Minimum Masking Level?

Hey all, I know a lot of us here are really distressed by our tinnitus and others not so, I guess I'm trying to work out if I'm blowing all this out of proportion..... I've had mine a month and a half now and have spent most of it scouring the internet for cures....

I'm wondering do others know what their minimum masking level is in decibels for their tinnitus? Like, how many dB must be around in order for them not to be able to hear their tinnitus?

I feel like my MML level is low but still my anxiety is through the roof. So.... what is your minimum masking level (maybe this only works if you've downloaded one of those decibel apps on your phone)..... and how much do you feel that your minimum masking level relates to your anxiety about your tinnitus?

Hope this makes sense. What I'm finding is you get people with tinnitus and they want to kill themselves, and people with tinnitus who are fine. People say it is all subjective and of course it is, but wouldn't it make sense that basically however high the MML is determine whether you are fine with it or highly distressed? (Unless there were cases on here of people who need a very high MML AND who are ok with it.)

 

Masking is more about distracting rather than trying to out volume your tinnitus.

 

Hi @2131e: You can't measure a masking level with a decibel meter. It must be done by an audiologist, as the noise is what your brain perceives, not a sound that actually exists, like music coming out of a radio.

An audiologist can tell your MML db level -- but you pretty much can figure it out for yourself. Just start listening to your masking sound and raise the volume slowly until you can't hear your T anymore. The db level that might be doesn't really matter. Some people with very loud tinnitus are fine; some with not so loud T are crippled by it. Most researchers agree loudness is not necessarily a factor in distress.

If your tinnitus is causing you anxiety, you need to deal with the anxiety.If masking helps, great. Meditation, exercise, cognitive behavioral therapy ... and, if need be, medication also can help.

By the way, the ultimate goal with masking is to listen at a volume level at which you can still hear your tinnitus. You may in the beginning need to cover your T but over time, aim to turn it down.

 

I agree with all of the above posts. When I'm looking for a patient's MML, we do each side separately, then binaural. Usually, binaural is a little less dB HL since you are stimulating both sides!

I usually ask patients to tell me even when there's partial masking, too. Any and all information you could get would be helpful for some sort of management system. And besides, like other posts have mentioned-- masking is really about blending and distracting and NOT about overpowering.

As far as the correlation between MML and anxiety levels, I think that would be something very interesting to research. It almost makes me wish that I didn't already have an Au.D. Research project! The overall trend that I've noted, though, is that there is a correlation to a certain extent. I think at one point, if your anxiety is just through the roof, it will just plateau. Definitely something cool to look into, though!

Also remember the limbic system (fight or flight) plays a big role in tinnitus. Do your best to try to keep your anxiety low (I know, easier said than done.) high anxiety = high T = high anxiety = high T (you get the idea....)

 

Thanks, @ashley. Didnt know you were an audiologist. Very helpful!

 

An audiology student-- half way through my graduate classes

 

Reliability of the Minimum Masking Level as Outcome Variable in Tinnitus Clinical Research

Purpose
The minimum masking level (MML) is the minimum intensity of a stimulus required to just totally mask the tinnitus. Treatments aimed at reducing the tinnitus itself should attempt to measure the magnitude of the tinnitus. The objective of this study was to evaluate the reliability of the MML.


Method
Sample consisted of 59 tinnitus patients who reported stable tinnitus. We obtained MML measures on two visits, separated by about 2–3 weeks. We used two noise types: speech-shaped noise and high-frequency emphasis noise. We also investigated the relationship between the MML and tinnitus loudness estimates and the Tinnitus Handicap Questionnaire (THQ).


Results
There were differences across the different noise types. The within-session standard deviation averaged across subjects varied between 1.3 and 1.8 dB. Across the two sessions, the Pearson correlation coefficients, range was r = .84. There was a weak relationship between the dB SL MML and loudness, and between the MML and the THQ. A moderate correlation (r = .44) was found between the THQ and loudness estimates.


Conclusions
We conclude that the dB SL MML can be a reliable estimate of tinnitus magnitude, with expected standard deviations in trained subjects of about 1.5 dB. It appears that the dB SL MML and loudness estimates are not closely related.

Source: https://pubs.asha.org/doi/abs/10.1044/2020_AJA-20-00047