In-Ear White Noise Devices

Hi
I am here posting because I am trying to help my son, 23, who has severe tinnitus, and I wonder if anyone might be able to help answer a few questions please?

We have tried tinnitus retraining therapy and our son has been wearing white noise in-ear devices for five months, with 2/3 extra counselling sessions on top. At the last visit, the therapist confirmed what our son had thought, which is that the tinnitus had not improved at all and that he was starting to feel ordinary noises more acutely.

So we are very concerned as his tinnitus has been constant, unrelenting ever since it started... and is now a 9/10. It is of one pitch, I understand.

Onset was alongside a neck muscle injury while weightlifting. We have seen a TMJ specialist and had botox in the face muscles which were in spasm and a splint made for wearing overnight. We have also tried massage, chiropractic work and cranial sacral therapy to improve general wellbeing, but nothing has relaxed him yet.

My questions on noise therapy are:
1. Is it too early to say if the treatment is working or not? It's been 5 months of wear so far.
2. Is it correct that other noise patterns might help more e,g, fractal noises? I saw some research which indicated that they might.
3. If so, what other recommended types of noise therapy are there? I have seen notched mention too.

Many thanks to you all.

 

I forgot to say that so far he has not engaged in the therapy process.

 

@brummygirl

Hi,
TRT tinnitus retraining therapy is one of the best treatments for tinnitus and hyperacusis. The treatment takes 12 – 24 months to work. Your Son must also use the white noise generators correctly and this is how it’s done and he must use a sound machine at night this is very important.

In the morning he should put on his white noise generators and set the white noise just below his tinnitus and then LEAVE them ALONE. Sorry to shout. The WNGs should be worn at least 8 hrs a day preferably 10.

Many people keep adjusting the white noise generators throughout the day especially when they are on the street as the traffic blocks out the sound of the white noise. Please tell him not to do this. Once the WNGs are put on in the morning he should leave them alone until bedtime.

Before going to bed he should remove the WNGs and use a sound machine by his bed and set the level below his tinnitus and have it playing throughout the night until morning, then the cycle repeats. It is very important that he attends the counselling appointments with his Hearing therapist. It is far too early for him to expect results.

Make sure and I can’t impress upon this enough, that he uses a sound machine at night for sound enrichment.

I will paste a link below, it is an article about tinnitus and TRT.

All the best
Michael
https://www.tinnitustalk.com/threads/an-introduction-to-tinnitus.12100/

PS: Please tell him not to listen to music through headphones even at low volume

 

Hi @brummygirl

Michael has covered TRT well so I won't add to that.

I do wonder though about treating the underlying cause. Has there been any real diagnosis of it? It sounds like they have tried a few things for you (or did you seek these treatments yourself?) but not sure they have given a real cause for you to try and treat.

I lift weights and I do often get a higher pitched tinnitus because of it, I generally have to be careful I don't overdo things - strong controlled lifts rather than throwing weights up. I do also have some rugby injuries and one from a steel girder to the jaw that contribute to mine, so I totally get the physical connection and the type of tinnitus it gives.

I can help out with some audio items, have your son check out some of my YouTube things here https://www.youtube.com/user/Tsounds1 - also if you find an audio therapy you want to try to see if he is a responder just shout me.

A lot of my tracks are masking types but also good for playing just below the tinnitus volume as you would in TRT. I can send any of them over mail or work up variations of any that seem to help.

 

Hey, I have a question for you. Does Xanax lower his tinnitus? If he is being tormented and it helps this is a temporary thing he could use. Long term it isn't good because it can cause tolerance and all kinds of bad things and it can be awful to get off for someone with tinnitus. It is so important this drug is not taken long term. I wonder if he could go to a doctor that really knows how to treat tinnitus. Also, I wonder if you can contact the makers of the drug AM-101 to see if it would benefit him.

http://www.aurismedical.com/product-candidates/am-101

 

Michael and Steve, thank you so much for your full responses.

Michael,
your instructions are excellent and very clear - thank you so much for taking the time to post as they are very useful. Thank you also for the link to more information.

Now, just noticing your final comment, our son has been wearing headphones for gaming (to distract himself) on top of the WNG. I take it that this is not a good idea from what you say? I thought it might distract him ?!? It has meant also that the WNGs have started rubbing on the back of his ear, making them sometimes too sore to wear. I can guess what your comments may be....

1) Now he would say that gaming is the only way to make his time tolerable. I am aware and he has been told that gaming will only increase his adrenaline levels and so isn't maybe the most helpful thing to be doing.
2) Maybe, saying the gaming has to stay that it would be much better to play with sound coming over speakers instead then?

What sort of sound machine would you recommend btw? We don't own one presently and our son goes to sleep listening to a podcast by his side. He has said that despite trying various ones on apps, he has never found any noise which alleviates the tinnitus.

Steve,
I am extremely touched by your kindness in offering to help.
To answer your questions first, all we know is that our son's neck muscles seem to have been damaged by the same event as caused the tinnitus. I have just tried to see the people that I thought might help as our GP said that he did not know what he could do. However, I did ask for a referral to the Royal National Throat, Nose and Ear Hospital in London where they have a multidisciplinary team, so I'm hoping they will cover all the bases methodically there. I think there is a three month waiting list currently for urgent cases.

Interesting that you find lifting has an effect on your tinnitus, Steve.

Now for your very kind offer to help! I do apologise, but I am a little overwhelmed by the choice of sounds that could help atm to be honest. Should he just work through your videos? So the acoustic neuromodulation aims to get the brain listening to these tones instead and start ignoring the tinnitus , while the masking sounds just hide the tinnitus? Or do they both do the same thing?

And when you talk about audio therapies, do you mean like the notched therapy? Sorry to ask so many questions!!

Enormous thanks to both of you for helping!!!

 

One thing you can look into is hearing aids and getting his hearing checked...if there is a loss and it can be corrected he might can lessen the tinnitus. The other thing is that many have built in maskers. Siemens/Signia has some with ocean sounds, Starkey Xino has some custom made tinnitus masking. Widex Zen has chimes.

 

@brummygirl

Hi Brummygirl,
Thank you for your kind comments.

Please tell your son that listening to headphones is not a good idea in my opinion even at low volume. Furthermore, having them playing sound into his ear with the white noise generators is not allowing the WNGs to do their job.

For your son to get the best out of the TRT programme, he needs to wear the white noise generators for eight to ten hours per day uninterrupted by additional sound sources. There is a strict protocol to the TRT treatment so the patient gets the maximum benefit from it.

When the white noise generators volume is correctly adjusted which is slightly below the tinnitus, over time the brain habituates to the white noise and slowly pushes the tinnitus into the background. For this reason the white noise volume control mustn’t be continuously adjusted throughout the day. Whilst is okay for your son to listen to music or his games through speakers, he should try not to turn up the volume too loud.

Oasis sound machines are the best and made for people with tinnitus. You can go to the their website which is in USA just Google it. Or you buy them from the British Tinnitus Association http://www.tinnitus.org.uk/departments/5 Model S-650 is popular.

Steve’s sound therapies are also good and if your son prefers to use them for sound enrichment at night that is fine. The sound therapy must play all night until morning and the volume must be set to just below the tinnitus.

Habituating to tinnitus takes time and patience. It is a little difficult at first so I understand how your son feels. We have all been there but it does get better.

If you have any more questions please ask and I or someone else will try to help.

All the best
Michael

 

I'm a big gamer. It does really help out, although if I'm playing competitive online games it often spikes my tinnitus because of the tension, both psychologically and muscular.

Definitely ditch the gaming headsets, they are poor quality, they generally are big in the mid range and bass and having them close to your ears is not good when people are talking, usually loudly. I gamed for a bit with high quality headphones and I felt they made my tinnitus worse too, games don't have the best quality sound for me. Definitely get him using speakers.

Yes, just go through them and see what he responds to.

There are a few different techniques. I would say though that if the cause is purely physical they may not do too much to help, although you never can tell (no data to back it up at this time). I can make any audio therapy that you see, they won't be perfect as most will have an audiologist testing the hearing and tinnitus but they'll be pretty close.

You can get your son to take an online hearing test, make sure it's with decent quality headphones. It's not quite as precise as an audiologist doing it but it can be pretty good none the less. Try this site from our friend Stephane, it's probably the best of its type http://hearingtest.online

Quick note on some therapies:

Acoustic neuromodulation plays tones either side of the tinnitus to reduce tinnitus. Notch therapy takes around a 1 octave notch from a broadband sound to reduce tinnitus. Fractal tones is a posh way of saying randomised tones, which are to distract from listening to tinnitus (not unlike using white noise). S-Tones are a tone at your tinnitus frequency, with the volume modulated at 40Hz to reduce tinnitus. (this may not all make sense to read )

 

Hi Jason!
Thank you so much for your response. I'm sorry, I didn't notice it when I wrote back to Michael and Steve.

I hadn't heard of Xanax, so I looked it up and see it is similar to Valium, which our GP did try our son on, but just for a week. This was mainly to help him get some control over his sleep, but it didn't work. He moved up from a lowish to a middle strength dose and it just made him jittery and totally unable to sleep - for stretches of 24 hours at a time. The GP was then unwilling to let him try a very high dose, so we gave up.

Yes, finding a doctor who knows how to really treat tinnitus is our aim. We are eagerly awaiting an appointment at the Royal National Throat, Nose and Ear hospital in London which has a major tinnitus clinic, and hope to see the specialist there - although the wait is very long at three months, even for an urgent case...

And, yes, we have had hearing tests, which are all clear.I have been offered a session with an audiologist where our son could try all these different devices that you mention. Can people get instantaneous relief from them? Or relatively speedy relief?

Thank you for the headsup, too, on the trial for AM-101. I'm going to look into it now.

Really appreciate all of your comments, Jason. I just so want to find a way to get him out of this nightmare, even to just ease the pain of it while he habituates. I can't bear to see him in such distress.

I hope your tinnitus is under control and you are not getting too much grief from it.

 

@brummygirl
Hi brummygirl.
I hope that you don't mind me giving you some additional advice. Your son is having the best treatment for his tinnitus in my opinion, which is TRT. I know he's under a lot of stress.

I'm going to tell you something that was told to me when I first got tinnitus 20 years ago by my GP when I asked him to please recommend a private clinic or hospital, that I could go to for treatment as I was in so much distress. My GP's reply was:
" You will get the best help and long term aftercare for your tinnitus under the NHS and following the TRT treatment". My doctor was one hundred percent correct. Twenty years on I'm still having very good aftercare whenever I need it.

Things will improve for your son but he needs to give it more time. He must try not to distract himself from the tinnitus by attempting to mask (cover it completely) with additional sounds. Just let the white noise generators do their job. Of course, it's okay to have low level music playing to fill in the background ambiance but not to try and cover-up the tinnitus otherwise it makes it more difficult for the brain to habituate to it.

I wish you both well
Michael

 

Thanks for your kind words. The sounds for Siemens is here

https://usa.bestsoundtechnology.com/hearing-loss-and-tinnitus/tinnitus-information/treatment/

You might could ask if he could hook up his headphones to the computer and play it at a safe volume level and seeif it masks his tinnitus and gives him relief.

The sounds for the Widex Zen is here:

Playlist: Zen by Widex

Starkey makes a custom thing for their Xino hearing aid. I hope your son gets better soon.

 

I also wanted to say that you can get your son a water fountain for his room. Maybe something like this or better:



Its best to go to a store and listen to a fountain first. The other thing I wanted to tell you was that maybe it is best that your son is not taking Valium. I took Klonopin for years and years and now it causes depression and I am trying to get off but it is protracted withdrawal. At first it was great and I never wanted to take it long term but because of the tinnitus I did. Since I have had depression problems I am not taking Lamictal because I hate the anti-depressants but they help others. Not saying he should take either of those drugs, but just telling you that is what I am doing right now. I knew klonopin was to be taken only short term but it was the only thing at the time I knew of that would calm my T down. Now though, I think it has increased it but I am hoping as time goes on, I will be able to stop it and my T will get better. Hopefully.

 

@Michael Leigh has given you excellent advice.
TRT is like gold star treatment and can take 1-2 years to come through the treatment.
It is so hard now to get it free on the NHS costing about 40 pound a session privately.
White noise genarators can take a while to master and see progress but they do really help with the TRT support .
I found my WINGs for short verry helpful and the instructions from @Michael Leigh is spot on .

It's hard when we see our loved ones struggling with tinnitus and their is no magic wand but we all totally understand what you and your son are going through and we will support you around the clock....lots of love glynis x