Instruments to assist in Tinnitus Management
An important principle behind tinnitus management is to avoid silence, that is, to direct your attention towards sounds other than your tinnitus. To achieve this purpose a range of devices or instruments may be considered for people with tinnitus.
There are five main categories:
More than half the people with tinnitus also have impaired hearing, which affects their reception of environmental sounds and of conversation. Having a hearing loss may cause you to focus more upon your tinnitus because external sounds are less easily heard. Ahearing aid will enhance natural sound input, distracting you from your tinnitus and reducing your awareness of it. It gives your ‘hearing brain’ a real job to do so that it is less likely to generate the ‘junk’ signals perceived as sound.
Additionally, many hearing aids today have specific tinnitus programs which generate noise, music or tones which can distract from the tinnitus when it becomes bothersome to you. An audiologist can recommend a hearing instrument based upon the degree and type of your hearing loss, your communication needs in the different listening situations you encounter, and your budget.
Wearable sound generators
Reduction in awareness of tinnitus, and lessening of annoyance, can be significantly sped up by the use of a wearable sound generator (in the context of a counselling program). This instrument generates quiet sound which is set at a level where you can still just hear your tinnitus. This helps to reduce your awareness of the tinnitus noise over time. Wearable low level noise generators are small in-the-ear or behind-the-ear instruments which resemble hearing instruments.
These are implantable hearing devices which are suitable for some people who are severely or profoundly deaf. Some people who receive a cochlear implant to assist their hearing also find that it makes them much less aware of their tinnitus.
The Neuromonics program uses a programmed device which presents music and neutral sound through small high-fidelity earphones. For more information see www.neuromonics.com
Other sound sources
This includes anything which introduces a neutral low level sound into the environment. Ideally, the sound should not be meaningful, so your favorite music may not be the best choice, however you should find a noise pleasant and relaxing to you. Today, there are a plethora of apps available, often free, which have a large selection of noise sources you may find useful to provide some distraction and reduce the awareness of your tinnitus. Other sound sources you could consider include a small table-top fountain, a wind chime outside the bedroom window, or recordings of natural sounds.
A digital sound source with a timer can useful for avoiding silence when you are trying to drop off to sleep at night. These devices come in many different shapes and sizes; even some that are safe to slip under your pillow.
Smartphone and digital application sound sources
A search of ‘sound generators’ or ‘relaxing sounds’ in an App Store will provide a number of applications for sound stimulation. The application ‘Easy Relax’, either the full or ‘lite’ version for example contains a number of environmental sounds which can be used as an external sound source. This application also has a timer function so you can setthe timer when you go to bed to assist you in dropping off to sleep. A number of other applications are also available to download at various prices.
Sources for instruments to assist people with tinnitus
Hearing aids and sound generators should only be selected and fitted by qualified audiologists or audiometrists. A directory of qualified audiologists is available via the Audiology Australia website www.audiology.asn.au. Some in audiologists in Adelaide will also provide the Neuromonics Protocol (see www.neuromonics.com).
Cochlear implants are only available through specialist cochlear implant clinics. In South Australia, contact the South Australian Cochlear Implant Centre or the Flinders Medical Centre ear, nose and throat outpatient clinic.
Table-top fountains and wind chimes can be purchased from garden shops, gift stores and larger department stores. Recordings of natural sounds are sold by music retailers and some specialist bookstores. Digital table-top sound generators are available from many hearing service providers. Consider: option of a timer, type(s) of sounds, ease of adjustment, e.g. volume controls. You can also order table-top sound generators and sound recordings on the Internet.
Subsidies for hearing aids and tinnitus devices
If you have a pension or DVA gold card you may be eligible for subsidised hearing aids. Contact the Office of Hearing Services on 1800 500 726 or www.hearingservices.gov.au to check your eligibility and find a provider near you.
If you are not a pensioner but do hold a Commonwealth Government Health Care Card (or can otherwise demonstrate financial hardship) you may be eligible for up to $500 financial assistance towards the purchase of a hearing instrument or tinnitus device through the Royal Adelaide Hospital (RAH) Da Costa Fund.
Please call the RAH Audiology Department on (08) 8222 4288 for more information.