Treating Reactive Tinnitus and Hyperacusis with In-Ear White Noise Generators (TRT)?

Discussion in 'Support' started by David S, Sep 1, 2021.

    1. David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      My reactive tinnitus and hyperacusis is a little bit more challenging at the moment. I have no pain involved but my tinnitus reacts to a lot of every day sounds. I'm trying to overcome it.

      Last time around I had great success treating this with SSRI and Widex Zen sound generators. I think it is time for me to go looking for my old Widex Zens.

      I am going to an audiologist but your advice on how to set the white noise generators would be most welcome :)

      Here is the plan:
      1. Adjust the white noise so it feels as comfortable as possible.
      2. Start on a very low volume (just clearly audible, but not more than that) for 1 hour a day.
      3. Next day for 2 hours a day, and so on...
      4. Once I reach the full day, I will snap up the volume one step and do so every second week or as I feel comfortable.
      Any other suggestions?
       
    2. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Location:
      Brighton, UK
      Tinnitus Since:
      April /1996
      Cause of Tinnitus:
      Noise induced
      Hi @David S.

      Please go to my started threads and read my posts on TRT. They explain how to use white noise generators correctly. They should be introduced to the auditory system slowly. My advice is to always keep the white noise slightly below the tinnitus and not increase the volume as you have mentioned in the second week of use.

      Some audiologists tell tinnitus patients to first treat the hyperacusis, by slowly increasing the volume of the white noise, to help with desensitising the auditory system. Unfortunately, this often results in irritating the hyperacusis and spiking the tinnitus.

      Michael
       
    3. 2noist

      2noist Member

      Tinnitus Since:
      04/02/2015
      Increasing the volume like you have planned can improve your sound thresholds and reduce your reactivity.

      However, having it so loud that it masks your tinnitus completely is not a good idea. I think it's widely accepted that tinnitus shouldn't be completely and persistently masked for the brain to better adjust.
       
      • Agree Agree x 1
    4. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Michael Leigh, thanks for you kind advice. I saw in a previous thread that you recommended 1 hour of use and the same time of rest in continuous cycles. That might be the way for me to start. Also it would require a very high volume to mask my tinnitus. I guess i need to find the optimal setting between the following:

      A: A good sound stimulation
      B: Not mess too much with my reactive part of the hyperacusis. I know it will react but that is also what I am treating.
      C: Hear normal external sounds like talking clearly through the white noise. I have minimal hearing loss (5-15 dB).

      Actually I can live well with my tinnitus. I am not too bothered about it. It´s once it starts to react to external everyday sounds that it gets difficult. I can see the same pattern a lot here on Tinnitus Talk.

      David
       
    5. Stacken77
      Wishful

      Stacken77 Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      10/2020
      Cause of Tinnitus:
      Noise (likely headphones & cars), Acoustic trauma did me in
      Hey David,

      I'm just curious; has your tinnitus always been reactive? How as it progressed? Do you, like me, wear hearing protection all day? How does your reactivity manifest; does the increases recede immediately, or is it like spikes that last a bit after the exposure is over?

      I'm also working with my severely reactive tinnitus and just now reintroducing sound again after a very long time of sound deprivation. I may be seeing signs of things going in the right direction, but I'm very careful to draw conclusions.

      All the best,
      Stacken
       
      • Like Like x 1
    6. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Location:
      Brighton, UK
      Tinnitus Since:
      April /1996
      Cause of Tinnitus:
      Noise induced
      Hi @David S.

      Noise induced tinnitus with or without hyperacusis and using white noise generators are my main areas of interest. I have used white noise generators for many years and used them exclusively when having TRT with good results.

      In the near future, I will be writing a post about white noise generators and hopefully, it might be of help to someone.

      My advice is not to mask your tinnitus when using the white noise generators. Keep the volume slightly below the tinnitus at all times. This was the way I was taught by my Hearing Therapist. Increasing the volume of the white noise generators or masking the tinnitus often makes the tinnitus and hyperacusis worse.

      All the best
      Michael
       
    7. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Stacken77, I typically find that the reactiveness fades over time. Then I have setbacks. I need to figure out why this is. I suspect 2 major things:

      1. Tension in neck and cheek. I am treating this right now with a specialist. Intense muscle massage.
      2. Too much noise exposure.
      3. Stress in general.

      Right now I use soft earplugs pretty much all day. I take them out once I get home to enjoy dinner with my family and some TV.

      Treatment protocol wold be something like this:

      Once it is really ugly and reactive, just leave it alone and protect.
      Once it improves, start to use white noise carefully.
      I also take SSRI and some Oxazepam.

      Noise generator all woken hours worked very well for me last time around.

      David
       
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    8. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Michael Leigh, I would just like you opinion because I know your are one of the few that really knows everything about sound enrichment.

      5 year ago I used white noise generators (Widex Zen) and SSRI with good success to treat my tinnitus. At the end of 18 months I had reasonable tinnitus (moderate) and pretty much no sensitivity to sounds. I could quite easy go by airplane without any protection etc.

      Then over the last few years I had some setbacks. In the beginning of my setbacks I just start with the SSRI again. I thought the medication was more effective than the noise generators. Now I start to think it is the other way around.

      Anyway, here is my question. Once you start to feel better with the use of the sound generators, and when you are about to let go of them on daily basis, how often do you think you should use them in order to keep the good effect? A couple of hours per day? A full day per week?

      David
       
    9. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Location:
      Brighton, UK
      Tinnitus Since:
      April /1996
      Cause of Tinnitus:
      Noise induced
      Hi @David S.

      You have asked an interesting question. If I manage to write my post on white noise generators, I would like to include it. Thank you for the idea.

      Once a person habituates to their tinnitus with white noise generators and the hyperacusis has been successfully treated, there is no need to continue with their use, unless a person wants to occasionally use them for sound enrichment. I have used them for many years for this purpose but for the last eight months, have used them daily for up to 10 hours. I will explain the reasons at a later date. I just want to say that my tinnitus has not increased.

      You had good success 5 years ago using the Widex Zen sound generators. You habituated to the tinnitus and oversensitivity to sound was not much of a problem.

      The increase in your tinnitus and in particular the hyperacusis, and having an oversensitivity to sound, I suspect is caused by one or two things. Either you have been subjecting your auditory system to loud sound without realizing it over time. It doesn't matter if you have been using earplugs, if external sound is loud enough it will pass through your head and transfer to your inner ear by bone conduction and cause irritation. At the time you may not be too aware of this because you habituated. However, if one continues subjecting themselves to loud sounds, there is a risk of the auditory system becoming so sensitive that one day it will make itself known and spike. Wearing earplugs is no guarantee that a person with noise induced tinnitus will be safe from external loud noise.

      The other reason is using any type of headphones. This includes earbuds, AirPods, bone conduction headphones, noise cancelling headphones and headsets. If a person with noise induced tinnitus uses any of these devices, even at low volume, they risk making their tinnitus worse and making their auditory system more sensitive to sound which can manifest into hyperacusis.

      After a person habituates to tinnitus, I recommend they try to avoid being in quite rooms and surroundings during the day for long periods. Therefore, use sound enrichment such as low level background music. Continue using sound enrichment at night until morning, using a sound machine to play nature sounds by the bedside. The sound should be set slightly below the tinnitus and not masking it.

      Hope this helps.
      Michael
       
    10. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      Michel, you are a wise man. This is exactly what happened to me a few times. Last time around was a few weeks ago. We were traveling on large car-ferry. I was out on the car deck for a few minutes. They had super large fans and I was walking just 1m from them (I cloud really feel the power from the fans). I had hearing protection, but it must have been the bone conductive part. It is so hard to protect yourself from situations like this this without limiting yourself too much. I am not really ready yet to move to a cabin on the country side...

      Now my auditory system is quite upset because of the incident. Should I wait a few months until it settles down before I start with the white noise generators?

      How should I ever be able to protect myself from random traumas like this in the future without limiting myself too much? I have a long haul flight with my family coming up in 2 month. I guess I will use both in-ear soft earplugs and my 3M Peltors on top of that?

      Thanks again Michael!
       
    11. Michael Leigh

      Michael Leigh Member Benefactor Hall of Fame

      Location:
      Brighton, UK
      Tinnitus Since:
      April /1996
      Cause of Tinnitus:
      Noise induced
      Hi @David S.

      Thank you for your kind comments. I just want to say, a lot of the information I have given you, many people with noise induced tinnitus know this already or will come to know it with time. The reason being, one can only learn this by living with the condition and acquiring experience.

      I have had tinnitus for 25 years. I have corresponded and counselled people with noise induced tinnitus at forums, by email and telephone. They have helped me to learn more about this type of tinnitus and will always be grateful to them.

      I don't think it was one event that has caused your tinnitus and oversensitivity to sound to increase. If you have been using any type of headphones regularly, or listening to loud music, being exposed to overly loud sounds, then your symptoms would have been building up for some time without you realizing it. This is the danger when a person habituates to noise induced tinnitus. Please go to my started threads and read my post: Will My Tinnitus Get Worse?

      You can experiment using the hearing protection that you have mentioned. However, I advise caution as it's not a good idea to become too dependent on them. Please read my post: Hyperacusis, As I See It. You will find it on my started threads.

      Take care,
      Michael
       
    12. SD7
      Angry

      SD7 Member

      Tinnitus Since:
      Mid /June 2021
      Cause of Tinnitus:
      Vaccine + Noise
      Hi David,

      Did the white noise generators lower the reactivity of your reactive tinnitus?
       
    13. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      Yes, I would say it did but now my tinnitus is far too reactive to start to treat it with WINGs again (white noise generators). As soon as it settles down again, I will start the treatment again.
       
    14. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Stacken77 and others with reactive tinnitus.

      Here is how I try to treat my reactive tinnitus. It would be interesting to compare with others. It is important to point out that in between my relapses I lived a very normal family life with my severe tinnitus. Of course there were limitations but nothing really big compared to what others have to deal with.

      Meds:
      15 mg Escitalopram (SSRI). Really helps to get my emotions under control.
      5 mg Oxazepam in the evening. I know to be careful but it is a really small dose.
      3.75 mg Zopiclone at 4 am when I typically wake up. It helps me to sleep another 3-4 hours.

      I hope to face out the Oxazepam and the Zopiclone within a month or two. I have done it before without any hassle.
      Sleep is really essential for me to heal. I need a good 9-10 hours per night.

      Food & Supplements:
      I try to use as little as possible sugar, gluten and salt. No processed food. A lot of fruits and veggies. Only french meat and fish. I will also try Magnesium, Ginkgo, Zinc, Vitamin D. I also have some Turmeric from last time around.
      I still drink 3-4 cups of coffee and 2 small glasses of wine per day. You still need to enjoy something...

      Physical therapy:
      I go to a therapist weekly who works hard on my neck and cheek. I have bad posture and and stiff muscles.
      I also started to use a mouth splint. 30-45 minute walks every day.

      Sound enrichment:
      I use 3M soft earplugs for half the days (know it is overprotecting right now). I cut them in to half. Normal speaking and tv without protection is ok, which is a progress. I would like to use WNGs but my tinnitus is still to reactive. I hope to start with the WNGs within 2-3 months once it settles down a little.

      In general:
      Try to live as normal as possible. Work 6-7 hours a day. I concentrate reasonably good despite these high pitched sounds.
       
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    15. Wrfortiscue
      Provocative

      Wrfortiscue Member

      Tinnitus Since:
      1999
      Cause of Tinnitus:
      Trauma
      How’s your quality of life now?

      There are times where I forget it’s there if I keep distracting myself. Other times it pierces right through my thoughts. Not obsessing over the sound helps even if it’s pretending to not obsess.
       
    16. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Wrfortiscue, when I got tinnitus almost 8 years ago my life was constantly 1-3 on a 10 degree scale. Now i would say I am at 3-5 (SSRI helps me not to get below 3). I would normally be at 5-8. I would say 5-8 is a good life. I would seldom get over 8 even before tinnitus.

      I hear my tinnitus constantly but most of the times it is not hard for me to concentrate on other things. I can work pretty normally.

      What I will do different this time around is to maintain the treatment of tinnitus even if i feel better. I will use white nose generator for a period of 3-12 months in order to improve my sound tolerance.

      I also suspect the minimum amount of bonzo that I consume does more harm than good. I will try to stop those quite soon.

      I suspect the following to be the reason for me getting worse the last few months:

      - A few too loud noise exposures
      - Tensed muscles in back and neck
      - I cannot rule out the very small amount of Oxazepam and Zopiclone. I used Zopiclone for a long time. It is short acting so I think the concentrations in the blood remain for a couple of hours.
       
    17. Stacken77
      Wishful

      Stacken77 Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      10/2020
      Cause of Tinnitus:
      Noise (likely headphones & cars), Acoustic trauma did me in
      Hey David,

      As you've had some bouts of reactive tinnitus previously, I'm curious; can you describe how your reactive tinnitus has manifested when at its worst?

      My tinnitus basically spikes to any sound, no mater frequency, which are louder than my heartbeat and breathing.

      All the best,
      Stacken
       
    18. AUTHOR
      AUTHOR
      David S

      David S Member Benefactor

      Tinnitus Since:
      10/2013
      @Stacken77, my tinnitus has like 3 stages, from the worst:

      1. High pitched unstable sinus tone (intrusive)
      2. High pitched morse code (intrusive)
      3. High pitched tickling (not so intrusive)

      The more sound I expose myself to, the higher up in the chain I go but there are times when it stays low for one or some days. It is reactive to most sounds but I got so used to it. Normally I cannot handle vacuums, frying pans, noisy fans etc.

      I think this is from damage to synapses or hair cells in the cochlea. I also think that it can improve over time if the damn hair cells decides to function again or more likely die off. I suspect tense/inflamed muscles in cheek and neck could be involved in this.

      Can you modulate your tinnitus? Try biting hard or open mouth wide while you push it back.
       
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