Answers to Hyperacusis and Habituation

Hyperacusis.

Two questions often asked about tinnitus are: How long does it take to habituate? How do I know if I have hyperacusis?

One of the main causes of tinnitus is exposure to loud noise. Quite often though hyperacusis, (sensitivity to sounds) accompanies the condition. This is because the nerves in the auditory pathway have been subjected to noise trauma and thus become highly sensitised. Hyperacusis can be extremely painful. It can cause tinnitus to spike sometimes making it last for days until it settles down again. Within this time the person affected can be in a lot of discomfort.

Music that was once pleasurable to listen to through a home music system or radio is now an ordeal so one prefers not to listen to it. The closing of doors, washing up of kitchen plates and cutlery is enough to send a person running for cover, as it can feel like a pneumatic drill is piercing through your ears and head. It can become such a problem a person is afraid to venture outside their home in fear of road traffic noise sparking an increase in their tinnitus due to their sensitivity to sound.

One of the best ways to treat hyperacusis is by using “sound enrichment”. This can be achieved in many ways but I one of the best to wear white noise generators. Two should be worn to keep your auditory system in balance. The sound level of these devices must be adjusted correctly so as not to cause further irritation to a person’s auditory system, which can make the hyperacusis and tinnitus worse. It is best to always make sure their sound levels are set just below the tinnitus. Wngs are usually worn for up to ten hours a day. Two things are achieved over time.

The hearing system is constantly subjected to low-level non-intrusive white noise, which will help to desensitise it. Secondly, they help the brain to focus less on the tinnitus and push it further into the background making it less noticeable. This form of treatment is also known as TRT.

An alternative to wngs is to use a tabletop sound machine that plays nature sounds. This can be used for sound enrichment to help the healing process of hyperacusis. Again it is best to set the sound level just below the tinnitus. As previously explained sound machines can be very useful at night by the bedside and in the day used to fill in the background ambiance in room.

Treating hyperacusis takes time as there is no quick fix and everyone will respond to treatment differently.
Please bare in mind that a person with tinnitus and hyperacuisis, if the hyperacusis is left untreated sensitivity to sound will always remain a problem. In some cases hyperacusis can get better naturally without using sound enrichment but there is no guarantee.

A word of caution. Some people use earplugs to help suppress external sounds because of their sensitivity to sound. Earplugs are available but should only be used when in noisy surroundings and not to suppress normal every day sounds, as doing so can prevent the healing process of hyperacusis.


Habituating to Tinnitus.

Habituating to tinnitus often seems shrouded in mystery for the more seriously affected people that are in distress and have had to seek help at ENT. It can be particularly difficult for people that are new to tinnitus to comprehend. How does one know when they have habituated to their T and more importantly what does this actually mean?

The following doesn’t apply in every case of tinnitus for there are some people that have large fluctuations in their T and every day can be a different experience. This is one of the most severe forms of tinnitus and medications may be required to help cope with the condition. Habituating to this type of tinnitus is still possible to an extent but does present additional problems.


To others I will say this: You’ll know when you have habituated to your T regardless of whatever treatment you are using via ENT etc as your brain will over time push it further into the background so it becomes less significant, in a similar way to the people that have mild tinnitus. Although your T may be present and on occasions it will spike, over time it will cease to be so much of a problem unless you deliberately focus on it and bring it to the forefront of your mind.

Michael

 

Hi @Michael Leigh ,
Thanks for the post. Is it always advisable to wear both wng? I was given a pair but don't use both all the time for masking. Regards Phil

 

Hi Phil.
It is best to always wear two white noise generators even if the tinnitus is in one ear to keep the auditory system in balance. The volume of the WNGs should be adjusted to just below the tinnitus although, some people choose the mixing point, this is where the tinnitus and white noise are heard together; I personally prefer to set the wng below the T. To get the maximum benefit from wearing wngs as part of TRT (Tinnitus Retraining Therapy) tinnitus councilling from a Hearing Therapist / Audiologist is advised. Councilling helps to dymistify the negative thinking often associated with intrusive tinnitus and hyperacusis.

 

Hi @Michael Leigh
Thanks for the response. I note you have done TRT. Are you in the UK, and if so are you aware of any TRT practitioners in the North of England. Thanks again Phil

 

Made my day see your fantastic posts on here Michael.....lots of love glynis

 

Hi Phil,
I'm in the UK, born and bred in London but now live in Brighton as my picture shows. I had TRT twice in the 20 years that I've had tinnitus. I have had very good care/treatment at the NHS hospital that attended to me over 20 year and I'm still and out-patient. Ask your GP if there are any NHS hospitals in your area that practice TRT or at the clinic where you were give the wngs. TRT can be sought privately but the treatment is expenisve as it can last from 12 to 24 months sometimes longer. If you have any more questions I will try to help.
All the best
Michael

 

Hi Glynis,
Thanks for the kind words and it's good to see you here too and read your great contributions throughout Tinnitus Talk...
Michael

 

Hi @Michael Leigh
Thanks.
As far as I am aware there is no provision for TRT on the NHS, but rather class based CBT / Stress management therapy. We are setting up a support group and I have had some advice from @glynis. We will be discussing TRT at our next meeting. Best wishes Phil

 

Hi Phil,
TRT is practiced at some NHS hospitals. CBT, stress managment, relaxation therapy are also good. Glynis and I are very good friends and go way back..
All the best
Michael

 

Hi Phil....@Michael leigh is my dearest friend and known him many years ....he's a lovely person and a wise old owl with his depth of tinnitus knowledge.@Michael Leigh hope your laughing.....lots of love glynis

 

Hi @glynis
Great to have experienced people like yourself and @Michael Leigh on board prepared to help us newcomers adjust / learn about T. Regards Phil

 

Indeed I am laughing Glynis, but would rather not like to be referred to as an old owl. However, a young owl is quite acceptable...lol.
Michael

 

Can you describe the progression of your condition, from the beginning to today?

Thanks.

 

Phil is right there is little or no provision within the NHS for TRT you are exceptionally lucky to have had any.
Audiology where i live see us once every 3 months and say how are you doing etc. That is it. When I asked about TRT they say, this is it. I was offered CBT, the woman thought T and H were like a spider phobia and knew nothing about T or H and refused to get or read any books on the subject. I have rung numerous places and can get nothing. The theme these days is 'self management' basically that means we are on our own.

 

Hi @noisebox @glynis @Michael Leigh ,
I understand genuine TRT requires a therapist. There is a clinic in Clitheroe, Lancs but its £60 per hour. I have been using IWLM's Back to Silence method. I have found in addition I have needed to use masking. At night sound enrichment and during the day WNGs which were fitted on the NHS. Reading posts by members who have done TRT and kindly passed on their patient experience I have compiled this strategy. We have a support group in Blackpool which meets every 3 months. Hope this helps. Phil

 

Thanks Phil, I am in Yorkshire, I have h too so have no desire to travel miles for therapy. I was completely habituated but have had a medical setback this year and I'm worse than at the start with H too now. I cant bear WNGS Im afraid, I have unmaskable T, as it just ups its game. The only thing which masks it is running a tap, not recorded has to be the real thing, I've tried. I don't need sound at night, just a clock. Its daytime, trying to watch TV is worst as my T competes. I know basically we are on our own, its mind set which I don't have sadly. I simply hate it and cannot get used to it. Plus it cycles from one day to the next it alters, in fact it alters within one day many times.
I've done no caffeine, lowered salt, use magnesium, melatonin for sleep, added more fruit to diet, try to be calm (thats so hard with T as it is my only stressor), oh and having walks too. Run out of ideas now.

 

Hi Mike, I'm new here in Tinnitus talk , I've read most of your posts and I wanna give u thanks, I live in Brighton too btw
I'm suffering T (high pitch ringing in both ears) and Hyperacusis from 12 years, from playing loud music in a rock band, I've been dealing with this all this time quite well using earplugs in loud places and stuff but from a couple of months I have a new sound in my lef ear, a low frequency sound wich's more annoying and my Hyperacusis in that ear's getting worse..dunno what to do.. Is there anyone who has experienced this ?
PD: I have had bad times where my tinnitus and Hyperacusis got worse and then got better again but always the same pitch ringing, now there's this new low ringing and worse Hypersensibility than never ever before ..
I really would like to contact u and if It's possible have a coffee at some point if you want and share our experiencies.
Thanks Michael.