Hush Tinnitus Sound Therapy Experiences?

Hi all,

Have any of you tried HushTinnitus sound therapy? I can’t find any discussion about them so I assume they’re quite new?

www.hushtinnitus.com

I was trawling around the internet really just looking for good masking sounds and found them that way. The masking works really well (better than other sounds I’ve tried, because it’s tuned to your hearing I think) and what’s amazing is my tinnitus gets loads quieter after listening to it – and it lasts a minute or so! (this is called 'residual inhibition' apparently).

I downloaded the sound tracks a few days ago and I’ve been using them in the evening and at night when my tinnitus drives me mad! It’s helped keep me calmer. I can set it up to play on a loop so that you hear the sound for a few seconds then have about a minutes silence, then it plays the sound again for another few seconds before my tinnitus comes back. It’s SO GREAT to have a break from listening to my loud tinnitus!

I guess it’s not for people who’ve habituated and that’s still what I’m aiming to do but it’s nice to have something to fall back on when the anxiety sets in…

Carol.

 

I've just started out on this sound solution: http://www.hushtinnitus.com. It costs $30 and you get 67 tracks and a comprehensive user guide. I'd be interested to know if anyone else is also trying it out and whether it has worked/is working for them. It's a residual inhibition-based approach and grounded in lots of research. Take a look at the thinking behind it here: http://www.residualinhibition.com/residual-inhibition.pdf

Best wishes,

Jeremy

 

I just tried it. Went through the long process of getting the sound ready, then played it and it did nothing at all for me.

I play around with a lot of sounds that give residual inhibition and this one doesn't effect me, although high pitch tones like the one it generated can have that effect. They can also put your ears into a kind of shock / defensive mode and dull your hearing for a while, so I wouldn't use it as it recommends you to.

It seems like a glorified masker. They ask you to play it louder than your tinnitus, which could easily damage your hearing if you don't get the right sound to naturally mask your tinnitus. Something like that really isn't any use in my eyes unless it's properly overseen.

 

Hi,

I’m the founder of HushTinnitus. I’d like to share my thoughts in response to some of the comments made on this thread. I disagree with some of the remarks made on supposed safety issues: in my view, the comments made do not fit with published independent research. As discussed below, independent research shows that both residual inhibition sounds and masking sounds can be used totally safely, following the kinds of guidelines given on the HushTinnitus website.

In terms of safety, the HushTinnitus sounds are fundamentally no different to any other form of sound. With any type of sound, sound levels should always be kept to a comfortable and safe level. The HushTinnitus website enables people to listen to a pre-purchase preview of one of the types of custom sound in their download. At two separate points during the test, the website text clearly reminds people to make sure that their volume level is set so that it is “not uncomfortably loud”. This is a simple reminder to use common-sense safe volume levels – just the same as you would with any sound. The first page of the User Guide also clearly gives the same guidance.
I’ve written up a review of safety-related information regarding residual inhibition and masking sounds at http://www.residualinhibition.com (please see page 11, the section titled “Is it safe?”). The information comes entirely from independent peer-reviewed research papers (which are all referenced inline in the text, so you can easily find the original publications).

The section on safety is part of a larger review (covered by the document as a whole) in which I’ve attempted to review every paper ever published that deals with residual inhibition. I’ve reviewed over sixty research papers that deal with residual inhibition, masking, or related subjects (please see the end of the document for the list of papers reviewed). From this whole review process (which took me a year to do), here are my thoughts on the safety comments that have been raised on this thread:

• Across all the publications in the review (which involved thousands of tinnitus patients in total), not a single persistent adverse effect has been reported from the use of sounds for masking or residual inhibition. (The masking and residual inhibition sounds used by the HushTinnitus system are based entirely on the independent research covered by the review. For full details please see page 20 onwards in the review.)

• The comments in one posting on this thread referred to effects including “shock”, “defensive mode”, “dull your hearing for a while” and “easily damage your hearing”. None of these terms (or even any similar descriptions) appears in any of the papers reviewed – so the comments appear to not be based on published research.

• The same posting seems to imply that playing sound louder than your tinnitus is inherently dangerous. There is no research basis for that. In fact, it is totally standard practice to play residual inhibition and masking sounds *moderately* louder than the tinnitus. (Please see page 13 of the review, which refers to several different independent studies doing that.) Even when masking sounds are played so that the tinnitus can still slightly be heard (as is recommended in Tinnitus Retraining Therapy, for example), it can still be the case that the masking sound is a little louder than the tinnitus level. (That’s because the sound would typically need to be louder than the tinnitus level in order to mask the tinnitus completely – please see reference [36] of the review for evidence.)

• Of course, any sound must always be played at a safe level, as already discussed. So, for people with unusually loud tinnitus, masking and residual inhibition may not be suitable. But studies have shown that such cases are rare: the vast majority of people with tinnitus have their tinnitus at a level that allows safe use of masking and residual inhibition. (Please see http://www.tinnitusarchive.org/dataSets/1/tinnitusTestResult/loudnessMatchesAtTinnitusFrequency/ . It's a tinnitus loudness-matching study on over 1,400 people, carried out by Oregon Health and Science University.) For the large majority of people, this allows masking and residual inhibition sounds to be played at a level that is loud enough to be effective, but still totally safe.

• The same posting also suggested that the use of these types of sounds needed to be “properly overseen”. To me, in most cases this seems an unnecessary level of “hand holding”. If people with tinnitus can be trusted to safely set the volume level of other audio devices (like their radio or TV), then by the same principals they can be trusted to safely set the level of masking and residual inhibition sounds. Of course, as with all sound, care needs to be taken, but this is something that people are used to in their everyday dealing with sounds. The research reviewed contains no mention of any problems to do with safe volume setting. (For example, please see references [44] and [57] of the review. These were at-home studies in which people were allowed to set their own volume level for residual inhibition sounds. The HushTinnitus sounds are pitch-tuned in the same manner as the sounds in these studies. No problems to do with volume levels were reported.)

I’d be very happy to discuss any of these matters further – here on TinnitusTalk, or to my email address.

 

Hi @HushTinnitus and welcome,

Reading my post back the language is a little harsh sounding, so apologies for that. We usually debate things in this forum and my comments were written too quickly and in a condemning style.

I was referring to the sound generated when I went through your process. It is a personal opinion only, but for me the type of sound generated didn't inhibit my tinnitus in any way - and I can get RI effects through certain sounds.

I turned the sound up louder though and if I had put it to a level where it masked my tinnitus it would have been high enough to cause hearing damage over a sustained period of listening. On headphones / earbuds we know the issue on perception of loudness and actual loudness can be damaging, so I think there is potential.

For me it generated a high frequency sound, quite shrill. This made my hearing dull after a short time, the effect you get when you have had a long day of mixing, listening to music or similar, or when you hear a sound that sends your ears into a protective state.

General masking, which you have referenced above, uses a broadband sound that covers all frequencies, easy to mask a particular tone, whereas the sound I heard was in a specific range, not so easy to mask specific tones unless it is designed in. If a person has 500Hz tinnitus for example your sound would have been very loud before it drowned it out, I have a low rumble which wasn't even close to being masked at a higher volume by your sound.

I believe that when you are using a particular frequency and telling the user to mask their tinnitus with it that you should identify their tone, preferably their hearing profile also. This could be done via a program, though it would need to be relatively sophisticated as correctly identifying your own frequency is difficult for most.

Properly overseen for me would be a program to make sure the listener has the right tone, that it doesn't need to be played too loud (using the baseline data from the initial sound test you could analyse the difference in volume during a Q&A with the listener and roughly check they don't need to have it too loud when listening), checks and balances, or alternatively direct intervention. The latter would be difficult given the product and delivery method.

I don't believe we need hand holding, but I do believe that somebody desperate for help has an implicit trust that you have all checks in place.

Steve

 

Without a specialist audiological examination I doubt that anything could be tuned to your hearing especially over the internet. I'm pretty sure that I wouldn't pay $30 for a minutes RI when I can use my mp3 player as a partial masker and get as much relief as I want for free. I read the Customer Comments from the HushTinnitus website and I'm skeptical especially when you read something like "It Works" and "Very effective reduced my tinnitus straight away" and "eased my tinnitus". Even the comment: Instant Tinnitus Relief is enough to make you think twice before you cough up nearly $30 for something that will not do for you what you can do for yourself and for free.

 

Hi Steve,
Thanks for your reply, and for your welcome to the TinnitusTalk forum. I’ve been a keen follower of the forum since I first got tinnitus myself back in April 2012. To discuss all of your points most effectively, I’ve put a quick numbered summary immediately below. But to properly support my arguments, I’ve then inserted proper full responses into your original posting below. (I’ve also numbered the most important inserted replies, matching with the numbers in the summary below.)
Summary:
(1) Most people who try the HushTinnitus online preview state in their online response that they get a masking response and/or a residual inhibition response from the preview sound. This fits with independent research. But like any system addressing the hugely varied condition of tinnitus, it doesn’t work for everyone. (I’ve been totally open about this in what I’ve published online.) Steve, I have a plausible explanation for why it didn’t work in your particular case.
(2) Regarding safety: nowhere on the website does the text ask you to turn the volume level up until it masks your tinnitus. In two places (including during the preview sound), the website reminds you to keep volume levels so they are “not uncomfortably loud”.
(3) The website generates custom sounds for each user. These are frequency-tuned to the estimated frequencies of the user’s tinnitus, using a correlation identified by several independent research studies (detailed below).
(4) As an additional aspect of safety, the online software includes a number of design and logic safety features, which have been extensively tested on end users. These provide a range of additional checks, balances and methods to help keep sound levels in a safe range.

My full replies:

Thanks for that, Steve, that’s appreciated. I’m a big fan of open and reasoned debate and peer review, and I welcome having a reasoned discussion on all these matters, in a mutually respectful style.

(1) Sure. As I’m sure we’ve both read, research has shown that tinnitus is extremely varied from person-to-person: in terms of the types of tinnitus sounds that people hear, the pitch ranges of their tinnitus, the loudness of their tinnitus, and of course the way that different people cope (practically and emotionally) with the condition day-to-day. Add to that the findings of research specifically into residual inhibition and masking, and the picture becomes even more varied: two people with the same tinnitus sound characteristics can have completely different levels of residual inhibition response (in terms of the depth and duration of their tinnitus reduction) or distinct differences in their masking response. With this enormous variation between different people, I think it’s fair to say that no one system can work for everybody.
That’s my main thinking behind offering a pre-purchase preview on the website (and also for providing a post-purchase “for any reason” refund guarantee). I feel it’s essential that people can try it out, to see if it works for them – with their particular tinnitus and responses.
For those who are interested in published numbers from general tinnitus research (like how many people show a positive residual inhibition response, how many show a positive masking response, and so on) I’ve summarized the findings of the independent research in my review document (please see the link in my previous posting). Please see page 6 onwards for the numbers for residual inhibition. The headline figures… The different studies (which cover a wide variety of different test sound types) found that between 52% and 88% of people had at least some residual inhibition response. (In the “52%” study the experimenters played the sound quieter than in the other studies, which probably explains the lower response rate.) Regarding masking, 94% of people achieved masking responses with pitch-tuned sound in one study (see reference [56] of the review). (On the HushTinnitus website, as you’d probably expect we see similar figures to these, looking at the responses people give after listening to the pre-purchase preview.)
So, when an individual person tells me “it didn’t work for me”, I have to say that it doesn’t surprise me. Given the huge person-to-person variation in tinnitus, and in responses to stimulus sounds, we’d always expect a minority proportion (unfortunately) to not have a tinnitus reduction response. Of course, there is a good proportion of people (consistent with the studies) who do show a positive response.
But Steve, from what you’ve told me about your own tinnitus below, I believe I have a plausible explanation for why the pre-purchase preview didn’t work in your particular case, with your particular tinnitus. You’ve given me enough information to point the finger to a very specific matter, specific to the description of your tinnitus. Please see later for my thoughts on that.

(2) OK, there are a number of points here. Regarding the text on the website:
· Firstly, as already discussed, the text reminds people in two different places that, like any other sound, volume should be kept so that it is “not uncomfortably loud”.
· Secondly, you say “I turned the sound up louder though and if I had put it to a level where it masked my tinnitus it would have been high enough to cause hearing damage over a sustained period of listening.” Regarding the website text, the main point here is that *nowhere* does the website text ask you to turn the volume level up until it masks your tinnitus. In fact, on the screen where the preview is playing, first there is the volume restraint reminder, then the text simply says, “As it plays, please note whether your tinnitus is reduced.” That’s totally different. The user has been reminded (for a second time) about volume restraint, and is now simply being asked to make a yes/no observation.
In addition to the guidance in the website text, there are other features in the software designed for safety (whether the user is using headphones or speakers) – which I discuss more below.

(3)…
· The HushTinnitus System software does indeed use a strategy to estimate the frequency of the tone or tones of each person’s tinnitus. (Please see page 24 of the review, paragraph 2 onwards.) That’s because a large number of different studies have found that sounds, for causing residual inhibition or masking, are most effective when they are tuned to the tinnitus frequencies. (All the research references regarding this are on page 24.)
· Another relationship found by several different research teams is that the frequency range(s) of the tinnitus generally matches the frequency range(s) of regions of hearing loss. (Recent references [60], [64], and earlier references [2], [4], [5] and [9] in the review.) I’ve used this relationship to estimate the tinnitus frequency regions (detailed further in the next point).
· Steve, you say that “…correctly identifying your own frequency is difficult for most”. I totally agree. Several studies have found that many patients have difficulty reliably finding the pitch of their tinnitus in the “traditional” way, i.e. using an external pure tone to decide “is it higher, is it lower?” (References [23], [40], [64], [6], [43], [60].) There are also “likeness” matching tests ([43], [60], [64]), which report better test-retest reliability. However, they are somewhat lengthy to complete, and many people don’t have patience with lengthy online tests. So, in the pursuit of both reliability and shorter test times, the HushTinnitus System uses the relationship in the previous bullet-point.
· The website test makes a set of measurements to get estimates of some particular features of the user’s hearing profile. I’d like to stress (as I also do in the review document) that the test is not trying to take a full standards-calibrated audiogram. That’s not the point of it. Rather, the point is to estimate the location of certain *large features* (tens of decibels variation) in the user’s hearing profile that are typically associated with frequency regions of both hearing loss and tinnitus. If you’re interested in the exact details of what the HushTinnitus test does, please read pages 24 and 25 of the review (it would make this posting far too long to repeat it all here).
· The word “typically” is important here. The HushTinnitus test investigates hearing-loss features that cover the large majority of people with tinnitus: the upper audiometric edge frequency (which varies greatly from person-to-person, and is therefore specifically estimated with a frequency-sweep test), and any hearing loss at the commonly-identified notch frequencies, which (in order of prevalence, according to later studies) are 6, 4, and 2 kHz. Across all the tinnitus studies in the review, this covers the large majority of people with tinnitus.
· But no one system works for everybody, and by publishing a detailed description on the web (of both what the system does, and why), I’ve tried to be totally clear about what the system does and doesn’t cater for. For example, the system doesn’t currently cater for people with Meniere’s disease (which accounts for about 10% of tinnitus cases). Also, Steve, if you have tinnitus down at around 500 Hz (which would generally be expected to accompany at least some hearing loss there too), that’s quite rare (if you don’t have Meniere’s) according to the studies, and I’m afraid the HushTinnitus software doesn’t cater for that. Even 2 kHz notches are relatively rare, and (except for Meniere’s) anything lower is even less common, according to the studies.
· So, in your case Steve, the system probably tuned your sound to around your upper audiometric edge frequency (if you have no other notches at the common notch frequencies). This is where it would be most effective as a masking or residual inhibition sound for *most* people, given that measured profile. (But, to briefly touch back onto safety, even though it’s not effective for your particular tinnitus it’s still totally safe for you try it – if you’re following the on-screen guidance, and/or the same everyday approach you would use to setting any volume level safely.)
· All this goes back to why I have made a pre-purchase preview available in the first place. It gives an upfront opportunity for everybody to sample whether or not the system works for them.

(4) During the online test there are other checks, balances and methods in place regarding loudness – not just for safety, but also for comfort during the test. For example, the online check includes a series of “threshold” tests to find the quietest tones (in terms of relative amplitude) that people can hear at a number of frequencies. All of these tests progress from extremely quiet (too quiet to hear) to only-just-audible – at which point the user clicks to finish that stage of the test. This keeps these test stages extremely quiet and comfortable for the user.
The same is true of the frequency-sweep tests. These sweep down, from the high frequency end, so it’s totally imperceptible to start with. (Its amplitude also keeps to a quiet level during the sweep.) So again, the user only just hears it quietly, and then clicks to proceed.
I’ve put a lot of consideration into the relative sound level of the preview sound compared to the earlier sounds, and I’ve done extensive user testing on this. From that testing, I’ve derived figures for the range of typical sound pressure levels that people experience when the preview sound starts. I’ve designed the system to place those typical sound pressure levels in a comfortable and safe range (while still being in the required range for effectiveness for most users). The definition of “safe range” was taken from independent publications on audiologically safe levels (e.g. regarding audiological testing and hearing aid setting).
There’s a lot more detail involved the considerations here, but I’m trying to keep this post as short as I can while still covering the important points. For example, consistency tests are performed by the software to make sure that certain user responses “make sense” (compared to the requested action) in terms of the relative levels inferred by the responses. This adds an extra “checks and balances” level of safety.
When the preview starts playing, the design of the website wording and sound levels is such that the large majority of users end up with a level that is both comfortable and at the right level to be effective. However, of course different users do different things (and can have different reactions to the same sound pressure level), and for that reason the words at that stage encourage people to change the volume (up or down) if needed.
Steve, you mention direct intervention. From talking to a lot of users, I think most people don’t want that. They want freedom over what device to use (be it an MP3 player, an iPhone/iPad, a laptop, a CD player, or whatever) – because then they can use the tracks where and how they choose. All these devices have volume controls, of course. And I don’t think users want their volume control “nailed down” to a particular setting. So, it’s really then down to having the right guidance wording on the website and in the User Guide – which I feel I have already put in place.

I have gone to considerable lengths to try to make sure that all reasonable checks and guidance are fully in place. (In addition to all the discussion above, please see the first page of the User Guide, on the HushTinnitus website, linked on the About page.) This is in no small part motivated by my own personal experiences: excessive sound levels (from a car music system) were exactly what caused my own tinnitus. (My “tinnitus story” is on the HushTinnitus website, again linked on the About page.)
Taking the widest overview on all of this, the “safe use of volume levels” is a general subject, as I see it – much more general that just HushTinnitus. In the tinnitus world, it’s general to all tinnitus hardware devices that allow the user to adjust the volume (and there are many), and of course all MP3s, CDs and audio apps aimed at people with tinnitus. Having had this discussion, I don’t really see a convincing argument that there is a problem with HushTinnitus regarding safe use of volume levels. All system designers need to thoroughly consider safety, and I would argue strongly that I have fully and comprehensively considered the various aspects involved, and addressed them.
To finish, here’s a quick summary of HushTinnitus safety aspects (in addition to the user’s common sense, of course):
· Repeated text on the website guiding users to maintain volume restraint, as they would with any sound.
· A fully analyzed and extensively user-tested design of sound levels throughout the online test.
· An extensive review of published research on residual inhibition and masking (published online), including a section dedicated to safety.
· Clear guidance in the User Guide, right on page one.

 

Hi @HushTinnitus,

Quick question. Is HushTinnitus only for tonal tinnitus?

Adam

 

Hi Adam,

Thanks for your question. It's very much aimed at non-tonal tinnitus too, as the external research I've based it on addressed both tonal and non-tonal cases. Quite a lot of HushTinnitus users have described their tinnitus to me as "hissing" , and other non-tonal descriptions.

Something you might find interesting, if you haven't seen it already, is a comprehensive survey of how people describe their tinnitus, which is part of the Tinnitus Archive maintained by the Oregon Hearing Research Center. ...I think this forum's software won't currently allow me to paste in a link (until my rating goes up when somebody clicks "like" on one of my postings!), so I'll describe how to get to their web page:

- Google for "tinnitus archive" and go to their website
- Click Overview
- In the "Data Set 1" listing click "Predominant Tinnitus Sound(s)" (Data Set 2 is smaller, but does split results by gender)
- Scroll to the bottom of the page to see the data presented as a nice clear bar chart

Best regards.

 

@HushTinnitus I haven't read your full post so for the sake of argument I'll assume you've answered my points and all is good. When I have the time I'll read it through.

So to get back to grass roots, what does your program do to help somebody with tinnitus?

As I understand there is a residual inhibition effect, for those it works on, where tinnitus drops out for a short time but comes back. There is no long term gain that I am aware of from RI and it isn't recognised as part of a treatment strategy that I know of. Neuromodulation often gives an RI effect but it is a symptom of the design of the treatment, which comes from a meticulous tone matching exercise.

The identification of tinnitus tone wasn't apparent when I tried it, so it doesn't seem accurate, and if it is based on roughly finding a users tone this changes over time for many, which would need a new program creating - would this new program be free or would the user need to pay another fee?

Can you explain to me concisely what your program aims to achieve?

 

I had a go @HushTinnitus, it's nice, my tinnitus is bad and have pressure pain with it, it masked the tinnitus nicely and pressure pain eased, but with respect pink noise does the same job for me.

 

I should mention @HushTinnitus that I'm a natural skeptic, which is why I ask so much. When I see treatments, especially audio based, I want to know the ins and outs.

Because I work with audio I naturally want to know what is different from something I would put onto YouTube for free.

 

Hi @Steve, thanks for your posts. Just like yourself, I always start off skeptical when I see something new. …And then I change my opinion if I can see there is a reliable body of robust evidence and reasoning.

The HushTinnitus sound tracks help people with tinnitus in one of two ways:

(1) For periods of relief. So, when a person is feeling particularly bothered by their tinnitus, they can play the tracks and “take a break” from their tinnitus. This is the way most of our customers use the system. The download includes custom-optimized sounds for achieving both masking and “repeating-sound” residual inhibition (see below). Customers use whatever type of track works best for them – both in terms of effectiveness, and also in terms of finding a track that is the least obtrusive for them. (The User Guide helps users find a “best fit” track for them, from the five albums of tracks provided.)

(2) For the long-term: as a tool to help long-term habituation, using established approaches like Tinnitus Retraining Therapy (TRT). The User Guide briefly introduces the idea of habituation (that is, becoming less aware of your tinnitus, and less bothered by it). The guide then points people in the direction of established other resources for supporting TRT, if that’s what you want do. From customer feedback, some users get on very well pursuing TRT (using just the Jastreboff/Hazell book, or with a TRT-trained audiologist): they report ending up “in a much better place”. However, a few customers have commented that “TRT is too complicated”. Naturally, people pursue their individual choices.

Personally, I started with (1) (in the early months of my tinnitus when I was feeling quite desperate about it, and simply wanted immediate relief) and then moved to (2). A TRT approach (using the HushTinnitus sounds for the “sound enrichment”) worked really well for me in the longer-term.

Of course, a primary question is, “What is better about HushTinnitus than other sounds I can get to do the above?” Well, in simple terms, HushTinnitus is my attempt to produce sounds based on a “best of” collection of principals from *totally independent* published research. I think that’s something different to many other products out there. Many tinnitus products are based only on the research done by the person or team behind the product. I’ve taken the opposite approach. There’s not a jot of my “own medical research” in there. Rather, I spent a full-time year finding out what other research teams have discovered about residual inhibition and masking: from 1903 to the present day. From that, it became clear that multiple research teams were in agreement that certain custom-tuned sounds produced better results (for most people with tinnitus) than simple white noise or pink noise. I wrote all this up as a comprehensive review document at www.residualinhibition.com : it’s a purely factual document, referencing all the original papers – and all references are inline, so you can easily check the accuracy and balance of any sentence I’ve written. (And there’s a nice light 3-pager intro right at the start, for anyone not up for the full 25,000+ words! ) The sounds of the HushTinnitus system are based entirely on that review of independent research findings.

Firstly, you mention “long term gain”. I’d like to make it unequivocally clear that nowhere am I trying to promote HushTinnitus as a “cure” or a “permanent tinnitus reduction”. My view on its role for long-term benefit is as above (in my point (2)). That said, there are a number of published reports (in peer-reviewed journals) of small numbers of people experiencing strengthening of their residual inhibition (i.e. longer durations of reduced tinnitus) with long-term use. Please see the section starting on page 9 of the review. Some of these reports come from quite “heavyweight” researchers, such as Jack Vernon (co-founder of the American Tinnitus Association) and Jonathan Hazell (the first TRT practitioner). In fact Vernon reports on two patients, with long-term tinnitus, whose residual inhibition got ever-stronger with use, until their tinnitus completely disappeared. However, my view is that such extreme cases are not “good medical science”, as this isn’t the outcome for the majority of patients. I believe it would definitely be unfair to promote any product based on small-minority positive outcomes. So, I don’t!

You say “…it [RI] isn't recognised as part of a treatment strategy that I know of.” Well, there *are* published studies specifically on residual inhibition as a therapy: please see references [40], [44], [57], [58] – reviewed in the section starting on page 8 of my review. In terms of RI treatment practice, rather than research, Canada seems to lead the way. The Canadian Hearing Society ran a study on Residual Inhibition Therapy (RIT) – please see [44] in the review. And there are some general audiology practices in Canada offering Residual Inhibition Therapy (RIT) – for example, Expert Hearing Solutions offers RIT at 14 practices across Canada. Also, in addition to HushTinnitus, there are a number of other RI products available.

But, beyond these, why isn’t RI more popular as a therapy approach? I think there are two reasons. Firstly, some people don’t have a strong enough residual inhibition response. For that reason, HushTinnitus includes sounds designed for optimal masking. These are sounds that can cause masking at quieter and less intrusive sound levels (for most people, according to several independent studies).

Secondly, even for people with a stronger residual inhibition response, there’s been too much focus (in most studies and other products) just on “one-shot” triggering, I believe. I’ll try to explain what I mean. In practice, there are two different ways you can use residual inhibition to keep tinnitus reduced:

· “One-shot” usage. With this approach, you play the sound (that causes the residual inhibition) continuously, for a minute or two typically. Afterwards, some people get a usefully long period of residual inhibition. (See page 7 of the review for timings from various independent studies.) Some HushTinnitus users take this approach before going to bed, for instance: for them, it gives them reduced tinnitus for a useful period as they are going to sleep. So far, two HushTinnitus customers have reported back to me that they get much longer residual inhibition: they play the sound for about a minute, and they then get about a day of reduced tinnitus afterwards. (Great for them!) What they’ve reported is totally consistent with the published independent studies: a *small* proportion do experience these longer periods of reduced tinnitus. But the trouble is, it is only a *small* proportion who have such a strong reaction. (For that reason, I’ve actually chosen to *not* put these customers’ testimonials on the website: it wouldn’t be representative of the general case, and that wouldn’t be right, in my view.) I think this has been part of the problem for the more widespread adoption of residual inhibition as a therapy: although some people can use one-shot stimulation to get a useful duration of quiet, it leaves many who can’t. But there’s another way!…

· “Repeating-sound” usage. Here, you set up the sound (that causes the residual inhibition) so you get alternating “short sound, longer silence, short sound, longer silence…” (So the overall sound pattern is mainly silence.) And that simple pattern just keeps repeating, as long as you keep it playing. This way, you can keep your tinnitus quiet (even silent, for some), as long as you want – even for a person with just a moderate residual inhibition response. The residual inhibition then just keeps getting “replenished” with each sound, and keeps the tinnitus suppressed. This “repeating-sound” approach was actually first discovered in 1971, by the researcher Harold Feldmann (references [9] and [24]) – but has stayed largely unused as a practical technique.

Personally, when I first tried repeating-sound RI on myself, in the early days of my tinnitus, I have to say I thought it was brilliant! I set the sound the up so I had a few seconds of “trigger sound” (to trigger the RI), then a much longer period (up to a few minutes, for me) of total silence, and that just repeated continuously in the background (in “single track repeat mode” on my iPod). For me, I found it much better than standard continuous masking: for the first time since my tinnitus started, I was now enjoying silence, with not even any masker sound playing for the large majority of the time. Since those early days, I’ve developed the sounds a lot further in a number of ways: there’s a research-based technique for fading the sound in and out in the least obtrusive way (page 30 of the review), and methods to make the sound content less obtrusive too (pages 31 to 37). These sounds are called “Type 1” in the HushTinnitus download, and users with moderately strong RI report getting on well with it. (And then there’s “Type 2”, for people with much less RI response, again based on published research – but this posting will get too long if I describe it here! It’s all on page 27 of the review, if you’re interested.)

Steve, I’ve already suggested a likely reason it didn’t work in your particular case, in my previous posting. (Please see the section starting “(3)…” in my previous posting: I address your experience specifically.) According to external published research, your described tinnitus characteristics are relatively rare (outside of Menieres), and are not covered by the software, I’m afraid. Published research, from a number of different sources (see last posting), supports the argument that the HushTinnitus tinnitus pitch-matching method is more accurate than “traditional” matching to an external tone, for the large majority of users.

You raise the point that people’s tinnitus can change with time. Yes, I agree. For that reason, each HushTinnitus customer gets a personal sign-in account on the website that allows them unlimited retests and downloads, for up to a year after purchase.

I’ve probably already covered this above: please see (1) and (2) at the top of this posting.

I’m happy to discuss further if you have any more questions or thoughts.

Best regards.

 

Hi @carlover. Thank you very much for your feedback on that. Yes, that’s totally fair enough, of course. People have all sorts of different relative responses (as all the studies show).

I think it’s interesting to compare pink noise with the some of the sounds people state they prefer (for masking) in various studies. Pink noise, as you probably already know, has “tilted” frequency spectrum compared to white noise: the low frequency end is boosted, and the high frequency end is reduced. In the published studies I found (summarized in my review), for masking purposes most people preferred the spectrum to be tilted the other way: high frequencies boosted up more than the low frequencies. …Of course, we can’t generalize too much, as this won’t be the case for everyone – it’s going to depend on the frequency distribution of each person’s particular tinnitus. But many more people have hearing loss (and tinnitus) at the upper frequency end of their hearing range than at the lower frequency end.

Regarding studies, you might be interested in this study by the researcher James Henry and colleagues at the US Veterans Association: http://www.ncbi.nlm.nih.gov/pubmed/15553658 . As well as looking at the spectral distribution of the masking sound, they’ve also looked at the role of dynamic (fluctuating) content. (The “Type 2” sounds in the HushTinnitus download are heavily based on the “winner” in this study, which has distinct dynamic content. However, whereas the sound track in the original study was just a fixed CD track (so the same for everybody), the HushTinnitus software produces a custom-tuned version for each user.)

Thanks again for trying out the preview (Type 3a) and feeding back.

Best regards.

 

Hey listen @HushTinnitus, cheers for a great response, I certainly meant no disrespect and at £20 it's worth a punt for someone.

 

@HushTinnitus, the word concise clearly isn't in your vocabulary.

 

@Steve: Accepted!

@carlover: Thank you for all your comments. I certainly think you're very respectful, and it's been a real pleasure chatting with you. I wish you well in finding the best help for both your tinnitus and your pressure pain.

Best regards.

 

Hi, back on here for the first time in a while! I can't comment on all the technical arguments (!) but the HushTinnitus sounds have been really helpful for me. These sounds reduce my tinnitus better than other types of sounds I’d tried.

I don't use it every day any more as I'm coping better now but I do use it every now and then on a bad day and it helps reduce my anxiety levels.

Yes, I agree that for some it wouldn't be any better than free sounds available out there but that wasn't the case for me, and anyway, you get to hear one of the sounds before you buy so you can make a judgement before you part with your cash!

You need to be sensible about how loud you turn the sounds up (as I always am when I listen to anything on my MP3 player) but I don't think it needs overseeing by a doctor if you use your common sense.

Carol.

 

When people place orders they should go through immediately. Everything you buy today is available immediately. My tinnitus was really bad today so I bought this course. That was 8 hours ago and all I have is a receipt but no tracks yet. I've sent 3 emails already and no reply.

Does this guy live on the moon?

 

Hello @worldcitizen1919,

I’ve sent you a reply to your email address but I’ll respond here too. The email with your download link was sent to you within a minute of your purchase. We did not get any email message back to say it had not been delivered, so it may be in your JUNK or SPAM folder. In any case, I’ve resent a second copy of the email (with a link to download your tracks) to you just now. I always respond to customers promptly within UK working hours (including weekends), but due to the time difference between where we both live I was not able to respond to you immediately: I'm afraid it coincided with Sunday evening/night here in the UK. Yours was the first email I addressed today when I started work.

Best regards.

 

Eggs and tomatoes very red are my main dish today. Geez you sure got back from the moon quick!! So quick that I came here just now to (hopefully) delete my post and not bare my stupidity to one and all but the God's won't hear of it! I guess you have a really fast space ship Clyde! So here I am now wondering how people like me survive on this planet. Makes you wonder doesn't it?

I saw a number 2 in red in the Google in box all day and just didn't think it was a spam alert! You beat me here to the forum, granted. But we did win the Ashes after all didn't we?

Thank you very much for your excellent support. I sincerely apologise for misunderstanding.

 

Hello @HushTinnitus, I will likely go for the purchase during this afternoon. I just wanted to check with you if you felt there was a best length of time to be using the tones during the day or does it really not matter?

I am assuming you just use it when you like for no matter how long you like but can you just clarify for me please and do you think as in your case that possibly the more you use it perhaps the longer the residual inhibition periods may become?

Thank you.

 

Hi @worldcitizen1919,

I'm very glad you've got your HushTinnitus tracks now, and have them playing! No worries at all about the misunderstanding: spam filters are constant trouble-makers - can't live with them, can't live without them! ...Yes, my moon-ship is pretty fast-moving - more so than our English cricket team of late! I really hope you get on well with the tracks, and of course do drop me an email if there's anything else you'd like to discuss.


Hello @Freddie,

Many thanks for your questions. Yes, you're right about the length of time to play the tracks... It depends on how you're coping with your tinnitus, and also on what you're trying to achieve with the tracks. Some HushTinnitus customers play the tracks only when their tinnitus is particularly bothersome - like in the evenings, when it's quiet, or before bed. Other customers play the tracks for long periods each day, if they are finding it harder to cope. Some customers use the tracks as part of a structured "habituation" program, such as Tinnitus Retraining Therapy (TRT), to train themselves to become much less aware of (and less bothered by) their tinnitus. TRT is discussed briefly in the HushTinnitus User Guide, and I've put a few links to TRT information below. Some HushTinnitus customers do report long-term reduction in their actual tinnitus loudness - a cumulative strengthening of their residual inhibition as they use the tracks more. (These reports from our customers are consistent with reports in independent medical research: for example, please see Page 9 of www.residualinhibition.com .)

I hope that gives a feel for the range ways different people use the tracks. Whatever decision you make regarding HushTinnitus, I wish you all the very best with your tinnitus journey.

Kind regards,

Clyde


Some links for helpful info on Tinnitus Retraining Therapy (TRT):

- The two researchers who developed TRT have their own websites: www.tinnitus.org and www.tinnitus-pjj.com

- They also wrote a book: Pawel J. Jastreboff and Jonathan W. P. Hazell. “Tinnitus Retraining Therapy: Implementing the Neurophysiological Model.” Cambridge University Press, 2008 . You can read the first few pages for free on Amazon, to get a feel for its approach: www.amazon.com/Tinnitus-Retraining-Therapy-Implementing-Neurophysiological/dp/0521088372#reader_0521088372

- You might be interested in my own “tinnitus story”, in which I discuss how I approached habituation: www.hushtinnitus.com/about-me

 

I will give it a try, too.
Listening to high-pitched cricket sounds also suppresses my tinnitus.
And also the generalfuzz sound hel me get some relief.

 

Hello @HushTinnitus - you may remember I downloaded your Hush Tinnitus program some time ago. I find it gives me great relief, but I use mainly the white noise (65 type3a x 15mins) - in combination with several other sounds (@Steve's Bell Melody) and three others; Tropical Rainforest, River and Crickets and finally the Aussie Bell Miner bird (Bellbird) in a continuous repeat mode on my mp3 players - they play all night and I sleep like a (buzzing) log.

These sounds are all only for relief, I'm not worrying about habituation yet as I have a lot of conditioning to get rid of - nearly 30 years - and as such I find they all work very well - whenever the tinnitus gets too much, I just plug in using open-type earphones so I can still hear normally but the masking does work very well as relief and afterwards it seems a little quieter. Whether that's only in my mind or not I don't really care - if I'm imagining it then I'll still take it. But I think it's real because if I only plug in one ear, after I stop the masking that ear is quiet while the other is going like the clappers - it seems to be trying to make up for the quieter ear! So much of this affliction is just plain crazy.

I play it all a little lower than my tinnitus (which is quite loud) so I can relate to Steve's comments about it being too loud if I drowned it out completely.

I recommend reading Jastreboff's book also as that explained a lot to me, although it was damn heavy going for a lay person like me.

Personally, I commend both of you, Steve and Clyde, for giving us forgotten 'howlers' somewhere to go when it all gets just that little bit too much. After 29 years of living with tinnitus my hat is off to you both and I'm really looking forward to your album, Steve. I don't know either of your thoughts about my 'mix' of sounds, as that's just something I came up with. Maybe I need a customised sound that I can get more serious about habituating with?

Cheers and thanks a million to you both, and @Markku.

Ray S.

 

Hi Ray,

It's good to hear from you, and thank you for your kind comments to Steve and I. I'm glad you've found a set of different things, from different sources, that you find helpful. Yes, I agree the Jastreboff book can be a bit heavy going. (Personally, I do wonder whether TRT patients actually do need quite so much detail on all the neurophysiological theory!) And, yes, I'd agree, habituation is something to be taken step by step, over the longer term... Sounds to me like you've got a good practical approach there.

All the best.

 

The worse thing about the site is the way the volume is measured.
You end up with very high volume on headsets.

Without setting the output volume perfectly the results and produced audio might be not accurate.

"Set a little higher then how you usually listen to the tv" - that's a joke in my opinion.

That is the biggest problem of all the online tests. Volume is not set correctly resulting either with over or under hearing.

 

Hello @HushTinnitus, and thanks. I have been trying this for the last few day's and when the tinnitus gets to a 10, this takes it down to a 5. Best 30 dollars I have spent. Dennis.

 

Hi, Mark here, just joined...

Tried the HushTinnitus test, and was advised email with sounds ready to send... once payment received.

As the last post from @HushTinnitus was June 2014, is this still running??

Cheers

 

What are we talking about please. And their address.