Why Advise Against Headphones?

Ooh yeah this is kinda what I meant when I said having sound waves pound in your ear all day. I don’t know much behind the science of headphones or the technical terms. I haven’t read a ton of stories of people who control both time and volume, usually headphone users abuse one of the two.

Either way, mine have been stashed away ever since I got my tinnitus/hyperacusis and I plan on keeping it that way. Not worth the risk for me.

 

One that is proven to work I might add.

 

I've had stable tinnitus for 28 years - then developed a new sound 3 years ago. There was no noise trauma, no illness, no change in medications or diet, nothing. I did, however, use headphones almost continuously. At that time I was already "tinnitus-aware" so I used them quietly (I set the volume to match the volume of people talking around me), so I did everything right.

There's no way to be sure that it really was the headphones that caused the new sound. But since that onset I've completely discontinued headphone use and the sound never worsened and I got no new sounds.

My theory is that there's nothing special about sound generated by headphones, so a 70dB headphone isn't going to be worse than 70dB reaching the ear from another source. But headphones are so convenient that it's very easy to be exposed to music 10-12-14 hours a day and for compromised ears, even a theoretically "safe" 70-75dB noise can be too much if they hear it all the time, every day, for years on an end.

During my Lenire sessions I do use headphones now for 2x30 minutes a day and I do use them for maybe 1 hour per week for some conference calls. But that's the limit for me, I'm staying away from these things - one cannot be too cautious with tinnitus.

 

Before anything I'd like to tell @Lane that you have my full respect and sympathy for living with ME/CFS, I have pretty extreme and crippling hyperacusis and even so I can't imagine how hard must be living with such conditions, you're a warrior and your struggle is totally recognized by me, I hope everything turns out well for you my friend.

About the headphones use, I agree with some of @Michael Leigh statements, if your tinnitus/hyperacusis is due to noise exposure it's so risky to use the earbuds, even at low volume because there re so many things that can go wrong, a sudden change of volume in the music, the quality of the earbuds, and even if everything is perfect, are you really going to risk to get permanently worse?

Not to mention that sometimes the low volume you're considering safe might not be...

Also I don't believe (this is my opinion I might be wrong and have no scientific base) there's a safe dB, some people are exposed to x dB and have no issues, while others are exposed to lower dB than x and end up with hearing issues.

Some hyperacusis severe patients have long standing pain from very low dBs as well...

In resume, I'd not risk, if you screw up there'll be no help coming beyond acceptance and habituating.

 

Vibrations of what?

 

What proof?

 

Most people with noise induced tinnitus damaged their hearing with speakers.

And yet you frequently listen to speakers, as you've described.

Why reject headphones but not speakers?

By your own logic, wouldn't speakers also not be worth the risk?

 

@Jack V

I have written many posts in this forum and articles on Noise induced tinnitus.
Please read my article: Tinnitus, A Personal View in the link below. It is long but I clearly state: noise induced tinnitus is typically caused by: Using headphones at too high a volume and listening to music through speakers, at clubs and concerts.

Many young people today listen to music at high volume levels through earbuds/headphones attached to their mobile phone. It is one of the main reasons tinnitus has increased among young people. This is followed by frequently attending clubs and concerts where loud music is played. Also movies at the cinema because sound levels are so loud. You are correct noise induced tinnitus can result from listening to music through speakers and listening to music through in-car audio systems at high levels.

All the best
Michael


https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

 

I must have expressed myself wrong. I meant I wouldn't go for just any sound therapy using headphones if I didn't have the certainty that it would at least give an improvement. So no Lenire for me.

 

Not all sound waves hitting the ear drums get through to the inner ear, a portion get bounced back. If the concealed nature of earbuds or headphones can cause the sounds waves to bounce back and forth inside the ear canal, then it is possible for ear buds or headphones to be felt differently from speakers, even at same level. Have you ever wonder why ear buds can feel loud and enclosing even at very low volume? I never understand why.

 

Can you point a link to more info regarding this? Reflection is a natural phenomenon, but it's not clear that the energy reflected would be anything but negligible, especially if you count the second reflection required to bounce back towards the ear drum.

Yes, because there is no external sound that mixes with it, so you don't have to crank the volume to compete with such external sounds so that your music (or other content) can "stand out".

See explanation above.

 

Your ear canal is made to direct sound towards your eardrum. If sound were to bounce around in your ear you would notice some delay or echo effect, so that's not the case.

I'm not sure if headphones are more dangerous than speakers. If it were like that, then hearing aids are in the same category as earbuds too.
In my opinion, decibels are decibels, regardless of where they're coming from.

I agree it's easier to get a loud unexpected blast through headphones, so I don't use them any more. But some people are probably exaggerating the risk.

You hear a lot about headphones and earbuds being the cause of tinnitus because, well, they're literally everywhere. Many people use them all the time. Look around you on public transport in the city. Chances are you'll see a large number of people with AirPods, headphones etc...
It stands to reason some of them will go on to develop problems. A big majority doesn't.

Use of personal listening devices has boomed. With so many people listening there just have to be many stories of headphone induced tinnitus but it will still only be a small percentage of total users. with longer battery life and more storage or streaming since the inception of the humble Walkman, I think exposure TIME is the biggest culprit.

 

@Bartoli

Just be careful of taking advice from people that have tinnitus that wasn't caused by exposure to loud noise, and say headphone use causes no harm at low volume for people with NIT. This is not true for everyone. People that have tinnitus caused by an underlying medical condition within the auditory system know nothing about noise induced tinnitus.

Some people with noise induced tinnitus have used the Lenire without any problems. However, there are people such as the late @Allan1967 who was a member of this forum, reported his tinnitus got worse two weeks after using Lenire. His posts can still be accessed on the forum where it is mentioned. He also told me this during correspondence by PM.

 

I've read your articles and I have to say, I appreciate them a great deal. Thank you for them.

What I'm asking is why demonize headphones and not speakers since both can be responsible for this wicked condition, and both can also be used responsibly?

Why demonize one and not the other?

The advice I'm getting from doctors is to use headphones judiciously, for sound enrichment, and flying.

Thanks.

 

I understand. I think I would need evidence such as statistics that overwhelmingly people were being helped including large numbers of people who have severe tinnitus.

 

I haven´t got noise induced tinnitus. For the last 5 months I started using earphones again at low volume, playing music, tv etc and I haven´t had any problems.

 

I agree totally. I figured it out three years ago getting tinnitus and hyperacusis from a explosion in a 55-gallon drum my head was directly over. I was burning garbage , and had a heavy hat with ears down and hood on top of that. (winter) I went deaf and instant ringing started. I have 80% hearing lose in left ear 40% loss in right. However about a month later after I could hear slightly, it was impossible to use the phone. I could hear, but the sound made both tinnitus and hyperacusis spike. I now only use speaker phone and keep it far enough away from me to tolerate. I do the same at night to shield my T. Put the cell phone with nature sounds near or under pillow to drown out T. I do not think they will ever be able to cure tinnitus and hyperacusis . When I am in a stressful situation, it gets worse. Some medicines makes it worse and takes days to settle down. Wearing hearing protection has its limitations. I use double hearing protection, but you cannot use a mower all day. I must take a break after every hour or the T will spike for days. Just before bed and in the am, when I wake up its always the worst. If I have a nightmare my T gets overboard. Yet the doctor said from an explosion it will clear up in several months. Wishful thinking.

 

Thanks for the concern. I've said in my post, I don't use headphones. I have done so in the past with mild tinnitus (noise-induced) and it hasn't let to any worsening. Only time I use them is while doing a hearing test.

I'm just trying to challenge some of the views that all headphones on low levels are bad per say. In my previous post I stated that headphone use is so widespread that it's probably very easy to find stories to support the view that headphone use is bad. If that's the case, then hearing aids are bad, In-ear monitors are bad, etc...

Again, I'm trying not to be biased in any way. I'm just seeing the headphone anxiety growing to grotesque proportions and am giving my own 2 cents of advice.

I don't even think that there's a distinction to be made between noise induced tinnitus and non- noise induced tinnitus. As you use Allan as a case-in-point, his original tinnitus was because of a botched ear surgery, made worse by noise exposure years down the line.
Whether it's medication, noise, stress, autoimmune disease, barotrauma, or another cause (barring maybe head injury and jaw problems), if they product of that is hearing loss and tinnitus, it's probably safe to say that whatever changes in the inner ear are likely similar. We can't really check for sure of course.

The point I'm raising is that headphones are far from the only cause of tinnitus and I know people with tinnitus that keep using them and are fine. Which by no means does any injustice to the point that one has to be cautious.

 

@Jack V

Thank you for your kind comments.

The advice that I give about headphone use and tinnitus is for people that are specifically affected by: Noise induced tinnitus. Also known as tinnitus caused by exposure to loud noise. On your Avatar is reads: Tinnitus caused by entropy. I believe this is a gradual decline in hearing that has resulted in you developing tinnitus? Therefore, your tinnitus is not noise induced.

The ear canal is approximately 26mm in length 1 inch. A headphone placed over the outer ear or an earbud inserted into the entrance of the canal and music played, produces airwaves/sound pressure. These airwaves only have one course of travel and that is straight towards the eardrum. Behind the eardrum the cochlea is situated. People that have suffered an acoustic trauma/noise induced tinnitus the cochlea seems to be more sensitive to sound even after habituation has been reached. I believe the reason for this is because a lot of people that develop noise induced tinnitus, have some oversensitivity to sound known as hyperacusis.

People that have tinnitus which wasn't caused by exposure to loud noise do not usually have hyperacusis as a result of exposure to loud noise. However, I am aware some do experience oversensitivity to sound which may be classified as hyperacusis.

The severity of hyperacusis when caused by exposure to loud noise does seem to vary between people. However, even after it has been treated or improves by itself and a person no longer experiences oversensitivity to sounds. For some reason the auditory system has been affected in such a way it's not like it was prior to the onset of Noise induced tinnitus. One could say it's like being cut by a knife, although the wound heals a scar remains. This is what I have surmised having corresponded with people at various tinnitus forums and spoken to on the telephone that have noise induced tinnitus. Many of these people have returned to using headphones and used them at low volume and found their tinnitus has got worse. This may not happen immediately but once it does, the tinnitus doesn't usually return to its previous baseline level. In contrast to this some people with noise induced tinnitus use headphones and suffer no ill effects.

I have corresponded with a lot of people with noise induced tinnitus, who have returned to using headphones and regretted it because their tinnitus has increased. There are many posts in this forum written by people with NIT that have returned to using headphones after they have habituated and regretted it. I just don't think its worth risking your health, knowing how debilitating tinnitus can be when it reaches severe levels and this is sustained.

Music played through speakers can cause tinnitus to spike and increase to a new permanent level. However, providing a person with noise induced tinnitus, is careful of not being exposed to overly loud sounds from speakers they will usually be alright. Sound from speakers is dispersed over a wider area before reaching the ear. One must still exercise caution and don't put faith in noise reducing earplugs and think, going to a club or concert where loud sounds are played all night they will be safe. Nothing more could be further from the truth. If external sound is loud enough, it can pass through the head and be transferred to the inner ear by bone conduction and cause irritation spiking the tinnitus, which could increase it to a new permanent level.

ENT doctors are physicians they are not tinnitus experts. In fact they do not treat tinnitus, they treat underlying medical conditions within the auditory system Ear, Nose, Throat, that is causing the tinnitus. They treat them medically or surgically. When there is no underlying medical condition causing the tinnitus as in Noise induced tinnitus, the patient should be referred to Audiology. Here, they will see either a Hearing Therapist or Audiologist that specialises in Tinnitus and Hyperacusis treatment and management. This is the current practice in the United Kingdom. I do not know the procedures used in other parts of the world for people with Noise induced tinnitus.

Treatment for noise induced tinnitus at Audiology, can include: TRT (or elements of it) CBT, Counselling, Mindfullness, Relaxation therapy, Sound therapy using white noise generators, hearing aids and medication. One or a combination of these treatments may be used.

Using headphones as you have been told by your doctors will probably be fine for you. Those with NIT I advise caution.

As I have said ENT doctors are not tinnitus experts they are physicians. Therefore, some will tell tinnitus patients what they want to hear, without knowing the risks a person takes using headphones that has Noise induced tinnitus. Most of these doctors do not have tinnitus. Those that do probably have it mild and it may not be noise induced. I doubt the majority of them have experienced tinnitus at the levels most people experience in this forum. Therefore, how can they possibly understand how debilitating this condition can be for someone affected with it? Most of what they know about tinnitus is from consultation with their patients but they have little perhaps no experience of living with Noise induced tinnitus.

It is the reason so many people at tinnitus forums say: "My ENT doctor doesn't understand what I am going through". Some people give ENT doctors a sentimental reverence because they are medically qualified but this does not mean they know about tinnitus. They are physicians and understand the anatomy of the Ear, Nose, Throat. They treat these organs medically or surgically and I believe most will do this to the best of their ability, because this is their area of expertise.

My ENT doctor is an Audiovestibular physician with a Phd. I have a lot of respect for her and we have a good rapport. She once told me that I know more about tinnitus than her for the simple reason she has never experienced tinnitus. She also said ENT doctors do not treat tinnitus, they treat underlying medical problems that cause it. She continued and said: When there is no underlying medical problem found to causing the tinnitus, the patient is referred to Audiology to see either a Hearing Therapist or Audiologist that specialises in Tinnitus and Hyperacusis treatment and management. I also learnt that most (not all) of these health professionals were either born with tinnitus or acquired it at some time in their life. My Hearing Therapist who I saw for TRT treatment was born with tinnitus.

This is particularly useful in the treatment of TRT and CBT where counselling is given for tinnitus. In my opinion, unless a person has tinnitus, I do not believe they can give high quality tinnitus counselling. One can read about how tinnitus can affect a person and what can cause it but unless they experience tinnitus they cannot understand it.

Michael

 

Yes, there probably are, but what does that prove? People with noise-induced tinnitus responsibly using headphones and not getting worse won't think about writing about their experiences on... a tinnitus forum.

That's like saying people who had a tooth cavity and still keep using their teeth are bound to get teeth problems again. And you know this because you had plenty of proof talking to patients in the dentist's waiting room.

Not having a go at you @Michael Leigh. You have helped many people on here and you mean well, but your reasoning behind the headphones debate is flawed according to me.

 

@Bartoli

I have addressed the use of headphones and noise induced tinnitus many times in this forum and don't wish to do so again. As @Jack V asked for me to explain in more depth I decided to on this occasion. You and I may have a difference of opinion on headphone use and for people affected with Noise induced tinnitus, but I assure you the advice I have given is not flawed.

I have clearly stated not everyone with "Noise induced" tinnitus will be adversely affected by headphone use but many are. A Person with noise induced tinnitus can use headphones responsibly to use your words and their tinnitus will still increase, then again it might not. It is a risk. I correspond with many people with NIT and some contact me by telephone, in distress because their tinnitus has got worse due to headphone use. I know what I'm talking about.

It is up to the individual whether they want to take such a risk. It may seem perfectly okay when an ENT Doctor, Audiologist and people at forums say: Using headphones at low volume will cause no harm at all for people with Noise induced tinnitus. Should the tinnitus increase as it has done for many people in this forum due to headphones use, they will be the ones in the suffering all by themselves and no-one to help them.

I will not be commenting further on this topic.
Goodbye and I wish you well.

Michael

 

As a music producer, I've completely stopped using cans. After long sessions, I found my tinnitus way more intrusive and in worst cases, hearing distortion.

After switching to speakers, and of course making sure to keep the volume reasonable, I've felt better. As a neat byproduct, my mixdowns are sounding better as well lol.

I think it's mainly that it's way harder to keep the volume down with headphones, and the cravings to bump it up mid-session are real.

 

I would never say the advice you give is flawed. It's better to err on the side of caution. Especially if you can't afford to have tinnitus any louder than it is at the moment. Therefore, your advice will not harm anyone.

The reasoning behind some of the statements is relying heavily on accounts of people already suffering. As you're in contact with many sufferers and given the widespread use of headphones, it's normal some will report a worsening. Some people have worsenings without any reason at all.

You're not in contact with a cross-section of the population, but with sufferers. The accounts on which you base your opinion on are disproportionate in regards to the average population and it's probably not a good idea to form your opinion solely based on that.

I'm certain people can aggravate tinnitus using headphones, but I will still argue that the source of the sound has little value in whether it can damage the ears or not. The thing we don't agree on is if low-level listening is a risk.
For that reason I'm just adding my opinion to this thread. To balance things out, if you will.

 

With respect.
You are not balancing anything out you are giving your opinion which I accept even though it is wrong. It reads on your Avatar, tinnitus since 2009 and got worse in 2019 for which I am sorry to hear. I will assume that the original cause of your tinnitus was Noise induced. The most common cause for this type of tinnitus to get worse, is further exposure to loud noise or using headphones even at low volume. Based on my experience corresponding with many people and my own tinnitus which got worse due to Noise exposure in 2008. In your case it is either headphones use (though I doubt you will admit it) or exposure to loud noise from listening to music through speakers at your home or at a venue such as clubs or concerts. Or another type of loud exposure to noise/sound.

I rest my case.
Michael

 

It's your right to think so.

It says so in my information. So yes.

...correct. Or ear infection. Or brain injury, or barotrauma, or ototoxic medicine. Or stress.

I think not. Please give me one (1) source for this, other than anecdotal evidence.

Please do not make those assumptions on my behalf. You do not know me, still you assume I would somehow not admit to having damaged my hearing through headphones if that were the case. That's the same as calling me a liar in my eyes. Do you suspect I'm on the payroll of the headphone mafia*?

* there is no such thing as the headphone mafia

 

No I do not. You are someone with noise induced tinnitus that has a lot to learn, and you will given time.

I wish you well.
Michael

 

Though I find this condescending, I'd rather keep an open mind and learn.

I'll repeat my question. Please provide me with some evidence of your claim about headphones being dangerous on low levels.

 

This debate will rage on for years to come.

Look, at the end of the day, you are dealing with sound pressure levels. Your eardrum doesn’t care whether the source is a set of speakers, environmental sound, hearing aids, or headphones, etc. The SPL at your eardrum is all that matters. In other words, 60 dBA at the eardrum via headphones is no different to 60 dBA from any other sound source like conversational sound, for example. The sound wave hitting your ear would be scientifically identical and would carry the same amount of energy (ignoring infra and ultrasonic frequencies, of course).

There have been many studies conducted where special microphones were used to measure sound pressure levels at the eardrum. I’m not aware of any study that has suggested that equivalent low-level waveforms from headphones are different or inherently dangerous to human hearing. On a logical level, this makes sense as we are just following the laws of physics. If headphones are dangerous then so are hearing aids and white noise generators, that is unless they warp the space-time continuum somehow

The real risk with headphones is ear fatigue from overuse and a phenomenon whereby people can’t help but slowly increase the volume over time without realising it. As the brain normalises the incoming sound it’s really easy to get into dangerous territory unknowingly, and background noise can play a big part in this process. This is why both passive and active noise cancelling headphones were invented.

There is nothing out there that can validate the idea that headphones are inherently dangerous at safe volumes. @Bartoli is correct when he said it’s flawed to use data exclusively from a site full of tinnitus sufferers. There is no control for this which makes any conclusion meaningless and anyone who attempts to interpret such data either way is likely only confirming their own bias. This is why the scientific method is so rigorous, it has to remove all potential for human bias which is rife in all experimentation.

If one feels more at ease by never using headphones again then I’d say that’s a good course of action, but for someone to claim outright that headphones are dangerous at safe levels (and time exposures) is a bit misguided, I feel. There is no evidence to support such an idea.

Statistical analysis is a minefield. There is no way that one could conclude that headphone usage was the cause of a worsening. What else was that person doing? If they all ate cheese as well, then maybe it was that? Did they all wear shoes that day? How do we know the shoes didn’t cause it? Did they take antibiotics? Etc, etc.

This leads me to something I’ve already mentioned on here but I’ll say it again. I was at a lecture once where the topic of statistical data and it’s interpretation/analysis was spoken about at length. I also have a book about this which is a good read (forgot the title at the moment). There are so many facets to this that I couldn’t possibly fit them all into a paragraph, but I think it’s something worth knowing. One of the main points that sticks out, which he was very clear about, is when we automatically attribute a cause to a certain effect, and believe it to be true. Even when the evidence overwhelmingly suggests it. He simplified this with a demonstration that involved people who had experienced a yellowing of their teeth, that he labelled (A), and people with lung cancer that he labelled (C). He stated that the data would suggest - with a very high probability - that anyone with yellow teeth (A) would have a significantly higher chance of obtaining lung cancer than those with whiter teeth. This is where data can be deceiving and why its analysis is so difficult, because different lenses can be applied and truth can still be found. At this point he introduced smoking and labelled it (B), and only then does the scenario begin to make more sense. The yellowing of the teeth (A) becomes almost irrelevant once you add in smoking (B). Because it’s then that you can see that smoking (B) causes yellow teeth (A), but it can also lead to lung cancer (C). The link between (A) and (C) is no longer important, but is still true. Smoking (B) is the real cause, but if (B) is not known or understood then you wouldn’t have the information required to understand what is really happening.

This is why human biases are problematic.

 

The headphone vs no headphone debate continues!!!!!!

Unless someone can produce a document that says 60 dB from headphones is more dangerous than 60 dB from external sounds, there isn’t really anything to discuss. What is the difference between a sound that is 60 dB close to your ear vs a sound that is louder and farther away, but is also 60 dB when it reaches your ear? They are exactly the same. Unless someone can produce a scientific article discussing the difference and how it is harmful, it’s all the same.

No, I don’t want to read anyone’s opinions or audiologists' theories, I want scientific backed articles.

 

On most phones and computers these days you can set a limit for how loud sound is.

Computers even have “limiters” which will cut off sound at a certain level and not let it get any louder.

@astaff14 brought to my attention that using Apple headphones and an Apple phone you can see exactly how loud your headphones are using the Apple Health app. You can see, for example, that at this level my headphones are producing noise at 65 decibels. It even keeps track of how long you listen to it at that level.

I agree the two main problems here are people who slowly increase the volume, people who increase the volume when they are in a noisy setting, or people who listen to it for way too long. If people can resist the urge to turn it up, monitor what level it’s at, and use it for short periods over time, I don’t see any issue with using them.