Dr. Nagler, 11 dB SL Tinnitus and Niagara Falls

@Dr. Nagler has said he can hear his tinnitus in niagara falls on the maid of the mist boat

@Dr. Nagler has also said his tinnitus is 11 dB SL

how is it possible he can hear a mild 11 dB SL tinnitus on maid of the mist?

is loudness imagination? what makes loudness loud?

 

11 dB doesn't sound like a mild tinnitus!

Could it be the pitch of t playing role?

 

• Near total silence - 0 dB

• A whisper - 15 dB

11 db sounds mild ...?

 

I thought I read that his is 91db

 

this post
https://www.tinnitustalk.com/threads/my-tinnitus-has-changed.8372/page-7#post-100930

and sensation level (sl) is what matters!! so his tinnitus is 11 db...

 

Sorry, didn't see the SL for some reason!

 

In another thread he said it went from 8K to 12.5K.

Is that loud?

 

@valeri frequency has nothing to do with how louad something is! you may subjectively experience a higher volume because the sound is more annoying in certain frequencies but technicaly its no difference. the volume of a soundwave is described by her amplitude -> height of the wave. frequency is how often the wave hits 0 amplitude in an interval.

 

I don't think it's useful or productive to try to compare ourselves to other people, let alone to try to nitpick someone else's comments in an effort to... do what, exactly?

I'm sorry, I just don't understand the purpose of this thread. It seems to be making a case for inconsistencies in Dr. Nagler's posts... but this is the support forum, not the nitpick things people said in unrelated posts forum.... :-S

Tinnitus has no DB level, because decibels are a measure of air displacement from sound pressure. Tinnitus does not displace air. So, you can't actually measure it in decibels, thus when people do they are making some kind of analogy or comparison, which is inherently a subjective thing and I don't know how useful it is, to them, let alone for someone else to pick apart.

 

He didn't say his tinnitus is 11 dB, he said it is 11 dB SL, which as discussed in another thread is apparently not the same thing as dB. He said in dB, it's 91. So are you sure that 11 dB SL is silent?

 

I completely agree with @linearb. Moving on. Or at least I am.

 

I had never heard about db SL...

as for me, I noticed that my T is between 50 and 60 db. Meaning that I hear it completely under 50db (I tested it with my decibelmeter...) and around 55-56 db, the ambient sound masks it almost completely.

 

Does it matter how loud Dr. Nagler's tinnitus is? We'll never truly know how loud it is in his head.

 

That is correct. The almost deafening roaring sound of Niagara Falls does not mask my tinnitus. I can hear my tinnitus readily and clearly while in the Maid of the Mist boat at the foot of the falls.



But please understand, what I am describing is a real life uncontrolled reflection of maskability, not a formal measure of loudness taken under controlled conditions in an audiology booth. There are a number of qualities besides loudness that go into whether or not any given sound will mask one's tinnitus. In my own case, I have yet to find any external sound that can mask my tinnitus - including the very loud broadband roar of Niagara Falls.

I was specifically asked what the dB level of my tinnitus was on a tinnitus loudness match (done under controlled circumstances in an audiology booth), and I responded 91dB. In other words, when the audiologist introduces 85dB of sound into the audiology booth at the frequency (pitch) of my tinnitus in pulsed fashion (so I can differentiate it from my tinnitus) I tell her that my tinnitus is louder than that. Same for 86dB, 87dB, etc., all the way up to 91dB. When the sound reaches 91dB, I tell her that it matches my tinnitus exactly. But as it happens I have an 80dB threshold of hearing at the frequency of my tinnitus, which means I do not hear the first 80dB of sound introduced at that frequency. So it takes 11dB of sound above my threshold of hearing at that frequency to match my tinnitus. The unit used in such a measure is "dB SL." So my tinnitus matches at 91 dB and at 11 dB SL. It is interesting to note that in a study of 1630 individuals with tinnitus severe enough to lead them to seek evaluation and treatment at at university tinnitus clinic, less than 10% had a loudness match in excess of 11dB SL.

All that said, the tinnitus loudness match (whether in dB or in dB SL) means almost nothing in terms of actual clinical practice. Let me explain. The only loudness that matters clinically in tinnitus is how loud your tinnitus sounds to you. That loudness is a function of the strength of the tinnitus signal itself (from wherever within your auditory system it originates) and however your brain processes that signal as it goes through various pathways within your brain on its way to your auditory cortex, the part of your brain where you "hear" sound (i.e., where sound is consciously perceived). The parameter that represents how loud your tinnitus sounds to you is your tinnitus loudness rating, which is generally given on a 1 to 10 scale. And since nobody can hear your tinnitus but you, the only person who can assign a numerical value to your tinnitus loudness rating is you. For some people their tinnitus loudness rating might vary from day to day (or even hour to hour!) For some it remains remarkably constant. And my tinnitus loudness rating has remained roughly between 9 and 10 over the past 20 years.

As I see it, the tinnitus loudness match (in dB or in dB SL) has only two purposes clinically. One is so that a tinnitus sufferer can actually "see" his or her tinnitus on an audiogram chart, which can help in better understanding is otherwise completely amorphous enemy. And the second is in documenting the actually existence of tinnitus for medical-legal purposes, since a malingerer who is "faking" tinnitus in an effort to unjustifiably establish damages cannot replicate a tinnitus pitch and loudness match when the study is performed on three consecutive occasions spaced by twenty minutes. But other than that, there is no clinical role at all for the loudness match. Specifically, it has absolutely no therapeutic or prognostic implications. It may, however, have research implications as a parameter to look at in terms of testing the efficacy of various agents in blinded controlled studies.

I hope I have been able to adequately address that very good question in my response thus far.

There is nothing whatsoever imaginary about tinnitus, tinnitus pitch, or tinnitus loudness. Regarding what makes tinnitus loudness loud, that is a function of the strength of the tinnitus signal itself and how your brain processes that signal prior to its being "heard" in your auditory cortex.

stephen nagler

 

When it comes to tinnitus there can be low unmaskable tinnitus and loud tinnitus masked easially by any sound. I have no idea how this works, but it does...

 

Right. I totally agree with you.

Here's something else to put into the mix: When it comes to tinnitus, there can be very loud tinnitus that is not masked by any sound, yet the person with the tinnitus is not bothered by it.

stephen nagler

 

Agree. This has been addressed before by Dr. Nagler. Let's just move on and focus on supporting struggling members.

 

@Jesse Pinkman I think the pitch can make it hard to mask.

 

I don't think I would wanna live if my tinnitus was unmaskable during the day.

 

11dB is the top end of mild tinnitus Valeri.
Thers are tons of people matched to 30dB+.
I bet if this forum tested, all those with suicidal T would easily match to over 30dB sl .

Would you be kind enough to show us this study Sir.

 

Didn't think I could either but for the past year and a bit I have been able to hear my T all the time, and addressing the OP, as @Dr Nagler already addressed, when one talks about there T in db terms, It means the decibels it takes to mask it at your T frequency.

My T masking result was 19db, not very loud but still loud enough for me to hear it all the time!

The first year of my increased T level was almost unbearable but now I am on medication for my depression I am finding I have begun to habituate to this new T level and am starting to enjoy my life again.
I do wonder if the members here who are struggling to habituate are not in fact suffering with a bit of depression as well, I think that was my major hurdle and it looks as though I am winning this battle now, even though my T is still as ferocious as it has been since my increase.

 

http://www.tinnitusarchive.org/dataSets/1/tinnitusTestResult/loudnessMatchesAtTinnitusFrequency/

 

Just to be real precise here, it's the dB it takes to match the loudness of your tinnitus; masking tinnitus involves other factors in addition loudness (pitch, timbre, harmonics, etc.)

 

Lol yea that's a bit more precise than my laymen's explanation, Thank you @Dr Nagler.

 

You are welcome, Rich.

Bottom line is that where tinnitus loudness is concerned, the only loudness that really matters is how loud your tinnitus sounds to you!

 

Thank you Dr. Nagler.
It seems that super loud T is very rare, which might explain the lax attitude by doctors when this minority complains.

 

Using the tinnitus loudness match as a measure, yes it is rare. But using the tinnitus loudness rating (i.e., how loud your tinnitus sounds to you), it isn't rare at all. And the only thing that really matters is how loud your tinnitus sounds to you, right?

That "lax attitude" is no more common today than it was in 1994, when I started my own search for relief. And what I did back in 1994 was make it my business find a doctor whose attitude was not lax. It wasn't easy, but I did find a few. And as it turned out, one of those doctors changed my life!

 

If tinnitus is over 19db , its gonna sound loud! Loud match must equal loud perception...Sometimes people perceive soft tinnitus loudly....but not the other way around.

 

I respectfully disagree.

Let's assume for argument's sake, however, that you are correct. You say that 19dB of tinnitus is "gonna sound loud!" But 19dB sound is softer than a whisper. Check any dB chart if you don't believe me. What makes 19dB of tinnitus sound LOUD (or not-so-loud) has to do with central auditory processing (i.e., what your brain does with that 19dB signal) rather than the magnitude of the signal itself.

 

I chose 19db arbitrarily. It still might be soft- I don't know. Maybe loud tinnitus matches at 60db.
Unfortunately the medical system does not care to measure it.
Oh, and I said tinnitus Over 19db, not at 19db....big difference.