Have you ever found yourself completely unaware of the sound of your tinnitus whilst listening to music or enjoying a movie? If so, you'll have experienced sound therapy for tinnitus - the use of an external sound to distract you or "mask" the ringing, hissing or roaring noise. Sound therapy can be used simply to help you to relax and sleep, or using a more comprehensive programme to help you habituate to the tinnitus. Read on to understand more about sound therapy in tinnitus and how it can be used.
Fatema M Dawoodbhoy

Fatema M Dawoodbhoy

Medically Reviewed by
Dr Jameel Muzaffar
Content Writer | Medical Student
February 15, 2021

Sound Therapy for Tinnitus: The Ultimate Guide

Have you ever found yourself completely unaware of the sound of your tinnitus whilst listening to music or enjoying a movie?

If so, you'll have experienced tinnitus sound therapy - the use of an external sound to distract you or "mask" the ringing, hissing or roaring noise. Sound therapy can be used simply to help you to relax and sleep, or with a more comprehensive programme to help you habituate to tinnitus.

It won't cure you, but many people find it incredibly useful to help live with the condition. Read on to understand more about sound therapy in tinnitus and how it can be used.

Contents:

  1. What Is Sound Therapy?
  2. How Does Sound Therapy Work?
  3. Does Sound Therapy Work For Tinnitus?
  4. How To Use Sound Therapy in Tinnitus
  5. How Can I Access Sound Therapy?
  6. Oto and Sound Therapy

What Is Sound Therapy?

Sound therapy is the use of an external noise to distract or "mask" from the unpleasant sound of tinnitus. It was first used by a physician called Spaulding in 1903. He played piano sounds at the same frequency of his patient’s tinnitus until the ringing became temporarily inaudible to them.

Sound therapy can be used in many tinnitus management strategies alongside education and other therapies like tinnitus CBT or tinnitus mindfulness.

Quiet and silent environments can make tinnitus more noticeable and bothersome. This is why people with tinnitus often struggle to fall asleep easily as the sound can become more intrusive.

If you are struggling to sleep, make sure to check out our article on how to sleep with tinnitus.

Today, using any sound deliberately to reduce the awareness of tinnitus or reduce distress is considered sound therapy. Like the other tinnitus treatments, sound therapy does not cure tinnitus, but it can lower the perceived burden and intensity of the noise experienced. 

Check out this video from n Beats of sound therapy to reduce anxiety, mental health & depression. Adding visual stimuli can add to the auditory effect of sound therapy.

Spaulding pioneered sound therapy for tinnitus, where he played a piano note at the same frequency of the tinnitus
Spaulding played a piano note at the same frequency of his patients' tinnitus

How Does Sound Therapy Work?

There are 4 general mechanisms that form the basis of sound therapy. These are:

  • Masking
  • Distraction
  • Habituation
  • Neuromodulation

Masking

A tinnitus masker works by covering up your tinnitus either completely or partially, by listening to sounds that are at the same frequency of your tinnitus. The frequency and volume of your tinnitus will normally need to be measured first. This can be done in many smartphone apps, including Oto.


Distraction

Distraction is where an external noise is used to help you focus on something else other than the sound of your tinnitus. This noise could be anything from the sound of a fan at night, to music listened to through headphones, or a specific sound that you find pleasant to listen to on a smartphone app.

Habituation

Habituation is the process of your brain no longer regarding the sound of your tinnitus is a threat, so you no longer notice it. If you do notice it, it is not unpleasant as it was before.

Neuromodulation

This is perhaps the most experimental use of sound therapy for tinnitus. Neuromodulation minimises the neural hyperactivity believed to be linked to the underlying cause of tinnitus with the use of specially created sounds. 

Does Sound Therapy Work For Tinnitus?

A 2018 systematic review found that based on preliminary studies, there was insufficient evidence to demonstrate for certain that it is effective at reducing tinnitus severity.

However, it was noted that the quality of the evidence was low, and further research has been recommended to better understand the effectiveness.

Many people do find sound therapy a good way to relieve tinnitus, either alone or in combination with other therapies.

A systematic review of the research into tinnitus sound therapy was inconclusive
A systematic review of the research into tinnitus sound therapy was inconclusive

How To Use Sound Therapy in Tinnitus

Sound therapy can be used as a part of a larger tinnitus therapy regime (with a hearing aid for example), or simply as a self-help technique.

Either way, it can be a useful tool to help habituate yourself to your tinnitus.

Sound therapy has been found to be most effective when it is used at a slightly quieter frequency to your tinnitus level. While drowning out your tinnitus with loud sounds might provide temporary relief, it does not aid in long-term habituation.

Some people have found sound therapy acts as a great distraction tool but others have actually noticed it actually brings about genuine changes in their sensitivity to hearing their tinnitus, helping them to reach habituation.

We would suggest finding out what works best for you, and experimenting with different available techniques in combination with other tinnitus treatments.

Your audiologist should also be able to help with this.


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How Can I Access Sound Therapy?

You can access a number of different sound therapy programmes very easily through:

  • Smartphone apps - such as Oto
  • Hearing Aids (or wearable sound generators)
  • Music
  • YouTube
  • Environmental sounds - such as a fan or opening the bedroom window to hear passing traffic

The type of sound therapy preferred differs between people and their circumstances. We recommend that sound therapy works the best when it does not demand too much attention from you and it is additionally enjoyable to listen to.

Smartphone Apps 

There are many apps available for tinnitus, offering a wide variety of help and support.

Many have sound libraries for sound therapy, with others also offering CBT or other therapies.

It can be daunting to navigate and choose from the large number of apps available, so we created this helpful guide of the best tinnitus apps.

One of our top picks is Audiocardio - have a read for some more recommendations.

A variety of smartphone apps offer sound therapy for tinnitus
A variety of smartphone apps offer sound therapy for tinnitus


Hearing Aids / Wearable Sound Generators

Hearing aids can be used to good effect in tinnitus. They are usually worn in the inner ear or behind the ears. They can be paired with a companion smartphone app to deliver a constant noise into the ears to mask from your tinnitus.

It is worth mentioning that hearing aids are only usually effective if you already have hearing loss. If this form of sound therapy is prescribed as a part of tinnitus therapy, it needs to be professionally fitted by a specialist. We would recommend asking your audiologist about whether a hearing aid would be suitable for your tinnitus.

If you don't have hearing loss, a wearable sound generator may be more appropriate. These are fitted in the same way as a hearing aid.

Music 

There are many music libraries available via subscription, such as Spotify. This has a wide range of white noise sounds that you can use for personal sound therapy. Spotify is available for free on the App Store (with ads) or with an ad-free premium subscription. 

You can also listen to music through a number of other streaming services.


Environmental sounds can be used for sound therapy in tinnitus
Environmental sounds can be very useful in relieving your tinnitus

YouTube

There are thousands of tinnitus sound therapy YouTube videos.

You'll find everything from artificially created noises to beautifully crafted soundscapes.

These do vary hugely in both style and quality and it's a case of experimenting to find out what works for you.

Environmental Sounds 

A simple but effective way to get these sounds is by opening the window at night.

If you live on a main road, and distant traffic is a little too distracting to sleep with or the cold winter just does not allow this, smartphone apps with sound libraries or Spotify can provide you with many pleasant nature sounds. 

Something as simple as a fan can also provide relief.

Join Oto

The Oto app offers a variety of audio landscapes and more all in the palm of your hand. Reduce tinnitus intrusion using various resources the app offers:

  • A library of various sound categories such as urban, binaural, ASMR, 3D, sleep, nature, household, and coloured
  • CBT techniques
  • Sleep support including sleep stories, mindfulness for sleep, and sleep preparation
  • Meditation and breathing practice
  • Exercises for relaxation and physical wellbeing

Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!

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