The Term Reactive Tinnitus

The term reactive tinnitus is often something said to be made up here on the forums. I can not see why it is not a accepted term. This is how I see it:

Hyperacusis:
Pain or big discomfort with loud noises. You could have it with and without tinnitus.

Reactive tinnitus:
When your tinnitus try to compete with some or all external sounds. Most common is fans, ACs, vacuum cleaner with a broad spectrum of frequencies but it could also be a car ride, watching tv etc. Also sound generators could be tricky. Generally I would say that there also is no pain or discomfort involved. For some it settles down once out of the sound source and for some it sets off something that could go on for quite some time.

You see, this is for me 2 quite different things. We might not be that many with reactive tinnitus but at least we need some proper medical terms to describe it.

I used to have reactive tinnitus but luckily it almost went away. Now it is back because of a noise trauma. When the reactive part sets in it´s so much overwhelming information to my auditory system so it just exhausts me and puts me to bed.

 

Reactive tinnitus is not "imaginary" - my tinnitus sometimes competes with certain sound frequencies.

Why can't it be called "reactive tinnitus"? That's the best term for it!

 

I agree. I experience both things - H and Reactive Tinnitus (in form of "winding-up" effect) In my case worsening of T lasts more than several hours (sometimes several days and sometimes it becomes my new baseline) which puts me in the infamous "Category IV" bracket (you can read about Tinnitus categories in TRT literature)

I would also address controversion about using term "reactive tinnitus" in regards to TRT. It's true that the word is avoided by clinicians but indirectly the condition is recognized and referred as two different terms - "winding up" and "kindling". Here's the quote from book written by Hazell and Jastreboff:

"The term kindling is used in epilepsy to describe the process whereby a weak
electrical stimulus initially has no effect but repetitive presentation induces a full
epileptic attack. In the case of tinnitus, the term is used to describe the prolonged
worsening of tinnitus and/or hyperacusis as a result of exposure to a relatively short
period of moderate or loud sound. In “winding-up,” the worsening of a symptom
occurs from exposure to a continuous stimulus over a prolonged period of time.
This phenomenon is well recognized in pain; in tinnitus and hyperacusis it describes
the significant worsening to even very low levels of sound when the sound is presented
for a longer period of time."

Take a look at the expresion: "and/or" It's clear that you can experience winding up effect of your Tinnitus and Hyperacusis separately. You can have one without another. I'd like to know if @Michael Leigh has anything to say about it. On more than one occasion you stated that there is no such thing. The excerpt is from the book that you advised to read as a reliable source. ps. I hope you won't treat this question as a personal attack.

 

@David S @pytajnick

Pain isn't always experienced with Hypercusis. It comes in different levels of severity like tinnitus. Mild, moderate or severe. I believe as others do that there is no such thing as Reactive tinnitus and that the term was made up in tinnitus forums. There are people that disagree with this and that's fine, for we are entitled to our opinion. I am of the belief because "Reactive tinnitus" is commonly used in forums, some in the medical field have latched on to the idea of treating it as a separate medical condition using sound therapy. After this first stage of treatment the hyperacusis then treated using sound therapy as a second phase. If one believes in this then that is up to them. I have had tinnitus for over twenty years and do not believe in reactive tinnitus for a moment. I also had very severe hyperacusis that was treated with white noise generators for 2 years and the condition has been cured for 19 years.

Michael

PS: I will not be commenting on this topic further and believe as I've always done. Reactive tinnitus is hyperacusis and comes in different levels of severity and can be treated in most cases.

 

I agree with @David S that we need a proper definition for this since quite a few including myself experience it in the absence of symptoms of the classic hyperacusis, so I suppose the mechanism is a bit different.

If you read the TRT book, Jastreboff describes that a mechanism for the category 4 tinnitus that @pytajnick seems to suffer from (kindling/winding-up) could be that there’s a mechanical dysfunction of the cochlea, primarily the OHC and the basilar membrane, resulting in enhanced function of the cochlear amplifier. The oversimplification may be caused by a shift in the working position of the cochlear amplifier into a higher amplification setting, where it gets “stuck”. Also he says that hyperacusis is almost always the dominant problem in category 4.

Personally I believe the “reactive tinnitus” but without prolonged worsening when exposed to noise belongs in category 3 of TRT even though Jastreboff didn’t describe it as a separate phenomenon. In this category again the hyperacusis is the dominant problem.

Hyperacusis and tinnitus are very complex conditions and the way they interact with each other is not quite known yet. To me, “reactive” tinnitus seems to be somewhere in the middle . Not clearly hyperacusis not clearly tinnitus.

 

For me with bad hyperacusis for the moment (or reactive tinnitus like I would like to call it) it is easy to hear my tinnitus over airplane noise or a general noise around 80 dB. My explanation to this is that my T flairs up and comes in pulses. Like small electrical shortcuts or fast high pitch pulses but it is not a ringing and far from tonal.

But I would never say that my T is 80db. Sometimes when I plug my ears the pulses could be really low but always clearly there.

Remember once when I met an audiologist that did the masking test. He was looking at me with big eyes once we passed 80db saying that you can´t possibly hear you T now. He ended up writing something around 70db and scared the shit out of me. So he should have explained to me that I had a special subcategory of hyperacusis.

This is way I think this important. Not even the audiologist could categorize this for me. All doctors I met so far and it´s a few just say that I have tinnitus. If you do not mention pain or or discomfort the term hyperacusis never come up.

@Michael Leigh
Do you think the term reactive is relevant term as long that it is used as a subcategory to hyperacusis? Would you prefer another term? Where can I read more about all subcategories of hyperacusis? I never found anything about this but it must be at least 4-5 of them?

 

I suspect but I do not know for a fact that reactive may be a mild form of hyperacusis. I am waiting for more research on the topic,

Anyhow now I am going to post the science of hyperacusis to help get people interested in actual research instead of habituation and Jasterboffs quackery.

There are two kinds of hyperacusis I will list below
---------------------
1:Heightened sensitivity to noise (this includes reactive tinnitus if it is hyperacusis)

Inner hair cell nerve fibers are damaged and higher brain functions compensate by amplifying the damaged frequencies.
Certain hair cell and nerve fibers that are still functioning correctly are amplified as well making certain sounds they preceive abnormally loud.
The amplification of the lost frequencies causes spontaneous neuronal activity in the auditory part of the brain (tinnitus)

2: Painful sensitivity to noise
Outer hair cell nerve fibers have properties that give the ear a sensation of pain. When they are damaged the pain signal malfunctions
and as a result those damaged frequencies will cause the sufferer to experience pain from every day to day noises.


An interesting fact to know is that both are linked to hidden hearing loss

95% of the hair cells and nerve fibers are inner hair cells that represent Loud Hyperacusis
5% are outer hair cells and nerve fibers are outer hair cells that represent Painful Hyperacusis

One would image that therapeutics that target hidden hearing loss via auditory nerve repair should help hyperacusis and tinnitus sufferers.

 

@David S

As I previously mentioned I won't be commenting anymore on "Reactive tinnitus" because I've talked about it many times in this forum and the result is always the same. People will believe whatever they want to believe so I'll leave it at that. I can see that you are troubled by it and therefore, hope my suggestions may be of some help.

You have had tinnitus for a long time and it seems that you haven't habituated. If you have habituated to your tinnitus and hyperacusis or sensitivity to sound is the problem then this needs to be treated. Whether one wants to call it reactive tinnitus, hyperacusis or something else, your symptoms need to be treated if they haven't got better by themselves over time. If it is sensivity to sound is your problem then the only treatment for this is "sound therapy" because there is currently no medication that can treat or cure it. Sound therapy in the form of wearing 2 white noise generators for up to 8hrs hours a day is the best treatment. As mentioned in the TRT book written by Professor Jastreboff wearing white noise generators alone is unlikely to work, and counselling with a Hearing Therapist or Audiologist trained in the treatment of tinnitus and hyperacusis is required.

The way I see it is this: it doesn't matter what a person wants to call this sensitivity to sound, if it doesn't improve by itself over time and self help using a sound machine etc as mentioned in my post: Hyperacusis, as I see it, doesn't work, then a person will have to seek professional help with a Hearing Therapist or Audiologist as mentioned above. An ENT doctor does not usually practice in this field as they are not counsellors or work with tinnitus & hyperacusis patients on a one-to-one basis. However, I will as asume there are exceptions to this especially if the ENT doctor also has tinnitus then he/she will have a greater understanding of the condition and hyperacusis.

You mentioned that your Audiologist tried to mask your tinnitus and I will asume this was done with sound? This suggests to me that your Audiologist may well be skilled in this field but does not know much about tinnitus. Anyone that has tinnitus especially if it is loud knows that it cannot be masked with sound, at least not "totally". This is because the tinnitus noise is coming from within the head and is very difficult to mask with sound.

My advice to you is to try some of my suggestions in my post: Hyperacusis, As I see it, to try and decrease the sensivity to sound that you have. The post is available on my "started threads". If this doesn't work or any other method that someone suggests, then you need to seek professional help.

All the best
Michael

 

Sorry it came back, but glad to hear it went away the last time. Do you happen to have hearing loss? I'm wondering how many people with reactive tinnitus have hearing loss.

 

I stayed away a while as I am not convinced focusing on T and H help.
BUT there are some great people on here who helped me out when I was in PANIC mode with great advice @fishbone @Michael Leigh @glynis
So please, lets all just be kind to each other.
This is hard enough as it is.
At the end of the day why does a 'label' really matter ?
I have background T (continuously) which is pretty low level.
BUT some days ( for no known reason - not stress or anything I can pin-point ) it decides to get angry.
On those days it 'reacts' to external sounds - it ramps up when exposed to certain noises - it HISSES back at them - These noises are mainly cutlery and water sounds.
To me...a good description of this is it 'reacts' to external stimuli.
I don't care how its classified.
I just need to get rid of it and/or live with it.
So far nothing has helped and I think I have tried everything, except WNGs.
The reason I haven't tried WNGs is because I cant get them on the NHS and I can barely listen to a low level external speaker let alone a headphone, earphone or WNG ?
Stay cool you all.
Not hard in todays Blizzard...
Love you all.
X

 

Well said @Kelvin labels do not really matter it is treament that is required. If self help doesn't work then it becomes necessary to see a medical professional. My white noise generators were provided by the NHS and you should be able to get them too. They may not be available at your current hospital but if you're able to travel your GP can refer you. I commute to London whenever I need to see my consultant or hearing therapist or have an issue with my white noise generators. I have been under the same hospital for 20 years. I agree it's a bit nippy here in Brighton. Had a scare yesterday when my central heating boiler stopped working...Got British Gas engineer out quick, all is ok now

 

So question................ why would you need to fix your WNGs if you are habituated???

 

@Kelvin ,
You should get your White Noise Generators on the NHS.
ENT won't give them you as you need to be seen by Audiology for them.
Love glynis x

 

@Michael Leigh I'd like to ask you one last question regarding this the topic. As you said the first time you had T it was accompanied by severe hyperacuis. Did you experienced prolonged (lasting until sleep) increase of your Tinnitus volume as an effect of moderate noise exposure or was it just the pain and discomfort in your case?

 

In 1996 my hyperacusis was very severe to the point when talking to people I had to ask them to please lower their voice as my ears hurt. I wore earplugs a lot. I couldn't listen to music through my HI-FI at even 40 decibels as my ears would be in pain and my tinnitus would increase a lot. My whole head felt completely numb for around 6 months. I could hear but everything sounded as if I was listening under water and it was a very frightening experience. One night I awoke at 2 am to the sound of my ears blasting out a high pitch whistle that was as loud as an old fashioned kettle, that whistles when it has comes to the boil on a gas hob/cooker. If anyone wants to know what these sound like just go to YouTube and type: gas hob whistle kettle. You will then get a good Idea of what I experienced.

I believe I experience many manifestations of hyperacusis and tinnitus when I first got them in 1996. I started TRT in October and this lasted around two years. The tinnitus reduced to a very low level and the hypercusis was completely cured. It has remained this way till this day. In 2008 my tinnitus increased to very severe levels and started TRT for the 2nd time. It took 4 years to habituate but my tinnitus has not returned to what it used to be. It is now variable. From complete silence, mild, moderate, severe and can reach extreme severe levels. I take clonazepam when needed and still use white noise generators when I feel the need. However, I mostly use these when at home. When my tinnitus is severe they can be very helpful but occasionally use them when the tinnitus is completely silent, as I like using sound enrichment and always use a sound machine at night.

Michael

 

You know, that's a really good question. Really gets the noggin joggin.

 

I have a severe and unusual form of tinnitus so my ENT consultant and hearing therapist have told me. It is extremely variable. From complete silence, mild, moderate, severe and can reach extreme severe levels. It took 4 years for me to habituate for the 2nd time. Habituation can mean many things. No two people will experience it the same. Just because a person habituates it doesn't mean devices such as white noise generators, sound machines medications such as clonazepam (which I occasionally take) or antidepressants cannot be of use to help a person when they feel the need for them. Please read the posts below.

Michael

What does habituation to tinnitus mean?

Although I have written a post titled: Answers to hyperacusis and habituation, I would like to give my opinion of it again. I have read some posts where people believe when habituation is reached, the tinnitus is no longer heard but this is incorrect.

Put simply, habituation to tinnitus means one can live with the tinnitus and not be bothered by it. Although it may still be heard, the brain is not troubled by it. On the other hand, each person will experience habituation differently. For some, the tinnitus will reduce to a level where it is hardly heard and for others the tinnitus might be moderate, or even severe at times and the person is is able to cope and not be troubled by the noise. Habituation is about the brain accepting the tinnitus.

However, in my opinion, habituation does have its limitations. If tinnitus is severe and intrusive enough and this level is sustained for a period of time, the level of intensity can become too much for a person and they may need medication like Clonazapam (which I take) and is sometimes prescribed for people that have severe tinnitus. Clonazapam might not help everyone and if taken regularly, the body quickly habituates and more needs to be taken to get the same relief. Unfortunately, this drug can be addictive with unpleasant side effects, so monitoring by a GP is advised.

The habituation process.

Habituation is frequently talked about in tinnitus forums and probably comes in at second place to the popular question: when will a cure be found? It seems some people have become quite taken with this word and believe it is the most important thing to strive for when dealing with this condition. Everyone wants to habituate as soon as possible and carry on living their life doing everything that they want to and putting tinnitus firmly behind them.

I can honestly say that I see nothing wrong with that, but wanting something in the speed that we would like it isn’t always achievable, especially with something like tinnitus. A few people that have had tinnitus for a while, have contacted me to discuss just that. They have concerns about the length of time it’s taking to habituate. Similarly, I have heard from those new to this condition that want the habitation process to start as quickly as possible. Both groups tell me they are doing all the right things but it seems patience is giving way to despondency and despair and some are starting to believe habituation might never happen for them.

It is of little comfort to these people when they hear family and friends say, tinnitus is just a minor irritant and something that can easily be ignored. Occasionally, it might be intrusive but this is never more than temporary and they are still able to carry on with their life unperturbed. I often sense the frustration a person is under when they are relaying this to me. Whether I’m talking to them on the telephone, private messenger or answering an email. It is then that I’m often asked: why is it that the habituation process doesn’t seem to be happening for them?

Answering such a question isn’t easy because there is no single answer that I can provide but I will say this. Tinnitus is a common condition that comes in many forms and intensities and no two people experience it the same. It can be very troublesome especially in the early stages of onset, but gradually this gives way and the condition settles down and in time many manage to cope with it when it’s mild or moderate. Sometimes this may involve treatment via a hearing therapist or a person achieves this naturally without being referred to a clinic.

It should be noted that tinnitus can be a complex condition, depending on how loud and intrusive it is for the individual? So what I’ve just outlined won’t apply to everyone. There are other factors that also come into play. A person’s make-up or rather their outlook on life. Whether they are positive or negative thinking can help or delay the habitation process. In addition to this, stress and anxiety are often associated with tinnitus and a person might be taking medication such as an antidepressant to help cope with it. There are a myriad of scenarios that I could relay to you on how tinnitus can affect someone’s quality of life, their well-being and the habituation process. For now I will say this:

When a person habituates to tinnitus it means they are able cope with it but this doesn’t mean they will never hear it. Although some people habituate to a level where the tinnitus is rarely heard or stays at a very low level. Whether the tinnitus is silent for periods of time or remains low, mild, moderate or is occasionally intrusive, it doesn’t really matter, because it all means the same thing. When habituation is reached a person will know, because whatever the level it will not bother you. However, like everything there are exceptions and tinnitus is no different. I believe there are some limitations to habituation. As I have previously said the condition comes in many forms and intensities. Some people have variable tinnitus that can fluctuate from silent, mild, moderate and severe. When it is loud and intrusive (severe) and this level is sustained for long periods it can become very debilitating and a person might have to take medication to cope with it, which is usually supplied by their doctor. This level of sustained intrusiveness shouldn’t be confused with a tinnitus spike, which usually returns to baseline within a short period of time.

I want to say that I believe habituation is achievable for most people with time. In some instances a person might need the professional help of a Hearing Therapist or Audiologist, as there are a variety of treatment options available to help one in the habituation process. One should also try to be realistic. There are some people that will accept nothing less than a complete cure from their tinnitus and this is unfortunate, because they could waste a lot of time being miserable.

I have corresponded with people that have said, their tinnitus is very low and is only heard occasionally or in a quiet room, at night for instance. Yet these people are not satisfied because they want a complete cure and will deliberately seek out quiet surroundings to monitor their tinnitus, checking to see if it has increased or not. It’s as if they have become obsessed with this condition and to the point where is starts to affect their relationship with those that are close to them, and I don’t think this is healthy.

In summing up I want to say one last thing. Those that are having treatment with a Hearing Therapist, Audiologist, or finding that their tinnitus is becoming less intrusive and they are in the habituation process. Try not to read negative posts or associate with negative thinking people who are not in the same place that you are, as their beliefs can prevent your advancement, if you are not careful.

Is habituation possible?

I have often been asked this question by many people that are new to tinnitus and those that have habituated for some time but have noticed a resurgence in it’s severity, which hasn’t calmed down and cast some doubt on whether it will return to it’s manageable levels. I believe it is possible to habituate but it does depend on certain criteria. We are all different so no two people will experience tinnitus the same. It also comes in different forms and intensities, which will affect how a person relates to it and what their expectations are for the future, can make or break the habituation process.

It is not unusual for the newbie to want a complete cure from the cacophony of noise that has suddenly invaded their life like an unwanted interloper. Perhaps their Doctor has said those familiar words: There is no cure you’ll have to get used to it. As far as the patient is concerned they're out to prove otherwise and will throw everything at it that they possibly can. The Internet is a vast source of information and they will endeavour to research tinnitus to the hilt leaving no stone unturned. Depending on where one lives in the world and the accessibility for suitable treatment is another factor.

Many people don’t realize how complex and delicate the ear is until something goes wrong with it. Tinnitus is just one of many conditions that can affect the auditory system. It is for this reason, some ENT Drs are reluctant to intervene too early and prefer to wait for up to six months before offering treatment like TRT, CBT and white noise generators. Unless a person is experiencing additional symptoms such as dizziness, balance problems or deafness which could be an indication of another problem associated with the ear. Therefore, the most a person might be offered in the form of treatment is antidepressants, a sleeping draft or some counselling.

On the positive front: Tinnitus has been known to go away within six months sometimes a little longer and many people do habituate within this time and therefore, it’s no longer seen so much of problem. The early stages of tinnitus can cause a lot of upheaval in a person’s life, often making them emotionally unequipped to take on the treatments that I’ve mentioned, because they do require some calm, positive approach and the willingness to be patient.

By all means research tinnitus and gain as much knowledge about it as possible if that is your choice, but try not to put too much pressure on yourself or setting goals that at the moment might not be achievable. In the early stages, tinnitus can feel like you’re riding a rollercoaster. One day you're up and the next day down. Enthusiasm can quickly turn into disappointment and despair. It is advisable in this instance to take things slow and easy.

To the person that has habituated for a while and noticed a tinnitus spike is lasting longer than usual and is showing no signs of settling down as it would normally. Try not to panic. As you know stress can cause this, for life is problematic and few of us go through it without having problems. On the other hand some people habituate to the point where their tinnitus is hardly heard. Under these circumstances it’s easy to forget and throw caution to the wind. Have you been attending clubs, bars or gigs where music has been played loud and you haven’t been using noise reducing earplugs? It is something to consider.

Have you been listening to music through headphones? Although the tinnitus hasn’t bothered you passed, there’s no guarantee that you wont be affected now even when played at low volume. Whilst it’s good that a person habituates and carries on to lead a fulfilling life, it would be prudent to remember to protect one’s hearing at all times or at least be conscious of it. I have been contacted by many people having habituated for a while and stopped using sound enrichment at night and noticed their tinnitus becoming intrusive again over a period of time. Others attending venues where music is played loud, and those using headphones.

My advice is to be careful in whatever you decided to do. If the tinnitus doesn’t calm down after three weeks then I think it’s time to ask your Doctor to refer you to ENT. Hopefully, you’ll be put on a treatment plan. Since you have the experience of habituation and what this entails, it wont be long before you’ll feel like yourself again.

I have habituated twice in the twenty years that I’ve had tinnitus, although the second time was more difficult and took longer it was still possible.

Michael

 

Indeed it is a good question and I hope my answer will suffice. Habituation means many things and one can use many coping methods to facilitate this.

Michael

 

you know the drill

 

@Contrast

Thanks, like your explanation model here. To me it makes sense. I'm planning to get back to the subject that I believe that a lot of T/H is not generated from the brain but from damage to the inner ear. Hope you will be able to comment on that as well.

@Michael Leigh
Firstly, thanks for your kind advice. I totally respect you statement to not comment this anymore even if I still find it hard to find a medical term to what I really experience. What is more important is that I support 100% that WNGs are the only treatment available today to treat my condition if it does not solve itself.

Just a few words about my journey. I first got T 4,5 years ago. Fell into the darkest hole and lost almost all life quality. It took me about 2 year to get out of that nightmare. All awake hours white noise from WNGs and SSRI saved me. The last 2 years I was like habituated. T was not a big thing for me. I can see my last post here was from mid 2015. I lived my life like normal but always avoided too noisy places. It was not a big sacrifice for me. I am done clubbing! Maybe I got a little too much back to normal. Never protected on semi loud occasions like plane trips etc.

Then a month ago I took my family on a long weekend to Tokyo. Amazing place. My ears was a little upset after this incident but so does my wife say about her ears as well once we fly long haul. Just after that intensive weekend a had a ceremony on stage to attend. I was exposed to loud music and noise for about 30-60 min and because I normally just avoid loud noises I did not have any protection with me. That was of course a big mistake that I blame myself for but what is done is done. My T/H is quite bad now but my experience of dealing with this is way better than last time around. I have pretty much no panic in my body, just very exhausted that I need to go back and tackle this again. If this does not get stable with in a few months I guess I need to go back to the WNGs again. And also be more careful about noise. Always have plugs with me.

@Kelvin I am a kind guy and promise to be nice!

 

For what it's worth, I have this "reactive T" and painful hyperacusis in the same ear. Every time I scratch a piece of furniture, tap something, or even breathe, my left ear lets out a sharp "IING" in response, and then fades away. If I push it further with a more aggressive frequency noise, then the pain begins and lingers there after.

I pretty much agree with @Michael Leigh in concept on this. They're both just hyperacusis.

 

I guess that's a no?

 

@BuzzyBee I have hearing loss in my high freq. above 8k. It might be a little worse now but I did not test. I do not really know if it matters. From the day we are born we lose hearing from around 20k and downwards. Once really old we can only hear low freq. Also the tests done also just test a fraction of all our hearing capabilities. Let me know if I can be more specific.

 

I’m in a similar situation to you unfortunately. Making good progress only to have events that aren’t loud enough to be damaging (ie well under 85db), in effect resetting H in terms of sound tolerance and reactivity.

Hyperacusis and reactive tinnitus, for me, are part of the same thing, whether that should fit under the same umbrella term ‘hyperacusis’ is another thing. I’m not an expert. They can be experienced separately, which I know from my own experience, but most definitely seem to be connected. Kind of getting into semantics really. I don’t believe it’s a made up term for the sake of it.

 

Huh. I've always claimed to not have H. But I definitely have reactive tinnitus.

There was a point when my TMJ got super bad that I started to develop mild H. However, it was brief. Reactive T has stuck around regardless.

Great topic it's interesting to see if people have both H and reactive, or just reactive.

 

So you wouldn’t at least consider that they might be part of the same thing? Maybe just the amount of each can vary: sound tolerance and perception of sound vs reactivity of T to sound.

I guess we know for certain that no one knows exactly what’s going on. So much speculation and conjecture.

 

Once you are treated with the right form of sound therapy and this may include counselling with a Hearing Therapist or Audiologist, trained in tinnitus and hypercusis most people improve and the condition can also be cured.

Michael

 

@David S How long did it take for your “reactive tinnitus” to almost subside before the acoustic trauma?
Did it start dissipating gradually or you habituated and became unaware of it?

 

@Aegaeon It´s a little hard to say. My best guess would be after I started WNGs all waking hours and SSRI it improved within 6 months and was not a problem within a year to a year and half. SSRI took away my negative feeling once the WNGs did massage my upset inner hair cells. WNGs is easy to use in every day life. You get so used to them so get a little worried if you forget them in every morning. Just do not forget them in the shower.

 

@David S Thanks for your answer. My last question would be what kind of noise (white or pink) did you listen through your WNGs? I suppose you had to set them pretty low so they don’t upset your tinnitus. And if so, did you listen to this low volume all the way to the end?