Last updated on 13 April 2011
What is sound therapy?
People who have tinnitus often notice that it is more bothersome in a quiet environment (for example at night) and that listening to other sounds can make it less intrusive. Deliberate use of any sound to reduce tinnitus awareness or alleviate the distress associated with it can be classed as sound therapy. In Tinnitus Retraining Therapy, the term sound enrichment is sometimes used. Sound therapy is often used in the treatment of hyperacusis (over- sensitivity to noise) as well as tinnitus.
It is unclear exactly how sound therapy works. Some people feel it brings about actual changes in sensitivity in the hearing parts of the brain while others think it acts as a psychological distraction or an aid to relaxation. It may be a combination of all of these things. What is clear is that most people with tinnitus use it in some form or other.
Sound therapy can be used as a self- help technique or as a component of a broader tinnitus management programme at a hospital or clinic. Quite a lot of research studies have found it plays a less important part than counselling in bringing about improvements in people’s tinnitus, so it is perhaps best to regard it as one tool amongst several you might use, rather than a solution in itself. That said, using sound therapy is one of the easiest things you can do for yourself if you don’t need professional help or are unable to access it.
Types of sound therapy
Sound therapy can be provided by environmental sound, by CDs and tapes, by bedside/table-top sound generators, by sounds downloaded from a computer, or by wearable sound generators.
The type of sound therapy suitable for you depends on your circumstances and your preferences.
Most people get on best with a sound that doesn’t demand too much attention and is not unpleasant to listen to.
Many people find that some background sounds, for example distant traffic, the hubbub of a busy office, wind in the trees, or waves breaking on the seashore make tinnitus less noticeable. At times, just opening a window may provide all the sound therapy you need.
CDs, tapes and mp3 players
There are a number of CDs and tapes of relaxing music and nature sounds available from various sources. Many local libraries have some available for loan, so you can try a few out. The BTA produces a good- quality recording of the seashore which can be ordered on- line or by phone. A wide range of nature sounds can also be downloaded from various web sites to be played on mp3 players or other portable devices, and some of these are free. For example, the web site www.peterhirschberg.com has a piece of software called ‘aire freshener’ which is free to download for personal use.
Bedside/table-top sound generators
These portable machines sit on the bedside/table-top and provide a choice of soothing sounds at the touch of a button. You can adjust the volume to suit your hearing.
Having a pleasant, relaxing sound to listen to can help at night if you are having difficulty getting to sleep. If left on at a low volume all night, sound therapy also provides a soothing distraction from tinnitus when you wake up in the early hours, when your surroundings are otherwise quiet.
Some sound generators and most CD players, mp3 players etc can be plugged into a pillow speaker or sound pillow, making the sound less audible to partners. See the BTA Suppliers and Contacts list. However, many people without tinnitus also enjoy listening to soothing sounds at night!
Wearable sound generators (also known as white noise generators, or maskers)
These are worn in the ears, and produce a constant white noise; a gentle rushing sound.
They are an optional part of many types of tinnitus therapy, and should always be fitted by a tinnitus specialist as part of a tinnitus management programme. They look like small hearing aids, and can be worn in the ear, or behind the ear. The behind the ear sound generators are generally preferred, as they do not block the ear. It is very important that when they are worn you do not feel that the sound generator fitting blocks your hearing.
If you have hearing loss, hearing aids are likely to help you. They provide a form of sound therapy through giving you easier access to everyday environmental sound. Most people find they hear their tinnitus less when their hearing aids are switched on.
Hearing aids can also be used with CDs and tapes, or bedside/table-top sound generators, and the addition of a loop system can help improve clarity.
How to use sound therapy
The aim of tinnitus therapy is to enable people to habituate to their tinnitus, so that it is ‘filtered out’ most of the time by the brain, even though it is still present.
Habituation is probably best achieved if you use sound therapy at a level that is just below your tinnitus most of the time. Some people use masking (loud noise which drowns out the tinnitus) to give themselves a bit of relief, but this approach does nothing to encourage habituation, and sometimes the tinnitus appears louder when the masking is switched off.
Will I need to use sound therapy for ever?
Most people find that sound therapy is useful whilst their tinnitus is intrusive, but becomes less important as they habituate to their tinnitus. People who use wearable sound generators usually use them only until they feel they can manage their tinnitus better, and bedside sound generators may no longer be necessary once a better sleeping pattern has been established.
How do I get sound therapy?
A list of suppliers for CDs, tapes, websites, bedside/table-top sound generators, and sound pillows can be obtained from the BTA office.
Wearable sound generators and bedside sound generators may be provided by your Audiology or ENT Clinic, however, provision of equipment within the NHS varies from clinic to clinic. Tinnitus management is also available in the private sector, in which case sound generators can be purchased directly from the clinic.
The original version of this leaflet was co- written by Catherene McKinney and Ross Coles.
Lucy Handscomb, Hearing Therapist, St Mary’s NHS Trust, London
Catherene McKinney, Head of Audiology, Guy’s and St Thomas’ Hospital Trust, London
Updated March 2010
© British Tinnitus Association
using sound therapy is one of the easiest things you can do for yourself
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