Can Hyperacusis Desensitisation Therapy Lower Tinnitus?

I went to the Tinnitus Clinic in London the other day, the doc was saying I probably have Hyperacusis as I find noises like trains/car breaks/dogs barking very uncomfortable, he said that if any common noises are causing you to be uncomfortable scared etc then it's probably Hyperacusis.

The thing is I don't know if it's Hyperacusis or just me being overprotective of my Tinnitus getting worse.
Maybe it's both.

Anyway, suggested I look at Hyperacusis Desensitisation Therapy, where you wear a small hearing device and they steadily increase the audio it plays over a time, "in order to gently decrease abnormally elevated auditory activity in order to restore a normalised perception of loudness."

He said in theory this could lower my Tinnitus.

I don't know what to think, I don't really like the idea of having something play noise in my ear all day, and I don't see how could this actually lower my Tinnitus?

But if it's worth a try... well what have I got to lose...


Has anyone gone through this treatment or can offer some advice?

 

Sound therapy cannot lower your tinnitus. It might help you habituate to your tinnitus, which may cause you to perceive it to be quieter. But it can't lower the actual signal.

 

That is actually incorrect. You can find data from scientific studies related to sound therapies (not masking). If you are part of the subset of patients who respond well to this therapy, you can actually lower your T volume (which is obviously different from habituating).
Example: windowed white noise. There are others (ACRN, notched).

Changes in T volume for Windowed White Noise (from the link above):

 

@Michelle123 If you hit two plates together do you find the noise uncomfortable ? If you do, then it's very likely you have Hyperacusis.

If you visited the tinnitus clinic , did they not test your LDL's ? (Loudness Discomfort Levels). I thought that was a standard test that they performed with Hyperacusis. I may be wrong as I have not been to any of their clinics. I've stuck with the NHS so far as the treatments offered at the tinnitus clinic do seem expensive.

 

Good if they didn't

 

Hi @Michelle123

You have only had tinnitus for one month. In my opinion, it is far too early for you to be thinking about this kind of treatment as it’s likely your tinnitus and hyperacusis might become worse. Sorry to sound so sobering.

I have had TRT twice in the twenty one years that I’ve had tinnitus with good results. TRT is the wearing of white noise generators and having regular tinnitus counselling with a Hearing Therapist or Audiologist whose trained in this field. The Desensitisation Therapy that has been suggested to you, is the wearing of white noise generators and most likely no regular counselling is offered. Therefore, this treatment is unlikely to work and advise you to walk away. Furthermore, I believe it is far too early for you to be starting a treatment like this or TRT. More is explained in my post below.

The best treatment for tinnitus in the early stages which are you are in is to do nothing. Providing there are no additional problems such as: Pain in ears, balance problems, dizziness or difficulty hearing. Stay with the NHS as you will get the best help and long time aftercare that no private tinnitus practice can match in the UK. Please read the posts below that you might find helpful, and click on the links at the bottom of the page, for further reading on tinnitus.

All the best
Michael


What is TRT and when should it be started?

I have talked about TRT in many of my posts. One tinnitus talk member recently told me that I have mentioned it no less than twenty five times. He went on to ask, am I an Audiologist promoting my practice in this forum purely for business purposes? Another member was quite disgruntled and told me to stop mentioning it because where he lives the treatment is expensive and can’t afford it. It just goes to show one never knows what is going on behind the scenes when you think no one is watching.

I understand and empathise with people that are unable to afford this treatment or any other to help one’s health but don’t feel this is a good enough reason for me to stop mention it when I believe it can help, having had TRT twice in the 20 years that I’ve had tinnitus. I am not an Audiologist. I just consider myself like many others at tinnitus talk, who want to help people that are having a difficult time coping with this condition, as I was once helped many years go when I first got tinnitus.

Some people have been sending me private messages asking if TRT cures tinnitus? A member mentioned having two sessions with their Audiologist and was shown some slides, and told that anxiety can make tinnitus louder. Understandably this person wasn’t sure if this was TRT, and then asked if it’s something they could do on their own? As I have mentioned I have had TRT twice and I also have the Tinnitus Retraining Therapy book, written by Professor Pawel Jasterboff and Jonathon Hazell. It is available at Amazon should anyone wish to purchase it.

It is the reference book that Hearing Therapists and Audiologists follow when practicing TRT with their tinnitus patients. There are two parts to the 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. Throughout the TRT book there is no mention that this treatment cures tinnitus. TRT or Tinnitus Retraining Therapy, 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.

When should TRT be implemented or started?

The following is based on my own opinion and therefore is not professional medical advice. The onset of tinnitus can be quite an emotional roller coaster for a lot of people, and I believe a person needs time for this to settle. Many people habituate within the first 6 months to one year of the onset of tinnitus without any treatment. If a person just has tinnitus without any additional symptoms, such as dizziness, deafness or balance problelems. I think a period of six months should elapse before starting a long-term treatment such as TRT.

Michael

New to tinnitus what to do?

The onset of loud intrusive tinnitus can be very traumatic for most people. I use the words loud and intrusive, because tinnitus comes in many forms and intensities. When it is mild, moderate or occasionally heard in quiet surroundings it is usually not too bothersome and a person can go about their daily affairs quite happily and unperturbed by this anomaly. This type of tinnitus usually comes on gradually and in some cases it’s associated with hearing loss, as we get older and the usual treatment is the wearing of hearing aid/s.

Tinnitus can be caused by other things: an underlying medical problem, build up of ear wax (cerumen). Jaw problems. Some medications and even irregular blood flow through the body causing Pulsatile tinnitus. The most common cause is exposure to loud noise or music that has been played at high levels that has affected the cochlea in the ear.

This type of tinnitus can be loud, intrusive and very debilitating. Often leaving a person at a loss and not knowing which way to turn to escape the nightmare that has suddenly come upon them. Your Dr has probably told you, it’s tinnitus and nothing can be done, you’ll just have to learn to live with it. I remember those words as if it were yesterday, so fully understand how difficult it can be for someone new to this condition to take this in and believe it to be factual.

If you are having difficulty sleeping you might have been advised to try a night time sedation or an ant-depressant to help cope with the stress and anxiety that often accompanies tinnitus. These medications can be helpful especially in the early stages and they don’t have to be taken long term, so it’s something to consider. They can act as a safety net so you don’t become too down.

A referral to ENT will usually be recommended. In the mean time try to keep occupied with something you like doing, as it helps to distract the brain from focusing on the tinnitus. Avoiding quiet rooms during the day by playing low level non intrusive music such as classical in the background can be helpful.

At night a sound machine placed by the bedside playing nature sounds or listening to favourite mp3 tracks or Cds are good. Keeping the volume just below the tinnitus is ideal and set to play throughout the night until morning. It takes time to get used to sound therapy so please stay with it. Whilst in a deep sleep it supplies the brain and auditory system with sound enrichment. Over time the tinnitus is pushed further into the background helping to make its perception less noticeable during waking hours.

In the early stages of tinnitus, if one chooses not to use sound enrichment sleeping can sometimes be difficult and there’s also the chance of the tinnitus becoming more intrusive as sleeping in a quiet room can allow the brain to increase it’s own background activity. In doing so it will also increase the tinnitus making it more intrusive during waking hours.

There is a tendency for newbies to try and cure their tinnitus which is quite understandable. There are many remedies, treatments and concoctions out there. Some affordable others quite expensive. I am not adverse to trying to help myself but want to say, there are charlatans and con artists eager to relieve someone in distress of their money so please be careful. Even tried and tested treatments I wouldn’t recommend a person try until they have been seen at ENT. Often a person after been seen at ENT is advised to wait a while.

The reason being. Many people habituate to tinnitus within six months sometimes a little longer and it has been known to go away. The ear is a very delicate organ and many Drs prefer to wait before investigating further and then suggesting a treatment. If other problems are experienced such as: pain in the ears, deafness, dizziness or balance problems this is of more concern and a person will usually been seen quicker.

It is best to have a word with your GP if you’re feeling stressed or depressed in any way, as previously mentioned there are treatments available. Leaving things alone until ENT advise you of the next step is the best thing to do in my opinion. Don’t try to fix anything or throw large sums of money at treatments that you have no way of knowing whether you’ll get any relief.

It is not advisable to listen to audio through headphones even at low volume and keep away from loud sounds. By all means go out but anywhere that plays loud music then wear noise reducing earplugs.
Take things slowly and one day at a time. Read some of the positivity threads and ask other members for advice. Many people eventually habituate to their tinnitus and go on to lead a happy and fulfilling life even though it may take a little time.

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

Hi Michelle,

I would imagine you are probably where I am with my situation.

Which is a mixture of fear of noise (misophonia I think it's called) and sensitivity to certain frequencies.

Mine was brought on through acoustic shock by a high frequency sound and to be fair, since then I've considered TRT a few times too.

Michael has recommended this many times and I believe him on this.
--
If you find dogs barking and trains painful then I believe that's real hyperacusis .

If the sounds are a little distorted but you can cope with the sounds with no pain (like I can) then I'd guess you have some sensitivity going on.

 

@Michael Leigh

I've actually had Tinnitus for Over a year now, this is just a old account i havnt updated lol.

 

I have T for 2 years, I'm a 95% on the T International questionnaire. I have started desensitisation wearing hearing aids.
The aids do two things, omit a noise to drown out my T and amplify exterior noises. I only have a very small high frequency hearing loss.

My question if anyone would know is if I wear my hearing aids for 24 hours a day for say two years non stop, is there a chance my T will reduce, or that my brain will not hear the T as loud?
My hearing aids are omitting a sound equivalent to a 3 out of ten, which is fairly high.

Thanks!