How to Use Pink/White Noise for Treating Reactive Tinnitus?

Distortions I think.

 

No amplification this time, just sound. Amplification spiked me the first go around.

 

I consider it distortions if you can’t hear it in silence. If you still hear this chain sound while in silence but at a much lower volume, then I consider it to be reactive tinnitus.

 

Sounds like a dead hair cell trying to pick up sound.

 

That’s good to know.

 

I agree with @Wrfortiscue’s assessment then, that it’s likely distortions. Distortions alter the way external sounds are supposed to be perceived. Basically, things don’t sound how they normally should be. Like in my case, the sound of wind noise sounded like the noise a rattlesnake makes with its tail. I could not hear the natural way wind should sound like.

 

Be very careful @David S. You have started to make improvement which can easily be undone by going too far too quickly. Your tolerance to sound will naturally increase by keeping the volume of the sound generators low, at a level that is always below the tinnitus.

Some audiologists advise to gradually increase the volume of the sound generators to build up sound tolerance but often the reverse happens and the ear becomes more sensitive to sound and hyperacusis increases. My audiologist advised me to always keep the sound generators slightly below the tinnitus. This allows the brain to habituate to them and slowly push the tinnitus further into the background. At the same time the auditory system slowly builds up natural tolerance to sound.

Taking things slowly is the best way forward. There is no set time frame for this to happen because we are all different. It can take six, twelve or up to 24 months. It took four years for me to habituate the second time. I realize this is not quite the same as building up sound tolerance. I didn't experience any signs of hyperacusis after my second noise trauma. I am just giving an example that this can be a long slow process.

Being patient is the key,
Michael

 

@Michael Leigh, you are perfectly right. After 2 good days (tinnitus 3-5), I am having a setback (tinnitus 7-8). The old bad intrusive reactive one. I just need to figure out what could be causing the worsening? My SSRI? My small dose of benzo? Sleeping position? Too much sound exposure (I do not think I pushed it too hard with a few short car rides)? Or I just have to accept that this will take a long time.

I keep the sound generators at the same volume for a long time. I still use them even on the bad days. Once I feel really comfortable with the sound generators, I will start to taper the meds. First the benzo and then the SSRI. I guess it´s no rush. It´s hard already the way it is.

I guess I just have to be happy for the last good days. It was a long time ago I had 2 good days in a row so at least that is a sign of something in the right direction.

It is just so hard to be go back and forward between a tinnitus that actually is quite manageable and a tinnitus that puts a lot of limitation to my life. It is so strange that the sound sensitivity is going up and down from one day to another.

Thanks again for all your support!

 

You are welcome @David S.

I don't think your medication has anything to do with the slight relapse and I advise that you continue taking them. The reason is they act as a safety net so you don't become too down should your tinnitus or hyperacusis spike. Please read my posts on the habituation process. If there is no safety net to help control your moods when low points arrive, the stress can set you back further and it's something you don't want.

Remember, tinnitus and hyperacusis can affect our mental and emotional wellbeing considerably. Both these conditions cause stress and therefore, it's important stress is managed and your medication will help with this.

Give it time and carry on as you have been doing. You will improve even though you may encounter the occasional hiccup along the way, the medication will help you cope with this and the occasional glass of merlot or cognac during the evening for medicinal purposes I find helps!

Michael

 

The catastrophic days are really a challenge to handle. I get paralyzed pretty much for a full day. How to learn to live with that?

 

This is can be a challenge and I know precisely where you're coming from. My 4 year ordeal habituating to tinnitus for the second time was just that, an enormous challenge. This is such a solitary condition that few people we are close to truly understand. All I can suggest is to try and focus on the positive things in your life whenever the dark clouds are looming above. Look at the things you have and the people that are around you.

I would direct my thoughts to what's going on in the world and how people's lives are affected by them. Some don't have a roof over their head, warm bed to sleep in at night or haven't a clue where their next meal is coming from. Some people are afflicted with medical conditions that makes them totally dependant on others. I would close my eyes and think what would my life be like, if everyday I woke up to see darkness, or I was unable to walk and needed a wheelchair, how much my life would be affected.

I am by no means trying to diminish the severity of tinnitus and hyperacusis and the way they can affect a person's mental and emotional wellbeing. One only has to read the posts on my started threads, to see I understand the mental anguish these conditions can inflict upon a person. How they can drive some people to do things to themselves because they cannot endure their circumstances any longer.

This was one of the coping methods that I used whenever I felt things were getting too much.

Take care,
Michael

 

@Michael Leigh, in a lot of aspects of life I am very fortunate and I also got a lot of loved ones. I need to keep remembering that when at the bottom.

Thanks again!

 

@Michael Leigh, you often mention the risk about setting your sound generators too high (masking tinnitus or close to masking).

What about the opposite? Is it possible to set them too low?

 

Even on the lowest setting, most wearable sound generators will emit some white or pink noise into the ears @David S. This will provide some sound enrichment and help with treating hyperacusis and tinnitus. Ideally the volume should be set slightly below the tinnitus and not masking it or set at the mixing point. The mixing point is when the tinnitus and white/pink noise blend together so both are heard. A lot of people find the mixing point causes irritation.

Michael

 

One thing that I noticed after starting to use the sound generators daily is that my tinnitus changes a lot more. From ringing to hissing to more like morse code. Always very unstable pattern. Sometimes maskable by faucet, sometimes not. I also have the normal 10-15 second intensive tone tinnitus where my normal tinnitus seems to disappear for the same time. Hope this is a good sign...

 

Hi there @MindOverMatter, I've read some of your posts on reactive tinnitus. I see that you have gotten a handle on this condition through sound therapy. I'm starting sound therapy for the third time. It's almost easier to tolerate my ears without the sound therapy, but it's still so unbearable and I'm willing to muscle through this process if it will eventually make it better. I gave up a few times because I wasn't confident it was doing anything and worried it was getting worse. As of a few weeks ago I started again. I'm currently playing white noise only in my left ear. When I also play through my right, my brain starts making these awful high pitch squeaks that move from one side to another. My audiologist recommended starting with my left (since it's the most problematic) until I get it under control. The following are my questions:

1. In one of your posts, you said to play the white noise just below the tinnitus. My issue is that the tinnitus/reactiveness lifts in volume. I have a hard time finding a volume that is just below the tinnitus. I worry if I play the volume too quietly, I won't be getting any benefit/relief from the sound therapy. Additionally, if the volume is too low, I don't get any relief from the noise. What did you do in this situation?

2. Also, did the noise you play cause reactivity? If so, did you muscle through this and one day it just lessened? It seems that all noise spikes the reactivity to some degree. Some more than others. For example, white noise is better than pink noise for me. Crickets versus pink noise is even better. Do you think if a noise causes reactivity it will hinder my progress or actually build strength over time?

I appreciate any help you can provide.

Thank you,
Renee

 

Hello Renee.

I will try to answer your questions:

1)
You will get some sort of stimulation and auditory input even if you start up with the therapy, or sound enrichment that I'd rather call it, at a very low volume. In fact you should start very low - just audible - and work your way gradually up over time (over 6-12 months). Both with volume and the amount of time with enrichment each day.

You might not feel any relief at all for 6+ months (this is very individual). It's important that you find a sound that you can be okay with, and you can get positive associations after a while. For me this wasn't white noise, but softer pink noise. You need a sound spectre that is tolerable. This is trial and error to find what works best for you.

2)
You need to build your tolerance very slowly - especially with the reactivity. You will experience many minor setbacks along this path, but think of this as a part of building tolerance over time. Sometimes you have to take one step back. Its not a linear process.

I had a hard time to find any sound that was tolerable for at least 6 months. Back and forth. Trial and error. And counselling.

"Experts" say that a broad spectrum noise is best, so if you can handle white noise of some kind - go for it. If it's winding your t up, go very slow and low volume - or try to find something that's more soothing.

To me, it was not only about building tolerance, but starting to, over time, get positive associations to sound again as the psychological aspect of this condition also outplays a major part.

Wish I had better answers. It just takes a lot of time getting better, and also letting go of the fear of worsening. Anxiety, to me, makes the reactivity wind up.

Don't be put off and lose hope even though you have to take a step back, or your tinnitus is winding up... think of it as a temporary part of the process of getting used to sound again and building tolerance.

 

I tend to notice this for myself as well.

 

@MindOverMatter, thank you for your feedback.

Now that I’m into this sound therapy for a month or so now, I have some more questions if you don’t mind answering.

1. When you first started with sound therapy, did your ears react more than usual?

2. How would your ears react? Mine is like a really high pitch, sharp, erratic buzzing noise. It goes up and down and penetrates my brain in varying degrees depending on the external noise present. It’s much quieter in very quiet places.

3. Is your reactivity influenced somatically? I notice if I do any type of posture exercises or ride my bike, it gets worse. I wear earplugs when I ride so it’s not loud.

4. How has your reactivity improved since starting sound therapy? What changes have you seen?

5. It’s been about a month now with no relief in the reactivity. In fact I think it’s almost getting worse. I still wear my devices for 6-11 hours, averaging about 8 hours per day. Do you think I should continue even if I feel like it’s not getting better?

Thanks for your help,
Renee

 

Short answer: Yes. For at least 6 months.

In many ways same as the experience you describe. This is of such high degree of subjectivity though, and I would try not to sort of measures this too much.

Yes, there is a somatic component for me too. Typical neck and jaw issues. This is quite common though.

Well, I've done sound enrichment (not TRT) for 2.5 years or so. Meaning I surround myself as much as possible with sound that I find okay. But nothing felt okay for the first 6 months ++.

Things slowly changed. But I worked slowly to build tolerance, and I've been doing it with the advice of a counsellor within the field of hyperacusis. I've had numerous setbacks along the road, and sometimes you just have to back off.

Nowadays I use my hearing aid with pink noise sound therapy, usually around 4 hours a day. Never on a level above the level of my tinnitus. Sometimes only with the amplification from the hearing aid.

Impossible to tell, only you would know. But to me it seems you have gone out too hard with your process of desenzitation. 8 hours a day is a little given you are only 1 month into this. You need to build tolerance slowly, or you might experience a lot of spikes. It could be counterproductive.

Annoyance of sounds are pretty much unavoidable at the start of this journey, but if you feel you are heading in the wrong direction you need to back off a bit. My advice.

 

@MindOverMatter,

If you don't mind me asking, what changes have you seen with your reactivity? For instance, mine reacts to fans, driving in a car, wind, etc. Are you at a point now where some noises used to cause reactivity, but don't anymore? Or is it that the reactivity in general is less frequent, but you still get it just as bad from time to time. Or would you say your reactivity has only improved with the pink noise you use for sound therapy, but still reacts to everything else the same?

I just need some encouragement that the reactivity element to external noises can in fact get better. And if not, at least have a more realistic expectation as to what specifically can change with reactivity.

Thank you for all your help. You've been an inspiration to me and the reason why I continue with consistent sound therapy.

Renee

 

Glad to hear I could be of some inspiration for you. How long have you been consistent with sound therapy, and for how long have you had reactive tinnitus?

For me, I've had sound sensitivity and reactive tinnitus, which to me is a subset of sound sensitivity, for soon to be 3 years. I've been going, and still going, to counselling for around 25 sessions during this time.

The most important for me personally was to, first of all, accept the things I cannot change. This took quite some time, but it is an essential part of moving on and not putting life completely on hold. I haven't done any sound therapy (such as traditional TRT or the likes) program per se, but sound enrichment. Took me a long time to get comfortable with that, and a lot of spikes and setbacks along the road...

I also use hearing aid around 4 hours each evening/night. With and without sound therapy (brown or pink noise) on. Depends what I do.

Things do happen in life that we don't foresee, and that challenges us in some many ways. Sound sensitivity (hyperacusis) and reactivity can be extremely tough to live with and to balance everyday life with. A/C, PC fans, frying, cars, water hitting the sink, heavy water streams, sheets, clothes that make scratching noises, people talking, TV, artificial noises, everything and anything can lead to a cacophony of noises, and tinnitus "riding on top" of every external noise.

I find it difficult to draw a timeline with this, because progression is non-linear to me. But what I can say is that looking back what is a less good day today is comparable to what I considered quite a good day upon onset of this 3 years back. To me that is a great motivation.

Acceptance, counselling, sound enrichment, staying occupied with work and getting out on nature walks and such (even on my hardest days), talking to others about my issues has been key factors in this, still ongoing, process. When I was starting to get more and more better days, I felt like coming back to life again - for real. But with more appreciation and gratitude of everyday life.

On the less good days, I remind myself that this is only today, and I recall that, hey, I was alright just a day or two ago. If not today, there is always tomorrow.

I have days now where sensitivity and reactive tinnitus feels non bothersome. At the times I even think: Wow, I'm back to where I was pre this. I guess it's all a combination of the above factors, time, acceptance and habituation process, and a change of negative response patterns. Time can often be a healer.

On these good days I'm pretty much not bothered by anything, or I do not notice it/have a negative response to it.

BUT, again, nothing is linear with this, and minor, temporary setbacks are real and unavoidable. Less good days are there. We live in a noisy world, and noise is all around us. But I try not to fight it, but of course I need to be cautious - but without limiting myself too much.

"I've survived" two weddings, airplane journeys, 10+ hours car drive, 10-15 birthday parties, dentist appointments, gym workouts, MRIs, hearing tests, balloons popping, fire alarms, etc. etc. during this 3 year time. Yes, I've had numerous spikes and temporary setbacks, but I've still been pre-cautious around sound as good as possible.

I'm not tensing up in the same way as I used to. When you are tense, the ears and brain are more responsive to external noise. Fear of noise makes your ears more vulnerable.

Not a too structured feedback perhaps, but I hope some of this make sense to you.

Feel free to ask me if you have any other questions.

 

Incredible post @MindOverMatter. You’ve given me a glimpse of what awaits me. Feeling really good right now. Thanks for writing this.

 

Informative post @MindOverMatter. Your posts have helped me immensely and I’m so grateful, for the hope and inspiration you have given me and others.

Thank you.

 

What I would really like to know is if this can get any better in terms of the amplified distorted sound staying louder than normal sounds or not, or if the dead hair cell will ever completely stop picking up the sound at all. I'd rather not hear that messed up frequency at all than hearing beeps and rattles.

 

So much of what you've described here matches my own situation, and I always pay a lot of attention to members who've walked-the-walk with tinnitus for many years.

I'm about 14 months post hyperacusis rearing its silly head and changing everything regarding my own long-term tinnitus. The hyperacusis for me came on in stages. I don't know if this is a good or bad thing but it's worse now than it was initially. My sound tolerance (for certain frequencies) has dropped considerably, and tinnitus does some crazy stuff modulating itself over various external trigger noises and 'reacting' wildly in a way it never did. Having said that, I've always managed to find ways through and live life relatively normally. Sometimes I just have to laugh at it.

I think similarly to you, what works for me day-to-day is being open with people about the condition (which I believe forms part of the acceptance), having a few coping strategies in place for when needed, being out in nature, doing physical work (this is a big one for me) and definitely aligning with the fact that this condition absolutely has a certain rhythm to it. There are good days and not so good days; something I remind myself when in the thick of the, not so good days, that the good days are just around the corner.

 

This was something I've been meaning to ask you about. Did you seek the counselling out yourself or was it offered as an extended part of your public health care?

Last time I spoke to my audiologist I was offered CBT (I think that's what it was). I didn't want to do it back then but going forward I think some form of specialist counselling that might provide me with additional tools and perhaps a more structured regimen to work to could be valuable.

 

@UKBloke, given your username, I'm assuming you are based in the UK. I cannot get any of this in my area (Chesterfield) for love or money in the NHS. It seems only available privately and then requires also substantial travel and associated costs. £2,500 for a 6 month package. Given it has disabled me, I'm also now not working.

 

I had to arrange everything myself, and usually there is a looong waiting list. I believe I had to wait for 3 months, but usually it's 6++ months wait. I got it all covered though (after an LDL test and questionnaire), including hearing aids and several sound therapy products from Sound Oasis.

In Norway you do not get this type of counselling for free with "only" tinnitus. Due to the fact that it's too common. You have to take an LDL test showing that you have issues with sound tolerance and hyperacusis.

I believe it's 120 pounds per session, and with 25 hours - and counting - it's expensive if not covered. But worth it, both in regards to the audiology part, CBT, and last, but not least, support from someone that specialises within the field.

You should grab the offer with CBT if possible. It's not Magic, by any means. But, as you say, it's good with the additional tools and such.

 

Hello @Nick47, I’m from Cumbria. The NHS provided hearing tests and in-ear sound generators.

However, my counselling I pay for privately and it’s been well worth it.

You can however ask to be referred to a Bernadette Parker on the NHS who specialises in hyperacusis and tinnitus. You can speak to her online via appointment. She is based at University Hospital Coventry and Warwickshire. I have also spoken to her.

But like @MindOverMatter, I’ve had to look into a lot of help myself.

Hope this helps x