Best Way to Habituate — Silence or Sound Enrichment?

[jcm1918]

All,

I'd like to solicit the thoughts of the group on an issue on which I've received conflicting advice. What is your opinion on the best way to habituate to tinnitus?

Option 1 - Do not use/overuse masking or white noise. Just accept the tinnitus, try not to be anxious or negative in response, and try to get used to it?

OR

Option 2 - Sound enrichment. Either masking entirely or using other sounds to distract where you can still hear the tinnitus but not loudly to try to teach the brain to filter out the tinnitus along with the other background noise? Or does the background noise inhibit habituation because you don't hear the tinnitus as much, such that when the background noises ends the tinnitus is as bad as ever?

I'm a new sufferer of tinnitus (2.5 weeks) and have received conflicting advice. As a new sufferer, could I try to avoid "imprinting" or minimize the brain associating the tinnitus as a dangerous noise by blocking it out, partially or entirely?

Any and all thoughts, advice, and experiences are welcome.

Thanks!

 

[fishbone]

All,

I'd like to solicit the thoughts of the group on an issue on which I've received conflicting advice. What is your opinion on the best way to habituate to tinnitus?

Option 1 - Do not use/overuse masking or white noise. Just accept the tinnitus, try not to be anxious or negative in response, and try to get used to it?

OR

Option 2 - Sound enrichment. Either masking entirely or using other sounds to distract where you can still hear the tinnitus but not loudly to try to teach the brain to filter out the tinnitus along with the other background noise? Or does the background noise inhibit habituation because you don't hear the tinnitus as much, such that when the background noises ends the tinnitus is as bad as ever?

I'm a new sufferer of tinnitus (2.5 weeks) and have received conflicting advice. As a new sufferer, could I try to avoid "imprinting" or minimize the brain associating the tinnitus as a dangerous noise by blocking it out, partially or entirely?

Any and all thoughts, advice, and experiences are welcome.

Thanks!

Habituation doesn't have a one size fits all scenario. people are different and how they might habituate will vary from one person to another. From my 31 years of experience with tinnitus, the most vital components are support and acceptance. Both of them take time, it's a day by day ordeal. If your tinnitus is new, making use of low level sound enrichment is a good idea. It gives your brain, a chance to hear another sound besides the tinnitus.

Gaining support from day 1 will be very beneficial to those that suffer form tinnitus. Gain support by talking to people face to face, this is very helpful. Forums are great but cannot compare to face to face support and bonding.

It can take some time to possibly achieve habituation, take it slow and just go for it.

 

[Michael Leigh]

Option 1 - Do not use/overuse masking or white noise. Just accept the tinnitus, try not to be anxious or negative in response, and try to get used to it?

Option 2 - Sound enrichment. Either masking entirely or using other sounds to distract where you can still hear the tinnitus but not loudly to try to teach the brain to filter out the tinnitus along with the other background noise? Or does the background noise inhibit habituation because you don't hear the tinnitus as much, such that when the background noises ends the tinnitus is as bad as ever?

HI @jcm1918

Tinnitus can be complex especially in the early stages which you are in, and it can become a little overwhelming, listening to different ideas on how to come to terms with the condition and habituate. One of the most important things is to find out, what caused the tinnitus then one can decide if treatment is necessary? You are just 2 to 5 weeks in and I gather from the information on your profile, the cause is left ear high frequency hearing loss? If this is correct and your tinnitus is not "noise induced" which is the most common cause of tinnitus, then I believe certain steps need to be taken in order for you to successfully habituate.

Since hearing loss is the cause of the tinnitus I will assume that you have already had a hearing test at ENT? Therefore, your doctor has determined the hearing loss is significant enough to bring on the onset of tinnitus something which is not uncommon. In order for you to habituate your hearing in the left ear needs to be improved. This is best done with the fitting of a hearing aid; so you need to be referred to an Audiologist or Hearing Therapist to be fitted with this device. If you are not fitted with a hearing aid then habituation will become difficult, as you have indicated your tinnitus was brought on by hearing loss?

When a person has hearing loss in one or both ears, the brain cannot hear certain frequencies from the outside environment. In order to address this the brain will turn up it's internal gain, in the process tinnitus can develop. Once a person is fitted with a hearing aid/s, the brain is supplied with sufficient sound and no longer has to turn up it's internal gain to try and compensate for any deficiency in hearing.

The hearing aid will do all the work by supplying your brain and auditory system with sound they need. There is no need for you to do anything else just leave it to time and habituation will naturally occur.

If your tinnitus was "Noise induced" then this is an entirely different matter. One of the best ways to habituate depending on the severity of the tinnitus, is by using "Sound enrichment". This should be used during the day and particularly at night. The tinnitus must not be masked, this is very important because the brain cannot habituate to the tinnitus unless it can hear it. Sound enrichment should be set slightly below the tinnitus. More about this is covered in my articles in the links below. I will also include information on habituation that you might find helpful.

All the best
Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/acquiring-a-positive-mindset.23969/
https://www.tinnitustalk.com/threads/tinnitus-and-the-negative-mindset.23705/
https://www.tinnitustalk.com/threads/the-habituation-process.20767/
https://www.tinnitustalk.com/threads/is-positivity-important.23150/

 

[Digital Doc]

You can put me in the column of silence for tinnitus, and not sound enrichment. I do not like white noise, and an electric heater at night masks the t well, and then gives me a spike the next day in a very consistent pattern.

I sleep with earplugs, that have helped me immensely get my tinnitus under control. My t got much better controlled when I wore my earplugs consistently st night, and the few nights I slept without them my tinnitus got worse right away over the last year.

 

[John Mahan]

You can put me in the column of silence for tinnitus, and not sound enrichment. I do not like white noise, and an electric heater at night masks the t well, and then gives me a spike the next day in a very consistent pattern.

I sleep with earplugs, that have helped me immensely get my tinnitus under control. My tinnitus got much better controlled when I wore my earplugs consistently st night, and the few nights I slept without them my tinnitus got worse right away over the last year.

I am too in the no sound enrichment camp. In fact, I am in the camp to move in the direction of more normal hearing, a broad exposure aka a normal sound exposure is in order, not a contrived sound signature or sound avoidance.

Which leads me to ask, why do you sleep with ear plugs? Do you sleep in a noisy room? What benefit to earplugs in a close to silent room during sleep?

 

[jcm1918]

Thanks for your response. I did have a hearing test with the audiologist and was diagnosed with some minor hearing loss in both ears, but only at 4,000 hz. The notch is slightly worse in the left ear, which is the only ear with tinnitus currently. The audiologist called it a hearing "notch." The ENT said that is consistent with noise-induced hearing loss and believes this is what is causing the tinnitus, but I have not had any extensive noise exposure that I can think of so I do not know.

 

[Digital Doc]

I am too in the no sound enrichment camp. In fact, I am in the camp to move in the direction of more normal hearing, a broad exposure aka a normal sound exposure is in order, not a contrived sound signature or sound avoidance.

Which leads me to ask, why do you sleep with ear plugs? Do you sleep in a noisy room? What benefit to earplugs in a close to silent room during sleep?

I originally turned to earplugs while asleep as with mild H a passing car was waking me up, as was the forced air heat when it turned on an off. It helped quiet those sounds, and also I noticed that my T was quieter in the morning, and also the T would get less within a few minutes of insertion. In fact, after a busy day when my T is louder, the earplugs at night quiet things all down for me, and promote a good night's sleep.

My room overall is not particularly noisy, and I live in the suburbs.

 

[Michael Leigh]

The ENT said that is consistent with noise-induced hearing loss and believes this is what is causing the tinnitus, but I have not had any extensive noise exposure that I can think of so I do not know

@jcm1918

I had suspected that your tinnitus was "noise induced" and not caused by hearing loss but went with what you have mentioned on your profile. If the tinnitus was caused by hearing loss, your ENT doctor would have recommend that you be fitted with a hearing aid. Something usually causes the onset of tinnitus and many things can be responsible. However, since your ENT doctor believes it is noise induced tinnitus and so do I, there are a few things that will determine whether this is the case, even if you don't think so.

Prior to the onset of tinnitus if you were a regular user of headphones, played loud music at home or in the car. Went to clubs, concerts frequently where loud music is played. Work in a noisy environment. Use a headset regularly to play computer games or work in a call-centre using a headset. Then your tinnitus is most likely to be Noise induced.

If yes to any of the above then I strongly suggest that you do not use headphones even at low volume, as you risk the tinnitus becoming worse, a lot worse. Please follow my suggestions in the links that I have provided.

Michael

 

[MasterFA]

@jcm1918

I had suspected that your tinnitus was "noise induced" and not caused by hearing loss but went with what you have mentioned on your profile. If the tinnitus was caused by hearing loss, your ENT doctor would have recommend that you be fitted with a hearing aid. Something usually causes the onset of tinnitus and many things can be responsible. However, since your ENT doctor believes it is noise induced tinnitus and so do I, there are a few things that will determine whether this is the case, even if you don't think so.

Prior to the onset of tinnitus if you were a regular user of headphones, played loud music at home or in the car. Went to clubs, concerts frequently where loud music is played. Work in a noisy environment. Use a headset regularly to play computer games or work in a call-centre using a headset. Then your tinnitus is most likely to be Noise induced.

If yes to any of the above then I strongly suggest that you do not use headphones even at low volume, as you risk the tinnitus becoming worse, a lot worse. Please follow my suggestions in the links that I have provided.

Michael

 

[MasterFA]

Wearing a headset at work as I'm in an advice center could worsen my T ? What if I keep sound very low. been working over the phone for 2 years. I'm curious to know if other people's T got worse working in call Centers

 

[Mister Muso]

Sound enrichment at night was essential in my early weeks of tinnitus. White noise, brown noise and nature sounds were my constant companion, day and night.

Since going on amitryptylene to help me sleep, I'm asleep so quickly that I don't feel the same need.

Also my tinnitus has evolved from a steady ring to a somatic hiss most days, which just gets louder in response to white noise. Soft music can still help though.

 

[Michael Leigh]

Wearing a headset at work as I'm in an advice center could worsen my T ? What if I keep sound very low. been working over the phone for 2 years. I'm curious to know if other people's T got worse working in call Centers

@MasterFA

Not everyone is the same. All I will say is that I have corresponded with people at tinnitus forums, whose tinnitus has become worse wearing a Headset for long hours in a call-centre, and it doesn't matter how low the volume is. Some people that I have spoken with, developed tinnitus because of wearing a Headset for long hours in a call-centre. I am sure not everyone that works in a call-centre and wears a headset is affect by tinnitus but some people clearly are.

Michael

 

[MasterFA]

Thx for sharing Michael. Im taking notes If I ever see bad effects, I will consider switching my role to fully off phone. For me it's more of an advice center then call center. I take like 15 calls a day and the rest is off phone. The workplace + vent is at 70DB, i heard that's very good but since I have T should I aim for lower?

 

[MasterFA]