory stimulus. This often can help resolve the tinnitus, even without further intervention. If you do not have hearing loss, there are many phone apps that can be used for sound therapy as well.
Resound Tinnitus Relief is a great app that offers a wide variety of nature sounds, deep breathing exercises, and guided meditation to support tinnitus treatment.
Mental Health Support for Tinnitus
Tinnitus is very common and affects over 50 million people worldwide. Tinnitus is when you perceive to hear a sound, whether it is ringing, buzzing, hissing, or roaring, without the presence of a physical auditory stimulus within your environment. Tinnitus can be in one or both ears and can fluctuate in both pitch and volume.
A large portion of the population who experience tinnitus are not bothered by it. They can complete all of their tasks during their day without noticing their tinnitus. Approximately 2 million people experience tinnitus so seriously that they fall within the debilitating category of tinnitus. This means the tinnitus is constantly present and bothersome and interferes with daily activities, their job, and their relationships.
When you have bothersome tinnitus there are many different forms of treatment that can be used to reduce the effects it has on your life.
Understanding the Root of Tinnitus
In order to talk about tinnitus treatment, we should first discuss where tinnitus is generated. Pawel Jastreboff, the founder of Tinnitus Retraining Therapy, created the neurophysiological model behind tinnitus. Neurophysiological, meaning that it involves our central nervous system.
Tinnitus does not originate within our ears, although it is often associated with sensorineural hearing loss and damage to our cochlea. Tinnitus is generated within our limbic system located in our central nervous system. The limbic system is very deep within our brain and responsible for our fight or flight response and our emotional responses.
Jastreboff’s Neurophysiological model states that when tinnitus is present, our fight or flight response is activated and causes our whole body to become activated and tense. This then creates a negative emotional response (annoyance, frustration, anger) which becomes associated with tension and tinnitus. This all starts a chain reaction, like a reflex.
Think about when you are cooking something on the stovetop. If you place your hand on the hot stove, you immediately pull your hand off before it gets third-degree burns. This is not something you have to think about or tell yourself to do. It is done automatically by our brain because it is a reflex. This is what happens for tinnitus but in a negative way.
Our brain tells us the tinnitus is new and scary, activates our need to escape the situation, and creates a negative emotional tie saying we hate the tinnitus. This cycle will continue unless we actively work on breaking it. This is where sound therapy often comes into play.
How Sound Therapy Helps With Tinnitus
Sound therapy is one common form of treatment option used for tinnitus. Sound therapy works by providing therapeutic sound directly to the ears, teaching the brain and the limbic system that it has access to sound and that sound is beneficial. Not all sound is harmful, and we need to remind the brain of this.
Sound therapy allows our brain to focus on sounds that are pleasant and start to learn to ignore the tinnitus. We often refer to elevator music to help explain this concept. When you walk into an elevator, you may immediately notice the soft tune playing in the background. It is not loud or the number one song played on the radio. Instead, it is often soft and relaxing and will quickly fade into the background. This is how we want to treat tinnitus, as elevator music. Sound therapy helps teach our brain to fade the tinnitus into the background.
How Sound Therapy Works
Sound therapy works by introducing noise directly into your ears, whether that be through headphones, your phone, or hearing aids. The goal is to blend this noise with the tinnitus, allowing your sound to still be audible but overall, less bothersome. The goal is not to completely block out your tinnitus with masking, as this has no long-term validity in terms of treatment success.
Often people ask why adding more sound is beneficial because they believe all sounds will be as bothersome as their own tinnitus. I use an orchestra to explain this. If you attended a concert and only a single violin was playing every piece, you may start to become annoyed by the violin. If we add in other instruments, then they all start to blend together to form a beautiful sound. Your tinnitus is the violin. It is bothersome, annoying, and a single sound. By adding another sound through sound therapy, we are adding in the rest of the orchestra. For sound therapy, specific noise is used as well. The most common are either low-level steady-state noise or fractal noise. Steady-state noise is white noise, or what people often think of as static noise. Fractal sounds follow no identifiable pattern and examples include nature and water sounds. This therapeutic sound can be present throughout the entire day, or only when your tinnitus becomes bothersome.
Often many patients with tinnitus will start and end their day with sound therapy as their tinnitus becomes most bothersome when they first wake up and when they are trying to fall asleep at night. Overall, the goal of sound therapy is to teach our brain and limbic system that sound is good and to start filtering out the bothersome tinnitus.
Personalizing Sound Therapy
As I mentioned earlier, sound therapy should not be bothersome or annoying. The noise used should create neutral reactions from your limbic system, and you are always in full control.
Along with your audiologist, you will set the volume of the sound therapy. It should be loud enough to be consistently heard throughout your day, but not mask your tinnitus sound completely. It should not interfere with your daily activities or communication, and if streamed directly into your ears should not be audible to those around you.
What Is Widex Zen Therapy?
Another form of sound therapy is called Widex Zen. This therapy can be used with Widex hearing aids or by downloading their Zen app onto your phone. This hearing aid manufacturer created six different combinations of fractal Zen tones that aim to relax our body and limbic system.
These are more representative of music, as each have a specific melody, timbre, and tempo. If you are bothered by the traditional static noise or nature sounds, this may be a better option for you if pursuing sound therapy.
The Link Between Tinnitus, Hearing Loss, and Sound Therapy
As stated earlier, tinnitus is often associated with hearing loss. When we have hearing loss, our brain is being sound deprived. This sound deprivation causes our brain to overstimulate our auditory system, creating its own sound (your tinnitus).
Currently, both hearing loss and tinnitus have no cure, but both can be managed. Hearing loss is treated with amplification that is fit specifically to one’s ear anatomy and severity of hearing loss. Although sound therapy uses therapeutic sound and is beneficial to our ears and brain, this does not manage hearing loss. For patients, who have both conditions though, you may only need to focus on one form of intervention. For 60% of patients with both tinnitus and hearing loss, both conditions are effectively treated by consistently using hearing aids.
Wearing well-fit hearing aids enriches the listener’s environment with sounds, allowing the brain more auditory stimulus. This often can help resolve the tinnitus, even without further intervention. If you do not have hearing loss, there are many phone apps that can be used for sound therapy as well.
Resound Tinnitus Relief is a great app that offers a wide variety of nature sounds, deep breathing exercises, and guided meditation to support tinnitus treatment.
Mental Health Support for Tinnitus
Aside from sound therapy, mental health professionals can also provide support for tinnitus. Cognitive Behavioral Therapy (CBT) is commonly used to help change negative thoughts and feelings surrounding tinnitus. If you do not have a psychologist or psychiatrist that you have previously established care with, reach out to your audiologist as they often have professionals who they refer to often.
If you fall within the debilitating category of tinnitus, it is important that you seek care from a mental health professional. It is often even more important that this professional be familiar with tinnitus and different management options.
If your tinnitus is causing significant distress and/or your own safety or well-being is threatened, please call the American Tinnitus Association hotline at 1-800-634-8978.
Takeaway
Tinnitus can be a scary condition, especially if your sound is new, loud, and very bothersome. It is important to remember though that there are many different treatment options that can help.
If you are someone who is bothered by your tinnitus, seek medical care from an audiologist who specializes in tinnitus. They are the best resource to help create an individualized game plan, make the correct referrals, and get you on the road to becoming unbothered by your tinnitus.
Aside from sound therapy, mental health professionals can also provide support for tinnitus. Cognitive Behavioral Therapy (CBT) is commonly used to help change negative thoughts and feelings surrounding tinnitus. If you do not have a psychologist or psychiatrist that you have previously established care with, reach out to your audiologist as they often have professionals who they refer to often.
If you fall within the debilitating category of tinnitus, it is important that you seek care from a mental health professional. It is often even more important that this professional be familiar with tinnitus and different management options.
If your tinnitus is causing significant distress and/or your own safety or well-being is threatened, please call the American Tinnitus Association hotline at 1-800-634-8978.
Takeaway
Tinnitus can be a scary condition, especially if your sound is new, loud, and very bothersome. It is important to remember though that there are many different treatment options that can help.
If you are someone who is bothered by your tinnitus, seek medical care from an audiologist who specializes in tinnitus. They are the best resource to help create an individualized game plan, make the correct referrals, and get you on the road to becoming unbothered by your tinnitus.
Ask an Audiologist today!
