Therabeep

Tinnitus is the sensation of ringing, buzzing, or hissing in the ears. This noise can take up different forms, being higher or lower pitched, softer or louder, and having a wider or narrower spectrum. Tinnitus is a relatively common phenomenon, which roughly affects 10% of the population and is more prevalent among older adults. Although in many cases Tinnitus is temporary and not very bothersome, it may become a serious issue which requires attention.

Tinnitus is divided into two types, subjective and objective. Subjective tinnitus is by far the most common type and involves hearing noises without the existence of any stimulus. This type of tinnitus can only be perceived by the patient and is hard to link to a specific cause.

The other type, objective tinnitus, usually involves the noise of the flow of blood vessels near the ear; this noise can be measured by using a stethoscope in the patient's ear, that’s why it is called “objective”. However, objective tinnitus is quite rare, and often a side effect of another disease such as high blood pressure.

What causes tinnitus?

Tinnitus is often attributed to different underlying conditions such as hearing loss, anxiety, depression, infections, or certain medications, however, it is often hard to link tinnitus to a specific cause. Subjective tinnitus is often the product of alterations in the part of the brain that processes auditory information, the auditory cortex. These alterations can be the product of different things that affect the auditory system such as ear infections, earwax buildup, hearing loss, or acoustic trauma. Caffeine, tobacco and alcohol increase the risk of developing tinnitus and can worsen its effects.

How can I prevent tinnitus?

Since hearing loss is a common cause of tinnitus, one of the first approaches to preventing it and keeping it from getting worse would be to limit your exposure to loud noise. Turning down the volume of your headphones, using hearing protection in loud places, or avoiding your exposure to loud noise sources like construction equipment, or other machinery.

What can I do if my tinnitus does not go away?

Healthcare providers will first try to treat the underlying conditions that cause tinnitus. When this is not possible, there are still several ways to manage its impact. These strategies usually aim at making the tinnitus less bothersome since, in many patients, it may never fully go away. At this point, it is important to remark that no single approach works for everyone and patients will often try different therapies in order to find someone that helps, or will even try different combinations of individual therapies.

The most effective therapies can be grouped into 3 families which are sound therapy, counseling, and drug therapy. Overall, sound therapy alone usually performs better than counseling or medication when applied individually, however, the combination of sound therapy and counseling, or sound therapy and drug therapy tends to yield better results.

Sound therapy

Sound therapy is a way of alleviating the intensity of tinnitus by using external sounds that retrain your auditory pathway. It is one of the best known therapies for tinnitus relief with hundreds of research papers on different sound protocols. This therapy can be administered using specialized devices, such as hearing aids that include sound generators, or using mobile apps such as Therabeep.

Sound therapy can be divided into two subgroups: customized and non customized sound therapy. On the one hand, customized sound therapy uses sound protocols based on the characteristics of the perceived noise. These customized sounds aim at reorganizing the auditory cortex so that the patient stops perceiving the noise, either by playing sounds similar to the perceived noise, or sounds that complement it. On the other hand, non customized sound therapy includes white noise, environmental sounds, or even music, with the aim to reduce the adverse emotional reactions to the tinnitus.

Some of the most well known sound therapies include coordinated reset neuromodulation therapy, notched music training, or auditory discrimination training.

Counseling

Counseling is another option which aim is to help patients change the way they feel and think about tinnitus. This kind of therapy is based on the asumption that what really makes tinnitus bothersome is not the ringing noise itself, but the psychological feedback loop of emotions that patients have in relation to tinnitus. The most basic form is educational counseling, where the goal is to educate patients about the auditory system and tinnitus. This form of counseling tries to reduce the fears and anxiety related to tinnitus which, in turn, will help the patient cope with it.

Another form of counseling is cognitive behavioral therapy or CBT. The main goal of CBT is to address the negative emotions associated with tinnitus. This kind of therapy is often performed by a mental health professional and will help with related psychological issues like anxiety which are often linked with tinnitus.

Also, behavioral therapies like CBT may be combined with sound therapy, like in tinnitus retraining therapy or TRT. TRT aims to both educate the patient, reducing the negative feedback that tinnitus causes, and to use sound therapy to make tinnitus less noticeable.

Drug therapy