Reducing your attention to the tinnitus

Most people find that they are more aware of their tinnitus when they are in a quiet place. For instance, the tinnitus can be particularly noticeable at night, when external sounds drop away, and can seem very intrusive when you wake in the quiet of the night. The contrast between the tinnitus and silence draws your attention to the tinnitus because it is the dominant ‘sound’ present. This is similar to the way in which our eyes are drawn to a candle burning in a dark room whereas we might not notice a candle flame in a well-lit room.

To reduce attention to the tinnitus sounds, it is recommended that people with tinnitus avoid silence. The aim is to reduce the contrast between the ambient environment and the tinnitus sounds. This can mean having the radio, TV or low music playing, or using sources of low level, neutral sound, e.g. fan noise, running water. The purpose is not to mask the tinnitus sounds but just to reduce the contrast between the quiet background and the tinnitus.

Some people find that they can successfully ‘mask’ the tinnitus with other noise, that is, cover up the tinnitus sounds so that they cannot hear them, similar to the way flowery or other scents can be used to cover up bad odors. Music or the TV might achieve this, or other continuous sounds such as the air conditioner. Using external noise to try and mask the tinnitus sound is not always effective, however, as some people may require quite high sound levels to achieve effective masking. Also, masking the tinnitus can delay habituation (tuning it out) because the attention system cannot learn to ignore a sound it cannot perceive.

Introducing low-level, neutral sound is preferable to masking and can help in several ways:

Having low level sounds around you can lessen the contrast between your tinnitus sound and the ambient sound environment. If it’s silent, the tinnitus sounds will dominate. If there’s some other sound present, the tinnitus may be less apparent.
The auditory system is used to having a job to do – it expects to be actively processing sounds. If the auditory system does not receive input, it can sometimes create ‘junk sounds’ for itself (the tinnitus perceptions). If it has ‘real sound’ to process, however, this can divert it from the junk sounds.
The attention system learns to habituate to (tune out) constant sounds, so low levels of ambient sound which do not demand attention can hasten this process.
External sounds also draw your attention outside the body so that attention to your internal sound perceptions is diminished. Many people with tinnitus AND hearing loss find that they are less aware of the tinnitus perceptions while they are wearing their hearing aids, because the aids increase the loudness of ambient sounds.
Sound sources
Domestic equipment – such as ceiling fans and heater or air conditioner fans – can provide suitable low level sound
Recordings of natural sounds – such as a waterfall, rain or crashing surf – offer a pleasant, neutral backdrop to your day-to-day activities, without intruding too much
Try the real thing – a table-top fountain next to the bed makes a low splashing or trickling sound, or install a fountain or wind chime outside your bedroom window
Low level music – particularly light classics, ambient electronic music or Gregorian chant – can be very calming
Tune your radio to the FM band, between stations, to hear the ‘hash’ sound. This is a ‘white noise’ which some people find very soothing and a gentle distraction from the tinnitus
Special recordings of neutral sound (e.g. white noise) which have been modified to match or mask common tinnitus sounds such as hissing
Noise generating programs and applications can be downloaded from the internet. You can then choose suitable sounds to mix with or mask your tinnitus and play them through your tablet, smartphone, computer or MP3 player.
Modern hearing aids often have specific sound generating or tinnitus programs. If you wear hearing aids, ask your audiologist if your devices have this feature to trial.
Neuromonics is an individual sound device that delivers music and neutral sound through small earphones.
Tinnitus therapies which use sound
Tinnitus Retraining Therapy (TRT)
TRT uses a combination of wearable noise generators or hearing instruments, counselling, attention control techniques and relaxation to encourage habituation to tinnitus.
Neuromonics Acoustic Desensitisation Protocol
Uses a wearable sound device, programmed to your own hearing levels, to deliver neutral sound and music to each ear. This is combined with counselling.
Sound Therapy International
Sound Therapy is a portable self-help program that uses specially recorded analogue audio- tapes of highly filtered classical music to “rehabilitate the ear and recharge the brain”. Sound Therapy presents constantly alternating sounds of high and low tone which may be helpful in distracting the listener from their tinnitus.