Tinnitus Masking: Bone Conduction Headphones (e.g., Aftershokz) — Share Your Experience

What’s your opinion on open can headphones? Wouldn’t this be the “safest” since it is effectively behind the ear while leaving the canal fully open?

 

If the stereocilia hairs get vibrated to harshly, it will cause damage, weather or not the sound is right next to the ear. Bone conduction headphones are touted as "safer" because they don't block the ear canal allowing the user to listen to the headphones AND still hear sounds around them (to hear warnings, an oncoming car or threat, etc). The problem I see is people would then turn the volume up to compensate with the outside noise (and the lack of bass that bone conduction headphones tend to have), thereby causing damage. The stereocilia still receive the sound waves and get vibrated, just not through the ear canal. Just my two cents

 

No type of headphones are suitable for people with "noise induced" tinnitus. A person with this type of tinnitus risks making it permanently worse each time they use any type of headphone even at low volume. Just read some of the posts in this forum (and there are many) from people that got tinnitus "by noise trauma". They habituated and began using or returned to using headphones, only to find the tinnitus increases in intensity and will not return to its previous manageable level.

Considering the risks that are involved with headphone use and people with noise induced tinnitus, it makes sense not to use these devices even at low volume.

Michael

 

It depends on your use case: if it's to listen to something that will compete with outside sounds (music, therapy, etc), then I personally prefer isolating headphones (I have noise cancelling ones) because I can keep the volume low (there is no need to crank up the volume to compete with external sounds), but if you want to have something fed to your ear "in the background" (like white noise or other stimuli) while hearing what's going on around you then open can headphones are probably a better choice.

In case of accident, I think the more "open" the headphone the safer, as there are more ways for sound energy to escape: a sealed environment reverberates like a cave and doesn't dissipate sound energy as well, so you are more likely to pay a higher price for such acoustic accidents if you use headphones that maintain a tight seal between the speaker(s) and the ear drum.

 

@drivera2592

I have read all your previous posts to try and come to a decision that I think will help you. The initial onset of your tinnitus was caused by attending a loud concert that lasted six hours and afterwards noticed ringing in your ears.

You have also mentioned the overuse of headphones could have contributed to the tinnitus. I agree with this if you had been using headphones a lot prior to going to the concert. Like so many people do without realizing it, the sound was probably set too high on many occasions for your ears but you didn’t notice any problems. Therefore, you have probably had tinnitus for quite some time but it remained at a low level and masked, by everyday sounds so you didn’t notice it. However, at night when it is quiet, if you had listened I’m fairly certain you would have heard the tinnitus ringing.

The concert was the final straw and your ears and auditory system had had enough of being exposed to loud sounds. This resulted with the onset of full blown tinnitus that you are now aware of. You are probably wondering why I am mentioning all this? Please be patient for I assure you there is a reason. Like many people that are new to “noise induced” tinnitus or noise trauma to the auditory system, you noticed the tinnitus fluctuating in intensity over the following weeks. From mild, moderate and sometimes reaching severe levels. A lot of people habituate to tinnitus within the first 6 to 12 months without having any treatment at all. It is for this reason many ENT doctors prefer to leave the ears alone as they are quite delicate, and will often right themselves if left alone. After 6 months if a person is having a lot of difficulty coping with tinnitus then a referral to a Hearing Therapist or Audiologist that specialises in tinnitus and hyperacusis management is advised. A variety of treatments can help, and depends what is available to you.

You have had tinnitus for 7 months. Usually, but not in all cases people with noise induced tinnitus will make some improvement within this time. However, if you have been using headphones throughout this period and I suspect you have, then I believe this is the main reason you have not been making progress and having difficulty with tinnitus management. If you have been going to places where loud music is played: clubs, concerts etc. These are also factors that would contribute to your tinnitus not improving. Loud noise/sounds and tinnitus do not go well together especially when the tinnitus is “noise induced”. I suspect you probably have some hyperacusis too: sensitivity to sound?

White noise generators are specialist devices. When they are used for the treatment of tinnitus and hyperacusis, a person should also be having treatment with a Hearing Therapist or Audiologist that practices tinnitus and hyperacusis management, otherwise the white noise generators are likely to be ineffective. The way that tinnitus affects a person emotionally, needs to be addressed in the form of counselling.

White noise generators should be used when a person is having TRT. It for this reason I do not advise you to buy them as you may not gain any benefit using them alone. In addition to this, if they are not used correctly they can make tinnitus and hyperacusis worse. My advice is to stop using headphones regardless of type and keep away from venues where loud music is played. If you can get a referral to a Hearing Therapist or Audiologist that specialises in tinnitus management then I advise you to do so. Please also follow the advice in my posts: New to tinnitus what to do, and Hypercusis, as I see it. Tinnitus, A Personal View in the links is below.

White noise generators are expensive. The information below explains how they are used to help with tinnitus and hyperacusis. I am not telling you to try TRT, I am just informing you how white noise generators are used to gain maximum benefit from them.

All the best
Michael

There are two parts to TRT treatment. Counselling and sound therapy. Sound therapy is supplied by wearing two white noise generators and then using a “sound machine “ at night by the bedside for sound enrichment. If hyperacusis is present the sound therapy will also treat it, by desensitising the auditory system. Over time sound therapy will help to push the tinnitus into the background making it less noticeable enabling the brain to habituate to the tinnitus. Tinnitus Retraining Therapy is not a cure, it is what it implies: Through regular counselling sessions there is a gradual retraining of the way a person thinks about tinnitus and to treat it as non life threatening.

At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. In many instances the tinnitus is gradually pushed further into the background making it less prominent. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol.

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/hyperacusis-as-i-see-it.19174/

 

Because the volume of noise generators is (usually) set to a safe level digitally on a computer which means that the generated sound is constant and not loud

 

I don't know whether you wear white noise generators @dingaling? If you do and yours were set up in the manner that you have stated then this is not ideal. The reason is becomes tinnitus often fluctuates in intensity so it's always best to have a WNG with an adjustable volume control. I have been wearing white noise generators for over 20 years. There are two types. BTE (Behind the ear) which closely resemble a hearing aid. The other is smaller and more discrete and known as in-ear white noise generator. These fit in the entrance to the ear canal.

Although some BTE white noise generators have pre-set volumes: 1,2.3 this is still not ideal. In-ear white noise generators, the type that I have used over the years, all have an adjustable volume control fitted, enabling the user to finely adjust the white noise to slightly below the tinnitus or at the mixing point. The mixing point is when the white noise is mixed (blends) with the tinnitus, which I personally do not like.

My current BTE white noise generators are digital types and were set-up on a computer by my Audiologist, when I was fitted. I had a choice of choosing two forms of sound enrichment out of three, via a rocker switch on the WNG. White noise, Pink noise and Sea waves. I chose white and pink noise. The Audiologist also tailored the sound of the white and pink noise to my requirements: pitch etc. The volume on the WNGs can still be adjusted by me and is not at a pre fixed volume set on the computer.

Michael

 

I had a hearing test done, and I have a copy of the test results. If I post it here, can you see if there's any form of noise trauma?

I will say that what I'm going through is most likely conductive hearing issues, seemingly Stapedial Myoclonus/Dysacusis.

 

As an update, I found a cool solution. I use my phone and place it under my pillow. The app for music has a timer so it doesn't play the entire playlist (I have one just for sleep). The pillow muffles the sound so it doesn't bother my partner but I can hear it just fine. This has worked very well for me!

Thank you, everyone, for your advice and for the discussion.

 

So, I do not believe that headphones will make tinnitus worse (it's more how loud you use them), but now that I have gone 6 months without them, I really like being able to hear my environment (noises drown out my tinnitus).

I found headphones that play through your cheekbone as opposed to playing directly in your ear, so you can still hear the environment. Has anyone tried these out?

https://www.amazon.com/Aftershokz-Titanium-Wireless-Conduction-Headphones/dp/B018XNGPD6

 

I have loud tinnitus and mild hyperacusis

I know there is some contention over the use of headphones in this forum. I do miss music when running or cycling even if possible at the lowest volume will be fine.

These bone conduction headphones made by Aftershokz are advertised by the British Tinnitus Association.

Are they recommended or safe to use?

https://www.tinnitus.org.uk/pages/shop/department/headphones-for-safe-listening

 

@Sash

I understand how you feel Sash but I strongly advise you not to use Bone conduction headphones particularly, if you have Noise induced tinnitus. The sound from these headphones is transferred by vibrations along mastoid bone to the cochlea in the inner ear. You risk making your tinnitus worse the same as using conventional headphones. I have corresponded with people with tinnitus that have used bone conduction headphones and regretted it.

I do not agree with the BTA advocating the use of bone conduction headphones or any other type of headphone for people with tinnitus even at low volume. Most of the people at this organisation have no experience of tinnitus. Contact them and you'll soon find this out.

Take care
Michael

 

All sounds have to go through the cochlea to register to your nerves. Any loud sounds can damage the cochlea, regardless of where it originates from. If you use the equipment at safe level, it should be fine but they are not anymore safer than regular headphones.

 

Since your tinnitus was caused by an ear infection and not Noise induced, you have no knowledge or experience of this condition. My advice is for people that have Noise induced tinnitus and risk making it worse if they use any type of headphones even at low volume. Some people with noise induced tinnitus use headphones and have no problems. However, the risk of it becoming worse is always there. Peruse some of the many posts in this forum, by people with NIT that have returned to using headphones at low volume, and found their tinnitus has got worse.

Michael

 

If you can't quantify this risk, what good is it? It's like taking medication that is possibly ototoxic. Almost every medication used to treat tinnitus distress has tinnitus as a possible side effect. But unless you can quantify it, it's impossible to make a risk/benefit analysis.

 

@GaryTH

I am not here to quantify anything.

I have corresponded with you on this forum and posted you links to my articles for you to read. I have also replied to your message on another forum where you keep asking the same questions. There, I replied to your post explaining the risks of using headphones for people with noise induced tinnitus which is what you have even at low volume. You are looking for concrete evidence and proof for your questions and I have explained to you that this will be difficult to find. The advice that I give here and on other forums is based on my many years experience with Noise induced tinnitus and hyperacusis which was very severe but completely cured in two years, wearing white noise generators as part of TRT and having counselling. I have also helped people at forums and by email with noise induced tinnitus and counselled those that have wanted to contact me.

I explained to you on the other forum that I've said my piece and have nothing more to say to you regarding headphones, white noise generators, hyperacusis and tinnitus because I saw that you agreed with others who may not have Noise induced tinnitus. That is your choice which you are entitled to, so there's no need for me to advise you further, since you clearly do not believe what I am saying. I have met people like you before and it's unfortunate they tend to learn the hard way.

I wish you well and goodbye.

Michael

 

Has anyone here done a direct comparison between in-ear maskers and bone-conduction headphones, to see which you like better?

I am trying to do such a comparison now, and here are pros I see for the in-ear maskers vs. the bone-conduction headphones:

In-ear maskers:

• More discreet
• Battery life allows a full day's use
• Can also use amplification if you have a hearing aid model

Bone-conduction headphones:

• Leaves the ear canal completely open (whereas a masker partially closes it partially even if not fully), so you get the full masking benefit from natural ambient noise
• Can play higher frequencies than in-ear maskers (as I confirmed by playing pure tones)
• Cheaper

I am trying some qualitative testing as well, e.g. to determine which I prefer listening to for long periods of time.

 

I've just bought a pair of Aftershokz Trakz Air's and they're brilliant. Very lightweight so you hardly notice you're wearing them and they have a great frequency response when playing masking sounds, plus you get to hear all of the existing noise from the environment.

I don't have very loud tinnitus but it's extremely high pitched in quiet environments. I find these comfortable and good at distracting my tinnitus day to day.



Do tinnitus maskers help you habituate faster?

 

I just got mine today!

I installed RAIN App (white noise) on my iPad and paired it with the Aftershokz and it pretty cool…

I have it on very low volume as Im scared it would make my tinnitus worse… hoping to hear reviews

 

Quick update: I have been using it for few hours now, not sure if it's placebo, but my tinnitus has gone down dramatically! Let's see how it goes

 

I'm listening to crickets on mine on a low volume right now, it works really well to mask my tinnitus.

 

Try this with the Aftershokz:

Sweeping High Frequency Noise Ten Hours 10 -...

 

A local trained TRT professional trained by Pawel Jasteboff recommended I use them due to not having significant hearing loss. It was part of TRT presentation. I use them on & off. They have not made my T worse overall. They don't really help long term. Hearing aids did not either. It's a fact that TRT does not help everyone.

 

Had mine a while now and listen to white noise and can still have conversation and watch tv!

 

I find no difference between using speakers, bone conduction headphones and open-back regular headphones (low volume) in terms of worsening. 30-40 dB max volume.

 

I just bought the latest Aftershokz Aeropex model, smaller and more comfortable than anything out there.

Beware of the under $50 so called bone conduction headsets, these are just earbud speakers that don't go in your ears, most reviews on Amazon will say they work great but anyone sitting near you can hear everything.

Afershokz have the least leakage but if you're playing high pitched tinnitus therapy music, the highest notes will still leak out, you can test this by taking the headset off and covering the ear pieces with your thumbs to hear what is leaking. I don't use them for phone calls but I understand they have good noise cancelling.

I love them, work great with my glasses. I don't like earbuds, hurts my ears, fluid buildup etc.

Plus these allow you to work with an over-the-ear headset, watch TV, drive, have clear conversations.

 

Don't use any kinda headphones.

 

I have used bone conduction headphones for the last 6 months with a very low volume high pitch sweeping sound and it really has helped me with my tinnitus. I would never go back to AirPods. I use Shokz OpenRun, quite expensive but really worth it.

The fact that it’s outside my ear canal and it’s so low that I can just faintly feel the vibration is helping me retrain my attention away from the tinnitus. Sometimes when I take them off I stay silent for a couple of hours. Almost feels like a cure once in a while. Almost. I have perfected my own therapy with some very specific sounds and techniques, and bone conduction is an essential part of my toolset.

I keep them on up to 8 hours a day, but I am gradually ramping down. No adverse effects.

It’s funny, because I discovered their benefit while doing video conferencing. I can’t avoid headphones in my line of work.

 

I agree, I have done the same and although it's not a cure it really helps and you can watch TV or listen to the radio at the same time.