Since We're Supposed to Stop Using Headphones, Can You Play Music and Podcasts Through Hearing Aids?

This is the crux of the headphone argument and anyone who cannot provide a reasonable answer here but continues to denegrate headphones is not arguing in good faith.

This is, from my perspective, similar to arguing with people who do not believe COVID-19 exists. When measurable reality is rejected by one party, arguing is a fool's errand, but I am but a fool with a keyboard (and an evidence based understanding of how speakers work).

 

I should also make it very clear -- I greatly appreciate @Michael Leigh's contributions to this forum, and see them treating scared new people with compassion and providing reasonable steering. Obviously I don't see eye to eye on this issue, and the inability to just dissect it and put it to rest based on the substantial amount of data we have about how sound interacts with humans, tilts me, exactly because the data does exist and to me it points in one direction only.

I have said enough here, I will let it go

 

Thank you for your kind comments @linearb. Whilst we disagree on the topic of headphones and noise-induced tinnitus, there are things we agree on as we both live with this condition. I thank you also for your contributions to this forum. It is refreshing to correspond with someone that has a different point of view and not having to withdraw from the conversation prematurely, due to bad manners and disrespect foisted upon me.

I wish you well.
Michael

 

First off, I'm definitely not as technically knowledgeable as you guys so I'm just posting questions here.

I keep trying bring up that maybe there are other factors involved beyond just simply the distance issue. Many of these factors have been brought up in this thread.

1) For instance you've already mentioned that closed back and earbuds can seal off pressure in a way that open back doesn't.

2) Michael mentioned the aperture size difference issue.

3) Jack Straw mentioned that the masking sounds made by noise canceling tech might be doing the damage.

4) FGG said speakers that put out more HF artifact maybe be problematic.

I myself mentioned that my tinnitus gets temporarily spiked when listening to smaller low quality speakers like the one on my phone or the ones on my laptop (I believe this might be a feature of my hyperacusis and reactive tinnitus). This is a very consistently reproducible thing that I experience. So I know firsthand that sound quality makes a difference and not just any speaker will do. I'm assuming the same applies to headphones and earbuds.

@linearb, what do you think about these other sound quality factors that have been brought up? Assuming I'm going to do my best to keep volumes low, what else should I look for or avoid in a headphone that might decrease the chance of a tinnitus spike?

 

Nonetheless I would like to say that I am grateful for your posts. They counteract the impression that Mr Leigh's opinion reflects some consensus on this matter, which it doesn't.

The very title of this thread suggests that such a clarification seems necessary.

 

Yes, thanks to everyone who's contributed info.

I think this is an important topic because so many people get through their work day listening to podcasts and music and they do not have the privacy to be able to listen to things through a speaker.

It's also important because hearing aids are so expensive and it's not something you can really go and sell to someone else like a car if it doesn't work out.

Michael, what do you think of playing only familiar masking sounds through headphones at low volumes. I, for instance, have a few masking sounds that I know work well for me since I've been playing them on a daily basis for almost 9 months.

Would you consider this a lower risk than just playing anything you want out of headphones?

When you're listening to songs on Spotify for instance, there's certain songs that are just much louder than others for some reason even though you haven't changed the volume. So you might turn up the volume to hear something better but then forget to turn it back. Happens all the time in movies too.

Do you think this is a major factor?

If you're listening to just familiar masking sounds, you can ensure a level of consistency in volume.

 

I agree completely, I have returned to using headphones at a sensible level and find them very helpful / therapeutic.

 

As I have previously said Mr_Orange, tinnitus should not be masked. If a person covers up their tinnitus with a sound so it can't be heard, it will make it more difficult for the brain to habituate to the tinnitus. There is also the risk of making the tinnitus worse if it is covered up with a masking sound.

I stand my all my previous statements on headphones and noise induced tinnitus. A person that has noise induced tinnitus, risks making it worse if they listen to any type of audio (including masking sounds) through headphones, earbuds, headset, AirPods, SleepPhones and noise cancelling headphones.

If you want to use headphones then it is your choice but please be aware you were warned. If your tinnitus increases it may not reduce to its previous baseline level. Sorry to sound so sobering but since you have asked my opinion, which is based on many years experience, corresponding with people at tinnitus groups and counselling people on the telephone, it I feel it would be remiss of me not to tell you my thoughts, as I visit this forum to help people with tinnitus, as I was once helped many years ago at a forum similar to this. I also contacted people by telephone that were experienced with tinnitus, who were kind enough to offer support when I was at a very low ebb.

Please refer to my reply above. If you wish to experiment and to see what works for you then go ahead, just be careful.

All the best,
Michael

 

I’m not gonna read what’s above, just know that it’s equally dangerous and hearing aids don’t magically convert sound into a safer form, if it’s played at the same decibel level as what you would use for headphones (or assume ceteris paribus on all other independent variables).

Generally, the smaller the driver and the closer to your ear, the worse the potential for irritation or damage is. Any audio device inserted into your ear is going to rank high in both of these risks.

 

Sorry, I keep using the word masking because it's faster than typing sound enrichment every time. Yes, Michael Leigh, I've been following your 'sound enrichment' concept since the beginning of my tinnitus and I understand it clearly. I've also heard of this idea from other sources too. I do believe that following this method has helped me habituate a bit, although I still feel like I have lots more room for improvement.

I see what you're saying about the headphone usage even with masking sounds now. So you'd even consider yourself to be rolling the dice to a degree when using the in-ear white noise generators then?

I understand though if your hyperacusis is bad enough. I remember when mines was peaking, it got pretty scary.

Thanks for clarifying your stance on this, Michael.

The reason I think this is further worth clarifying too is because there's actually quite a few YouTube videos from audiologists that market hearing aids and their ability to play masking sounds to treat tinnitus (not even just their amplification functionality). Some even have more particular methods like notch therapy for instance. I think many people (including myself) get the immediate impression that playing masking sounds through hearing aids is a tried and true, professional, safe way to treat tinnitus if so many audiologists are backing them.

 

This is still only relevant if you're using damaging volume levels to start with. But, yes, I think it's easier to fry your ears with closed backed cans or earbuds than open cans, and I also think it's easier to fry your ears with headphones than speakers. This is simply because people in general are bad at not turning headphones up unreasonably loudly.

What about that changes the fundamental nature of how sound works? If you could make headphones safer by tweaking the aperture size, there would be products on the market. In fact, there are headphones that have a tiny aperture and are designed for nonocclusive use by law enforcement and other people that need to maintain good situational awareness. I have a pair; the sound quality is garbage as you'd expect and they irritated my ears more than normal headphones by some margin. I gave up after 2 weeks.

Active noise cancellation isn't "masking"; I can believe cheap noise cancelling setups might generate inverse waves that are incorrect / too loud, but I spent a while digging into this and could not convince myself noise cancelling headphones are specifically problematic. I use them on airplanes, but I wear silicone earplugs underneath them.

HF noise may be more damaging at the same decibel level; also, we tend to lose our HF hearing first.

Yeah; I have like 3 pairs of $300 headphones and my wife has a couple too; I also only use open backed cans unless I am using noise cancelling Bluetooth cans usually for voice calls etc.

Feel your way through it and listen to your body. Some people are able to return to careful, moderate headphone use; other people feel it always spikes them even at very low volumes and this makes them uncomfortable.

I don't per se encourage headphone use generally, and especially not among people with tinnitus. It's kind of like a chainsaw -- if a safer saw will do the job, I use it, and likewise I use speakers a lot of the time. If a project calls for a chainsaw, then I use it carefully, and if a situation calls for headphones I use them carefully.

Nothing in this world is safe.

 

You need to give yourself up to 18 months to make substantial improvement and it can take longer. Try not to push yourself too hard, as habituation takes time and cannot be rushed.

White noise generators are a completely different kettle of fish and aren't like headphones or earbuds. Some people find them irritating because they haven't been taught the correct way to use them. They should be introduced slowly to the ear and auditory system otherwise the tinnitus and hyperacusis if it is present will increase. I have explained the way to use them in my articles on TRT. I have used them for 20 years and never had a problem.

Please read my thread: Hyperacusis, As I See It, for help.

Some people that only have hearing loss may find streaming music and podcasts to hearing aids a good thing. People that have hearing loss and tinnitus caused by an underlying medical condition may find the same. However, things might get a little dicey, when a person has noise induced tinnitus, even more so if they also have hyperacusis and decide to stream audio to hearing aids.

Michael

 

Headphones & bone conducting headphones are actually in my TRT literature with the Audiologist I am working with as shown. I know the Resident "expert" is going to vehemently disagree, as stated in the TRT treatment thread.

This is with someone who was directly trained by Jasterboff..

 

The problem is if I go back to work, I can't even listen to sound enrichment (assuming I'm strictly following your guidelines). I'd just have to soak in the sheer force of my tinnitus all day. Something I haven't had to do since my tinnitus started.

 

Noise-canceling headphones, with N/C turned on but with no music, masking, or other noises playing through them, are not dangerous. They lower the volume of certain incoming sound frequencies, not perfectly but enough to create quiet, if not total silence. I highly doubt that they inflict damage tour our ears with sounds that we cannot perceive. I have a very simple pair of N/C headphones, which do not supply masking sounds but such sounds could be added by the wearer, through a phone, MP3 player, or another device plugged into the headphones. I choose not to do this and only use the N/C feature. I would not use them for very high levels of noise unless I had the additional protection of earplugs.

 

As you know my advice should only be used as a guideline and therefore you don't have to follow it to the letter. Tinnitus has been around thousands of years and stems back to the Egyptians, when the first medical account of it was recorded and people coped. One has to find a way through it and adapt their life accordingly which isn't always easy. Although I advise people with noise induced tinnitus not to listen to audio through headphones and earbuds even at low volume, some do and are not adversely affected but unfortunately many are. Take your time and see what works best for you as my advice is not absolute.

Michael

 

At first I thought the idea of using musician style ear plugs underneath headphones seemed kind of crazy but then 2 of you have already brought this idea up. Check it out:

When my hyperacusis was bad, I used these earplugs called Earasers (tried a variety of similar concert plugs like EarPeace too). These ones had a very mild level of sound reduction which just took the edge off when listening to music and podcasts in the car on the freeway.

What do you guys think about this idea?

I think it might be tricky find over-ear headphones that don't press against ears that much to allow room for the earplugs.

To clarify, these are not those foam plugs that fully obstruct your ears. I'm talking about concert/musician style plugs with a hole in the middle that have very mild levels of sound reduction.

 

I checked out some audio forums and this topic is discussed there as well.

There's also been mentions of using open-back headphones being beneficial for tinnitus relief. For instance:

"I would check your headphones c frequency response. Our ears are more sensitive and more susceptible to damage in the 3-6 kHz range, so smoother headphones would be safer at higher volumes than say Grados."

Any idea what they would mean by 'smoother headphones'?

I feel like my tinnitus is sensitive to raspy static like sounds like you hear on a bad phone speaker driver. I tried watch an old movie from the 50's recently and the sound recording has that same irritating quality too. I think smoother does sound like the right way to describe speakers that are easier on my ears.

What kind of spec should I be looking for if I'm searching for a smoother sound in headphones?

 

I was wondering if any of you have purchased/used any decibel meters and what would be recommended so as to learn what volumes are going on around my environments (home music, car, office etc.)

 

If you are into the Apple ecosystem the Apple Watch has a dB meter on it so you can monitor your surroundings. It also gives me warnings when I am in situation that is too loud.

 

Just a simple $25 dB meter will do well. It’s okay to learn but not much to do with the info. A car, shower etc is 70-80 dB.

What feels uncomfortable is probably best guide no matter what a dB meter say.

 

What is the warning? What does it sound like?

 

You can open up the app on your Apple Watch and get a current reading anytime, but the cool thing is it constantly monitor the noise level of your environment and gives you a warning if it gets too loud (like for an instant) or if you are above 80 or 90 or whatever dB level for the amount of time that the CDC says is bad for you. It comes up as a notice with a vibration on your watch. Bright yellow "Loud Environment" notice with a description of how loud for how long. Sometimes I will get the notice in funny places like from swimming or in the shower, but overall it is a really cool safety feature.

 

Apple Watch.

 

Funny thing is... I had bought an Apple Watch Series 5 around Christmas in 2019. I returned it a week later thinking it wasn't going to be useful and was just an impulse buy. 10 months later my tinnitus got severe. I always wonder if I had just kept the watch if it would have warned me about all the loud music I listened to and could have saved me from getting so bad. I ended up getting the Series 6 just a couple weeks later.

 

So listening to music (speakers, not earbuds) at 60-65 dB should be safe?

I’m still trying to figure this all out again.

 

Apple seems to be serious about hearing health. If you open up the Health app on your phone it gives all the details of noise expose over your day, week, month as well as headphone levels. Plus they put in a bunch of masking sounds (Background Sounds).

 

Can you elaborate on this a bit. At night, I am experimenting with white noise sounds. I am "trying" to set them in a way where I can still hear the tinnitus but the edge is off. However, sometimes I wake up and it's bothering me and my choice is to turn them up a bit so I can't hear the tinnitus and go to sleep. Now, when I turn it off the morning, I certainly get a jolt from the tinnitus but I need to do this from time to time to sleep.

Aside from making habituation harder, is there any real harm to getting some relief from masking so you can sleep?

 

Looking for guidance on this issue. I too have been using my Bose NC buds without music because it substantially lowers the noise level for me in otherwise noisy environments. Is there any evidence that ANC is harmful to ears or aggravates tinnitus?

 

I'm gonna beat a dead horse. I too appreciate @Michael Leigh's contributions on this forum and to me personally. I already know Michael's response but I frankly cannot find a single scientific source suggesting that headphones - IEMs or otherwise - are dangerous in and of themselves.

Michael, is it possible that the folks that report worsening tinnitus from continued headphone use could have had their tinnitus worsen for other reasons? Or from irresponsible headphone use? To be clear, I plan to be very selective on using headphones in the future. I am not looking to stir the pot but I am looking to have a have a productive dialogue on the topic.

Here is an excerpt I found from the American Academy of Audiology:

"In a recent online article, Sound Guys author Tina Sieber, who covers auditory health and sustainability, reports on headphones and the relationship they may have with tinnitus. She emphatically states in the beginning of her article that both wireless headphones and earbuds are harmless when used responsibly.

We as audiologists know that Bluetooth and noise-cancelling features in headphones or earbuds are not to blame for tinnitus. Unfortunately, we are also aware that headphones and earbuds are often not used responsibly.

The problem is that people, especially young people, tend to listen at high volumes for extended periods of time. Herrera et al (2016) reported that 79 percent of young people use portable music devices with 34 percent of them having long periods of exposure; in addition, more than 37 percent of them use these devices at a high volume. This can and often does cause hearing loss, which in turn can cause tinnitus. Sieber (2021) suggests that those with hearing loss are twice as likely to have tinnitus when compared to those with normal hearing.

Interestingly, noise-cancelling headphones may actually help with tinnitus, in an indirect manner. By attenuating ambient noise, a user can listen with headphones or earbuds at a lower volume level, which can reduce the chance of obtaining or worsening hearing loss – and protect you from developing tinnitus.

Safe listening levels consist of no more than 70 percent volume with over the ear headphones and no more than 60 percent with earbuds. There are also mobile apps and settings on most phones that limit maximum volume.

To summarize, no, headphones and earbuds do not cause tinnitus; however, using them inappropriately can definitely increase your chances of noise-induced hearing loss, which in turn can increase your likelihood of developing tinnitus.

Think you have tinnitus? Learn how an audiologist can help you."​