Smartphone Apps for Tinnitus Management

A recent consumer survey by Deloitte reported that smartphone adoption rates are nearing their peak, with as close to nine in 10 adults (aged 18-75 years) having a smartphone that can support mobile applications (apps).1 Ninety-five percent of smartphone owners use their device every day, and smartphones have become the preferred device of the majority of users for activities such as online searching, watching and recording videos, checking bank balances, checking social networks, reading the news, playing games, making online voice calls, and taking photos. Mobile technology including smartphones also provides a medium through which people can access health-related information, e.g., tinnitus management options.

To date, no research has looked specifically at the use of mobile apps for tinnitus management. Paglialonga and colleagues2 identified and assessed apps for hearing science and care in general (available on the leading platforms: iOS, Android, and Windows Phone stores). Tinnitus apps identified fell into two categories: (1) screening and assessment (estimation of tinnitus pitch and loudness) and (2) intervention and rehabilitation (tinnitus management tools such as maskers and sound stimulation).

A search for tinnitus apps in the Google Play Store returned a list of almost 250 paid and free apps. While some of these apps have been specifically developed for tinnitus, others have been developed for other problems such as sleep, relaxation, and general well-being. Despite the increasing popularity of apps in general, it is unclear what proportion of people use apps for tinnitus management or which apps are the most popular.

SURVEY HIGHLIGHTS ON APP USERS
We conducted a web-based survey consisting of 33 questions about people's views on mobile apps used for tinnitus management, including reasons for use/non-use, important factors when choosing an app, names of preferred apps, perceived benefits for their tinnitus, and positive/negative aspects of the apps.3 A total of 643 people responded to the survey (289 women and 350 men; age range from below 18 to 75 years and over).

Reasons for Non-Use. A majority of respondents (75%) had never used an app to manage their tinnitus. The main reason for non-use that respondents listed was lack of awareness of the existence of apps that might help their tinnitus (59%). Other reasons included not being good with technology (20%), not being able to find an app that they thought would be helpful for their tinnitus (13%), or not owning a mobile phone or tablet (12%).

Apps for Tinnitus Management. A total of 120 respondents stated they had tried an app to help manage their tinnitus. A list of 55 apps was populated from their responses, indicating a large variability as to which apps individuals were using for their tinnitus. A list of the most popular apps is included in Table 1. Interestingly, the respondents’ most common reason for trying an app was to address sleep problems associated with tinnitus (23%). Other reasons included masking of the tinnitus sound (21%), following a recommendation (from a hearing professional, a family member, or people online; 20%), or to achieve more general goals such as tinnitus relief, find ways of managing their tinnitus, and cope with tinnitus (18%). Among the most commonly listed apps were those developed specifically for the management of tinnitus (Beltone Tinnitus Calmer, Oticon Tinnitus Sound, Tinntus Therapy Lite), those developed to address other problems but stated that they could also be applied to tinnitus (myNoise, White Noise Free), and those developed for other problems that did not mention tinnitus (Relaxed Melodies, Headspace, Sleep Bug, Sleep Pillow, Soothing Sounds Lite). Two listed apps (Beltone Tinnitus Calmer, Oticon Tinnitus Sound) were developed by hearing aid manufacturers. Instructions for these apps noted that they should be used as a part of a tinnitus management plan provided by hearing care professionals.

Six main components of the apps were identified based on descriptions in the app stores (Apple, Google, Amazon): (1) sound generation/therapy, (2) meditation and mindfulness, (3) information and education, (4) hypnosis, (5) relaxation exercises, and (6) assessment (Fig.1).

Important Factors When Choosing an App. Survey respondents noted ease of use (73%) as the most important factor to consider when choosing an app. Other commonly mentioned factors included a trustworthy source (44%), reviews (39%), and cost (39%). Interestingly, recommendation by a medical professional was further down the list, with only 25 percent of respondents listing it.

QUALITY ASSESSMENT OF APPS
Quality and functionality of health care apps, including tinnitus apps, can vary greatly. The IMS Institute for Healthcare Informatics4 assessed the functionality of 16,275 health care apps according to 25 individual criteria, including the type and quantity of information provided by the app, how the app tracks or captures user data, the communication processes utilized by the app, and the quantity of device capabilities included in the app. More than 90 percent of the apps received a score of 40 or less out of 100, suggesting low quality.

In our study, three researchers independently assessed the quality of each of the most commonly used apps for tinnitus using the Mobile App Rating Scale (MARS).3,5 MARS assessed four main aspects of each app (engagement, functionality, aesthetics, and information quality) on a scale from 1 (inadequate) to 5 (excellent). In addition, four questions in the subjective quality section evaluated user satisfaction with an app. Overall, the average MARS scores varied from 1.6 to 4.2. Scores in individual subscales varied from 1 to 4.6 (see Table 1). The White Noise Free app had the highest overall MARS score (4.2), followed by Relax Melodies (4.1) and Headspace (4.1). Two apps (Soothing Sounds Lite and Sleep Well Hypnosis) did not meet the minimum acceptability score of 3.0.

APP CONTENT & FEATURES
A detailed content analysis was conducted for the 10 most commonly used apps. In nine apps, sound was the main focus. Features included a wide selection of sounds, the ability to mix different sounds to create personalized soundscapes, sound adjustment capabilities (volume, balance, frequency- shaping, pitch, speed, intensity), random sound effects, binaural beats or isochronic tones, and the ability to record and play your own sounds.

Some apps featured meditation and mindfulness either as the main focus (Headspace) or as one of the features alongside other components (Relax Melodies and Beltone Tinnitus Calmer). While Headspace offered a wide selection of themed meditations on a variety of topics, Beltone Tinnitus Calmer offered six guided meditation sessions for managing the stress and tension caused by tinnitus.

Relaxation features included breathing exercises, with verbal instructions and an expanding and collapsing bauble on the screen to breathe in sync with (Beltone Tinnitus Calmer and Oticon Tinnitus Sound), and muscle relaxation exercises that instruct users to tense and relax certain group of muscles (Oticon Tinnitus Sound). These apps were developed specifically for tinnitus, and the main aim of the relaxation exercises was to counteract tension and stress caused by tinnitus.

Beltone Tinnitus Calmer included elements of cognitive behavior therapy, including changing negative thoughts about tinnitus and identifying pleasant activities to engage in to make life with tinnitus easier. Information and education within the apps included information about tinnitus, using sound for tinnitus management, sleep hygiene, insomnia and its causes, and principles behind meditation and mindfulness.

CONCLUSIONS & FUTURE RESEARCH
This study showed that when aware of their existence, people do look for and use smartphone apps for tinnitus management. The apps are most often used as a self-management option and not in conjunction with the care provided by a hearing health care professional. Further research should consider the place of apps in tinnitus management (i.e., as a stand-alone self-management intervention or a part of management by a clinician). Since the contents of the apps varied greatly with respect to sound options, information, and management strategies, further research should look at the desired content and usability features of apps for tinnitus management from patients’ and clinicians’ perspective. The choice of the best management app should be guided by a patient's needs and preferences.

Source and references: https://journals.lww.com/thehearing...martphone_Apps_for_Tinnitus_Management.6.aspx

 

The Beltone Tinnitus Calmer is identical to the ReSound Relief App (makers of my hearing aids with maskers). It is fabulous, especially if you can listen through your hearing aids. You can play up to 5 sounds at one time, I never have, but my go-to is fire and rain. It completely masks my ringing, even at a very low volume. Of course you can use it with hearing aids, headphones or just out loud from the smart phone. Naturally when you take them off, the ringing appears to be a bit louder but that holds true for any time you have headphones on. I also love a few of the YouTube neuromodulation audio files, they seem to calm down the screaming when it's loud. The only relief I can get is from masking. I have a sound soother and play either crickets or rainfall every night. I'm at least grateful that I can mask it, as I know sometimes you just can't. I jokingly told someone that those of us who live with the Demon tinnitus are the "cleanest people on Earth," because we love to take showers. (if you saw my house you would know that's not true)...but do try either the ReSound Relief App or the Beltone Tinnitus Calmer, both are free downloads on Google Play or Apple AppStore. Sometimes I just put up with the ringing, but it's good to know the technology exists to ease it a bit.

I remain hopeful that treatments will be developed in my lifetime. The infamous Dr. Bao is a researcher at the medical school I worked at for 30 years (University of Arizona Coll. of Medicine). He is only accepting study subjects who know their tinnitus is from acoustic trauma. I don't know what caused mine, I think it's congenital as I've had it for 30 years (but it would go away for years at a time)... until last May when it spiked and never calmed down!

I am like everyone else here, my life would be perfect if it were not for this damn screaming in my head. Like everyone else, I want it GONE. But being a realist, I am at least very grateful for the technology we have that masks it, so I mask it with a background noise all the time.

We need to all band together and get doctors to take this seriously, and people, companies, governments, etc to fund more research.

 

May I ask who Dr. Bao is and what is he developing?

Thanks.

 

He is a neuroscientist at the University of Arizona researching treatments for tinnitus with certain drugs. His current research study is with about 8 other universities and he is the principle investigator. Google Dr. Shaowen Bao, University of Arizona.

Lots has been written about him. He's had success easing the tinnitus in rodents, whether that can be done in humans is the question. Don't ask me how they know mice have tinnitus!! It has something to do with brain inflammation. Evidently, just like Susan Shore at UMich, he also has the Demon tinnitus. Researchers who suffer like us have so much more of a motivation to find viable treatments! I myself have to believe that there will be treatments in my lifetime!

 

So when could Bao's magic pill hit the market if you had to guess? Is this treatment supposed to work for all tinnitus? I have tinnitus from neck/jaw issues.

 

He was researching TNF alpha inhibition. There is a clinical study at Wayne State testing Enbrel (the most widely used TNF alpha inhibitor) on tinnitus. Their study is on blast induced, though:

https://clinicaltrials.gov/ct2/show/NCT04066348

 

Smartphone Apps in the Context of Tinnitus: Systematic Review

Abstract: Smartphones containing sophisticated high-end hardware and offering high computational capabilities at extremely manageable costs have become mainstream and an integral part of users’ lives. Widespread adoption of smartphone devices has encouraged the development of many smartphone applications, resulting in a well-established ecosystem, which is easily discoverable and accessible via respective marketplaces of differing mobile platforms. These smartphone applications are no longer exclusively limited to entertainment purposes but are increasingly established in the scientific and medical field. In the context of tinnitus, the ringing in the ear, these smartphone apps range from relief, management, self-help, all the way to interfacing external sensors to better understand the phenomenon. In this paper, we aim to bring forth the smartphone applications in and around tinnitus. Based on the PRISMA guidelines, we systematically analyze and investigate the current state of smartphone apps, that are directly applied in the context of tinnitus. In particular, we explore Google Scholar, CiteSeerX, Microsoft Academics, Semantic Scholar for the identification of scientific contributions. Additionally, we search and explore Google’s Play and Apple’s App Stores to identify relevant smartphone apps and their respective properties. This review work gives (1) an up-to-date overview of existing apps, and (2) lists and discusses scientific literature pertaining to the smartphone apps used within the context of tinnitus.

Keywords: mobile health; smartphone apps; tinnitus research; biomedical and health informatics 1.

 

Contemporary Review of Smartphone Apps for Tinnitus Management and Treatment

Abstract: Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for a while, there has not been a cure for tinnitus, and the usual course of action for its treatment involves use of tinnitus retaining and sound therapy, or Cognitive Behavioral Therapy (CBT). One positive aspect about these therapies is that they can be administered face-to-face as well as delivered via internet or smartphone. Smartphones are especially helpful as they are highly personalized devices, and offer a well-established ecosystem of apps, accessible via respective marketplaces of differing mobile platforms. Note that current therapeutic treatments such as CBT have shown to be effective in suppressing the tinnitus symptoms when administered face-to-face, their effectiveness when being delivered using smartphones is not known so far. A quick search on the prominent market places of popular mobile platforms (Android and iOS) yielded roughly 250 smartphone apps offering tinnitus-related therapies and tinnitus management. As this number is expected to steadily increase due to high interest in smartphone app development, a contemporary review of such apps is crucial. In this paper, we aim to review scientific studies validating the smartphone apps, particularly to test their effectiveness in tinnitus management and treatment. We use the PRISMA guidelines for identification of studies on major scientific literature sources and delineate the outcomes of identified studies.

 

Well, for those who live in California and are interested.

Adapting Personal Therapies Using a Mobile Application for Tinnitus Rehabilitation: A Preliminary Study

Objectives:
To develop a smartphone application providing sound therapy and cognitive behavioral therapy (CBT) for treating tinnitus and performing a proof-of-concept pilot study evaluating its potential efficacy.

Methods:
An interactive smartphone application available on iOS and Android platforms was developed, which provided an 8-week tinnitus-specific CBT and personalized and frequency-matched sound therapy. Included patients presented to our tertiary clinic between 2017 and 2018, while those waitlisted were regarded as controls. Three surveys were administrated: Tinnitus Handicap Inventory (THI), Generalized Anxiety Disorder 7-item (GAD-7), and Perceived Stress Scale (PSS).

Results:
A total of 30 patients enrolled in this study consisting of 20 treatment and 10 control patients and mean age was 55.4 ± 11.6 years. Treatment and control patients had similar age, sex, and pre-enrolment GAD and PSS (all P > .05). Baseline THI scores were also similar between treatment and control cohorts (50.1 ± 21.9 vs 62.0 ± 20.7; P = .15). After 8 weeks, though changes in GAD and PSS scores were similar (P > .05), the treatment group reported a significantly greater improvement in THI scores (17.7 ± 15.8 vs 5.3 ± 10.5, P = .04).

Conclusions:
This pilot study demonstrated potentially promising efficacy of a smartphone-based CBT and sound therapy platform for treating tinnitus and encourages future randomized controlled trials on this treatment modality.

Source: https://journals.sagepub.com/doi/abs/10.1177/0003489420962818

 

I still remember searching the App Store for tinnitus apps a decade ago when I got my first iPad. I tried several free ones with no luck, and then finally came across one that was $10. It's been so long that I don't remember how it worked or what it did, but I think it was some kind of sound therapy app. Paying $10 for an app pained me, but at that point I was willing to try anything. I still remember the sense of dread I felt after using the app for a while and realizing it was complete BS. I'm not sure how someone can sell a smart phone app for tinnitus. I can't tell if it's malice (and the person is banking on users having the placebo effect), or if they think they've actually hit upon a cure.

Research may show some promise for some of these apps, but based on the ones I used I don't have much hope for this area of study.