How to get started with tinnitus sound therapy

Tinnitus—often referred to as "ringing in the ears"—is incredibly common. According to the American Tinnitus Association, close to 20 million Americans have chronic tinnitus, with two million experiencing extreme and debilitating cases. Frustratingly, there is no known cure, and often it will take more than one treatment option to get suitable relief. One of the most well-established methods is known as tinnitus sound therapy.

How does tinnitus sound therapy work?

Tinnitus sound therapy uses a process known as habituation to retrain the way the brain interprets tinnitus. Essentially, the brain learns to reclassify the unwanted sound as something neutral or unimportant.

“You can hear a sound that sounds just like your tinnitus—like crickets—but when you go camping in the wilderness and hear the crickets, it has a different meaning,” Christina Lobarinas, Au.D., tinnitus coordinator for the UT Southwestern Tinnitus and Hyperacusis Program, explained. “When the sound is constant and your brain is confused as to where it’s coming from, that’s when the tinnitus sound becomes bothersome.”

Sound therapy helps a person "forget" about the sound. That might sound tricky, but your brain already does it all the time. 

“It’s very similar to when you put on your glasses and your nose [nerve endings] start sending signals to the brain that there’s something on your nose,” Dr. Lobarinas said. “After awhile, you tend not to think about the feeling.”

There are different methods and types of sounds that can help, and an audiologist trained in tinnitus therapy can explore several options. One common way to initially try sound therapy is by selecting a relaxing, neutral sound—like ocean waves crashing, rain falling, white noise or instrumental music—and playing it as background noise throughout the day. (Color noises like white noise and pink noise are not recommended.)

“After a time, the tinnitus becomes associated with this sound,” she said. “The brain says ‘it’s constant, it’s meaningless, it’s not something I need to pay attention to.’ It’s essentially a passive form of extinguishing a response to a stimulus by moving it from a conscious to a subconscious level.”

How do I start tinnitus sound therapy?

To get started, Dr. Lobarinas recommends downloading a free tinnitus app. “The key is to not set volume levels so high that it drowns out the tinnitus sound. You really don’t want to mask it. The goal is to retrain the brain so you need to hear the tinnitus along with the sound that you’re playing in order to help the brain make that connection,” she said.

Consistency and frequency are two other keys for success. Dr. Lobarinas recommends playing the sound for at least four hours a day, as well as while you’re sleeping.

More: Tinnitus habituation: How to tune out the ringing in your ears

Hearing aids and other tools for sound therapy

Sound therapy itself isn’t expensive; however, your audiologist also may recommend hearing aids. Hearing aids amplify external environmental noise, giving your nervous system more sound to process. Bringing in more auditory stimulus to the brain can help reduce the perception of tinnitus. Also, many hearing aids come with technology known as tinnitus masking built right in, which an audiologist or hearing instrument specialist can program for you. 

Keep in mind that tinnitus is often an early warning sign that a person has hearing loss. Treating the hearing loss promptly can help minimize tinnitus.

Who can benefit from sound therapy?

Almost anyone who is bothered by their tinnitus is a good candidate for sound therapy. This includes people with reactive tinnitus, which is ear ringing triggered by noise.

“If there is a medical condition contributing to the tinnitus and we can fix it, the tinnitus will go away," Dr. Lobarinas said. “If there is no medical condition, anyone who reports their tinnitus to be bothersome would be a good candidate for sound therapy.”

Besides hearing loss, tinnitus can be caused by a host of auditory and medical problems, including Meniere's disease, obstructions in the middle ear, head and neck trauma, temporomandibular joint disorder (TMJ), clogged ears, sinus pressure and barometric trauma, autoimmune disorders, among many other causes. 

Find a tinnitus specialist

If you think you would benefit from tinnitus sound therapy, make an appointment with your primary physician or ENT. Once they have ruled out any contributing medical conditions, consult an audiologist who specializes in tinnitus retraining therapy near you. Please note that not all hearing clinics treat tinnitus, so you may need to browse several clinic pages to find the right provider.

And be committed for the long haul. Sound therapy is a progressive treatment program that is most effective when it’s paired with educational counseling. It may take as long as two to three months to notice any changes and as much as a year before the tinnitus is no longer noticeable.

Behavioral help for tinnitus

In addition to sound therapy, many people find cognitive-behavioral therapy useful for managing the emotional impact of tinnitus. In fact, a review published in the Journal of the American Academy of Audiology found that “CBT treatment for tinnitus management is the most evidence-based treatment option so far.” 

'Celebrate small victories'

“Markers to shoot for are a reduced emotional response to the tinnitus or change in pitch or volume,” Dr. Lobarinas advised. “Celebrate small victories. Any little progress is good progress.”