Tinnitus sound therapy - how it works


Contributed by Debbie Clason, staff writer, Healthy Hearing

Nearly 50 million Americans have experienced the neurological and audiological condition called tinnitus, causing them to hear ringing, buzzing, hissing or whistling sounds when none are actually present. According to the American Tinnitus Association, close to 20 million Americans have chronic tinnitus, with two million experiencing extreme and debilitating cases. It’s one of the most common health problems in the United States.

A man looks at his phone
Smartphone apps are an easy way to try 

tinnitus sound therapy. 

Although there is presently no known cure for tinnitus, sound therapy is one of the well-established treatment options to help sufferers manage this condition and improve their mental health.

How does tinnitus sound therapy work?

Tinnitus sound therapy uses a process known as habituation to retrain the way the brain interprets tinnitus. Essentially, the brain learns to reclassify the unwanted sound as something neutral or unimportant.

“You can hear a sound that sounds just like your tinnitus—like crickets—but when you go camping in the wilderness and hear the crickets, it has a different meaning,” Christina Lobarinas, Au.D., tinnitus coordinator for the UT Southwestern Tinnitus and Hyperacusis Program, explained. “When the sound is constant and your brain is confused as to where it’s coming from, that’s when the tinnitus sound becomes bothersome.”

Sound therapy helps a person “forget” about the sound. That might sound tricky, but your brain already does it all the time. 

“It’s very similar to when you put on your glasses and your nose [nerve endings] start sending signals to the brain that there’s something on your nose,” Dr. Lobarinas said. “After awhile, you tend not to think about the feeling.”

There are different methods and types of sounds that can help, and an audiologists trained in tinnitus therapy can explore several options.  One common way to initially try sound therapy is selecting a relaxing, neutral sound—like ocean waves crashing, rain falling, white noise or instrumental music—and playing it as background noise throughout the day. 

“After a time, the tinnitus becomes associated with this sound,” she said. “The brain says ‘it’s constant, it’s meaningless, it’s not something I need to pay attention to.’ It’s essentially a passive form of extinguishing a response to a stimulus by moving it from a conscious to a subconscious level.”

How do I start tinnitus sound therapy?

To get started, Dr. Lobarinas recommends people first try downloading a free tinnitus app. “The key is to not set volume levels so high that it drowns out the tinnitus sound. You really don’t want to mask it. The goal is to retrain the brain so you need to hear the tinnitus along with the sound that you’re playing in order to help the brain make that connection,” she said.

Consistency and frequency are two other keys for success. Dr. Lobarinas recommends playing the sound for at least four hours a day as well as while you’re sleeping.

More: Tinnitus habituation: How to tune out the ringing in your ears

Hearing aids and other tools for sound therapy

Sound therapy itself isn’t expensive; however, your audiologist also may recommend hearing aids. Hearing aids amplify external environmental noise, giving your nervous system more sound to process. Bringing in more auditory stimulus to the brain can help reduce the perception of tinnitus. 

Keep in mind that tinnitus is often an early warning sign that a person has hearing loss. Treating the hearing loss promptly can help minimize tinnitus. Many hearing aids come with tinnitus masking tools built right in, which an audiologist or hearing instrument specialize can program for you. 

Who can benefit from sound therapy?

Almost anyone who is bothered by their tinnitus is a good candidate for sound therapy.

“If there is a medical condition contributing to the tinnitus and we can fix it, the tinnitus will go away,” Dr. Lobarinas said. “If there is no medical condition, anyone who reports their tinnitus to be bothersome would be a good candidate for sound therapy.”

Besides hearing loss, tinnitus can be caused by a host of auditory and medical problems, including obstructions in the middle ear, head and neck trauma, temporomandibular joint disorder (TMJ), sinus pressure and barometric trauma, autoimmune disorders, among many other causes

Find a tinnitus specialist

If you think you would benefit from tinnitus sound therapy, make an appointment with your primary physician or ENT. Once they have ruled out any contributing medical conditions, consult an audiologist who specializes in the tinnitus treatments.

And be committed for the long haul. Sound therapy is a progressive treatment program that is most effective when it’s paired with educational counseling. It may take as long as two to three months to notice any changes and as much as a year before the tinnitus is no longer noticeable.

‘Celebrate small victories’

“Markers to shoot for are a reduced emotional response to the tinnitus or change in pitch or volume,” Dr. Lobarinas advised. “Celebrate small victories. Any little progress is good progress.” 


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