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Managing Your Tinnitus: What to Do and How to Do itManaging Your Tinnitus: What to Do and How to Do it
Tinnitus EducationTinnitus Education
Tinnitus Education: OutlineTinnitus Education: Outline
What is tinnitus?What is tinnitus?
TIN-i-tus is a ringing, humming, buzzing, or other chronic noise that is perceived that does not have an outside source. This sound can occur from one or both ears, or within the head.
In the U.S., 50 million people have experienced tinnitus at some point and 10 million people visit physicians for this problem
TIN-i-tus is a ringing, humming, buzzing, or other chronic noise that is perceived that does not have an outside source. This sound can occur from one or both ears, or within the head.
In the U.S., 50 million people have experienced tinnitus at some point and 10 million people visit physicians for this problem
How we hear vs. tinnitusHow we hear vs. tinnitus
Sound waves in the air become transformed into signals that the brain recognizes as sound. With tinnitus there are NO sound wave vibrations that cause nerve fibers to activate. In most forms of tinnitus, it is thought that nerves fire on their own. The brain perceive these signals as sound
Sound waves in the air become transformed into signals that the brain recognizes as sound. With tinnitus there are NO sound wave vibrations that cause nerve fibers to activate. In most forms of tinnitus, it is thought that nerves fire on their own. The brain perceive these signals as sound
Figure 1
What Causes Tinnitus What Causes Tinnitus
When we get hearing loss, we lose some cells in the inner ear that sense sound. The brain cells that do the function of hearing, however, do not die. This causes an increase in activity in the brain cells that do the function of hearing.
Tinnitus is caused by a combination of this increase in activity and usually one of the following factors: Stress Anxiety Fatigue Poor sleep Depression
When we get hearing loss, we lose some cells in the inner ear that sense sound. The brain cells that do the function of hearing, however, do not die. This causes an increase in activity in the brain cells that do the function of hearing.
Tinnitus is caused by a combination of this increase in activity and usually one of the following factors: Stress Anxiety Fatigue Poor sleep Depression
What Causes Tinnitus What Causes Tinnitus
Factors such as stress, anxiety, depression, poor sleep, etc. cause some changes in the brain that makes the brain more aware of the tinnitus
Since tinnitus is affected by emotional factors (e.g., stress, anxiety, depression, etc), management of tinnitus requires managing any of these co-existing issues
This includes, sleep management, stress management, etc.
Factors such as stress, anxiety, depression, poor sleep, etc. cause some changes in the brain that makes the brain more aware of the tinnitus
Since tinnitus is affected by emotional factors (e.g., stress, anxiety, depression, etc), management of tinnitus requires managing any of these co-existing issues
This includes, sleep management, stress management, etc.
Sounds of TinnitusSounds of Tinnitus
Patients with tinnitus often report sounds of: Ringing High pitched tone Hissing High tension wire Buzzing Sizzling Crickets
Patients with tinnitus often report sounds of: Ringing High pitched tone Hissing High tension wire Buzzing Sizzling Crickets
You can hear more than 1
sound
How can tinnitus affect you?How can tinnitus affect you?
Tinnitus can affect a person’s life in a variety of ways Some of the main effects are: Concentration difficulties Emotional reactions Disrupted sleep
The onset of tinnitus can be life-altering
Tinnitus can affect a person’s life in a variety of ways Some of the main effects are: Concentration difficulties Emotional reactions Disrupted sleep
The onset of tinnitus can be life-altering
Tinnitus can affect concentrationTinnitus can affect concentration
The sound of tinnitus can disrupt work and tasks that require your attention
The chronic sound of tinnitus is unpleasant and cannot be eliminated Some people differ in their ability to ignore sounds.
For some, it is easy to ignore, but for others it can be challenging
Tinnitus does not make it difficult to hear, but it can disturb with focused listening
The sound of tinnitus can disrupt work and tasks that require your attention
The chronic sound of tinnitus is unpleasant and cannot be eliminated Some people differ in their ability to ignore sounds.
For some, it is easy to ignore, but for others it can be challenging
Tinnitus does not make it difficult to hear, but it can disturb with focused listening
Tinnitus can cause emotional reactionsTinnitus can cause emotional reactions
Tinnitus is a chronic noise and can become irritating Emotional reactions to tinnitus have been reported to
cause: Depression Anxiety Anger Frustration Worry
People with previously existing anxiety and depression are more prone to chronic tinnitus
The goal of tinnitus management is to manage these reactions to tinnitus.
Tinnitus is a chronic noise and can become irritating Emotional reactions to tinnitus have been reported to
cause: Depression Anxiety Anger Frustration Worry
People with previously existing anxiety and depression are more prone to chronic tinnitus
The goal of tinnitus management is to manage these reactions to tinnitus.
Tinnitus can disrupt sleepTinnitus can disrupt sleep
Many tinnitus patients have reported sleep problems Tinnitus can make it hard to fall asleep and returning
to sleep after waking up in the middle of the night The worse your sleep is, the worse your tinnitus will
be the next day Tinnitus can cause you to become sleep deprived
and make it harder to normally function during the day
Many tinnitus patients have reported sleep problems Tinnitus can make it hard to fall asleep and returning
to sleep after waking up in the middle of the night The worse your sleep is, the worse your tinnitus will
be the next day Tinnitus can cause you to become sleep deprived
and make it harder to normally function during the day
Why does tinnitus become a problem?Why does tinnitus become a problem?
1. Many people with tinnitus report that “it came out of nowhere.” Tinnitus is a different sound and it can be annoying by focusing on it.
2. It can be perceived as a threat and keep our attention. It can create fear that it is a serious medical condition or a psychological disorder. There are often reports of “going crazy” or “having a tumor”.
3. There are different reactions to tinnitus. The sound of tinnitus may disturb one person, but not another.
4. Tinnitus can be annoying because the sound is persistent. There is a loss of “peace and quiet”.
1. Many people with tinnitus report that “it came out of nowhere.” Tinnitus is a different sound and it can be annoying by focusing on it.
2. It can be perceived as a threat and keep our attention. It can create fear that it is a serious medical condition or a psychological disorder. There are often reports of “going crazy” or “having a tumor”.
3. There are different reactions to tinnitus. The sound of tinnitus may disturb one person, but not another.
4. Tinnitus can be annoying because the sound is persistent. There is a loss of “peace and quiet”.
Why does tinnitus become a problem?Why does tinnitus become a problem?
5. Tinnitus can trigger negative memories if the onset of tinnitus was associated with a traumatic event. Traumatic events can include stressful experiences, severe sleep disturbance, combat, head injury, or explosion. 6. Tinnitus is an unwelcomed sound and can be more irritating if it is louder. Those with a higher sensitivity of tinnitus appear to be most bothered by it7. The more attention given to tinnitus, the more it becomes problem. It may affect you lifestyle.8. Tinnitus can cause a lack of control. People with tinnitus feel like it is uncontrollable or escape it.
5. Tinnitus can trigger negative memories if the onset of tinnitus was associated with a traumatic event. Traumatic events can include stressful experiences, severe sleep disturbance, combat, head injury, or explosion. 6. Tinnitus is an unwelcomed sound and can be more irritating if it is louder. Those with a higher sensitivity of tinnitus appear to be most bothered by it7. The more attention given to tinnitus, the more it becomes problem. It may affect you lifestyle.8. Tinnitus can cause a lack of control. People with tinnitus feel like it is uncontrollable or escape it.
Is there a cure?Is there a cure?
Curing tinnitus means that the sound that you hear would be eliminated. Unfortunately, there is no cure for tinnitus yet.
There are available treatments to manage living with tinnitus. These treatments can: Reduce its loudness Reduce the person’s reactions to the tinnitus
Curing tinnitus means that the sound that you hear would be eliminated. Unfortunately, there is no cure for tinnitus yet.
There are available treatments to manage living with tinnitus. These treatments can: Reduce its loudness Reduce the person’s reactions to the tinnitus
There are many ways to try treat tinnitus, but there is no proven cure
Some ways to reduce its loudness are: Prescription drugs Use of sound
Hearing aids Masking
Generic Masking Table-top noise generator Music
Customized Masking Sound therapy customized to the hearing and
tinnitus profile
There are many ways to try treat tinnitus, but there is no proven cure
Some ways to reduce its loudness are: Prescription drugs Use of sound
Hearing aids Masking
Generic Masking Table-top noise generator Music
Customized Masking Sound therapy customized to the hearing and
tinnitus profile
Reduce Its LoudnessReduce Its Loudness
Prescription DrugsPrescription Drugs
There have been many drugs used to treat tinnitus, but most are based on a trial-and-error process.
The drugs used are designed to manage other tinnitus-related problems such as Depression Anxiety Mood disorders Lack of sleep
With this method for treatment, it must be approached with great care due to potential side effects.
There have been many drugs used to treat tinnitus, but most are based on a trial-and-error process.
The drugs used are designed to manage other tinnitus-related problems such as Depression Anxiety Mood disorders Lack of sleep
With this method for treatment, it must be approached with great care due to potential side effects.
Use of SoundUse of Sound
Hearing aids Hearing aids can assist in tinnitus management since
they allow more sound to reach the brain to reduce the perception of tinnitus, they increase background noise, this allows you to hear soothing and interesting sounds, also they can make difficult listening situations less stressful.
Tinnitus Masking This treatment method can give the perception that
tinnitus is eliminated or reduced in loudness. This method can give the patient a sense of relief from tinnitus.
Hearing aids Hearing aids can assist in tinnitus management since
they allow more sound to reach the brain to reduce the perception of tinnitus, they increase background noise, this allows you to hear soothing and interesting sounds, also they can make difficult listening situations less stressful.
Tinnitus Masking This treatment method can give the perception that
tinnitus is eliminated or reduced in loudness. This method can give the patient a sense of relief from tinnitus.
Reduce Reactions to Tinnitus Reduce Reactions to Tinnitus
Reducing the reactions to tinnitus is a way of management. This approach of treatment can help you better cope living with tinnitus. This includes: Psychological approaches
Cognitive-Behavioral Therapy (CBT) Mindfulness Based Therapy
Reducing the reactions to tinnitus is a way of management. This approach of treatment can help you better cope living with tinnitus. This includes: Psychological approaches
Cognitive-Behavioral Therapy (CBT) Mindfulness Based Therapy
Cognitive-Behavioral Therapy (CBT)Cognitive-Behavioral Therapy (CBT)
CBT combines helping patients change how they think about their tinnitus to help them feel better with everyday activity changes
CBT was initially used to treat depression, anxiety, and chronic pain.
It is now used to psychologically manage tinnitus by reducing negative reactions to tinnitus.
CBT combines helping patients change how they think about their tinnitus to help them feel better with everyday activity changes
CBT was initially used to treat depression, anxiety, and chronic pain.
It is now used to psychologically manage tinnitus by reducing negative reactions to tinnitus.
Mindfulness Based TherapyMindfulness Based Therapy
Mindfulness based therapy is used to acknowledge thoughts of tinnitus in a nonjudgmental way and living in the moment.
It is used to accept tinnitus by becoming aware of it.
Mindfulness based therapy is used to acknowledge thoughts of tinnitus in a nonjudgmental way and living in the moment.
It is used to accept tinnitus by becoming aware of it.
Can Tinnitus be Cured?Can Tinnitus be Cured?
“Cure” = eliminate or reduce the tinnitus No cure yet – research underway It can’t be cured, but you can learn to manage your
reactions to it
“Cure” = eliminate or reduce the tinnitus No cure yet – research underway It can’t be cured, but you can learn to manage your
reactions to it
Tinnitus ManagementTinnitus Management
There are 2 components to tinnitus
1. The sound that you hear
2. The reaction you have to the sound
To help Manage your tinnitus, you need to address both components
1. Using sound to help reduce the perception of the sound
2. Manage your reaction to the sound that you hear
There are 2 components to tinnitus
1. The sound that you hear
2. The reaction you have to the sound
To help Manage your tinnitus, you need to address both components
1. Using sound to help reduce the perception of the sound
2. Manage your reaction to the sound that you hear
Goals of Tinnitus Management (All Methods)Goals of Tinnitus Management (All Methods) Emotional reactions are reduced Stress is reduced Little if any attention is given to tinnitus Tinnitus does not affect any life activities in a major
way Further help is not needed or wanted These goals can be reached even if the sound of
your tinnitus doesn’t change!
Emotional reactions are reduced Stress is reduced Little if any attention is given to tinnitus Tinnitus does not affect any life activities in a major
way Further help is not needed or wanted These goals can be reached even if the sound of
your tinnitus doesn’t change!
Sound TherapySound Therapy
What is it? Sound that helps reduce the perception of tinnitus
How can it help? By giving you a sense of relief from tension and
stress caused by tinnitus When can it help?
Any time your tinnitus bothers you
What is it? Sound that helps reduce the perception of tinnitus
How can it help? By giving you a sense of relief from tension and
stress caused by tinnitus When can it help?
Any time your tinnitus bothers you
Sound Therapy Things to RememberSound Therapy Things to Remember Sound therapy is more soothing to some people, and
less soothing to others The goal of customized sound therapy is to direct
more sound to areas of the brain that are thought to be responsible for the perception of tinnitus
Music therapy is the combination of sound therapy and relaxing music
This allows you to listen to music while the sound therapy is playing in the background
Sound therapy is more soothing to some people, and less soothing to others
The goal of customized sound therapy is to direct more sound to areas of the brain that are thought to be responsible for the perception of tinnitus
Music therapy is the combination of sound therapy and relaxing music
This allows you to listen to music while the sound therapy is playing in the background
MarthaMartha
When Martha reads at home, she listens to music therapy
The sense of relief she feels from the music makes it easier for her to concentrate
This an example of using music therapy
When Martha reads at home, she listens to music therapy
The sense of relief she feels from the music makes it easier for her to concentrate
This an example of using music therapy
Background SoundBackground Sound
What is it? Any sound that is neutral (not soothing and not
interesting) For example like the sound of the air conditioner,
dishwasher or talking of others in a restaurant How can it help?
Reduces contrast to make it easier to ignore your tinnitus (we’ll explain!)
When can it help? Any time
What is it? Any sound that is neutral (not soothing and not
interesting) For example like the sound of the air conditioner,
dishwasher or talking of others in a restaurant How can it help?
Reduces contrast to make it easier to ignore your tinnitus (we’ll explain!)
When can it help? Any time
Imagine a Lit Candle in a Dark RoomImagine a Lit Candle in a Dark Room
The candle is the only light in The candle is the only light in the roomthe room
There is sharp contrast There is sharp contrast between the bright candle between the bright candle and the dark roomand the dark room
The candle naturally attracts The candle naturally attracts a lot of attentiona lot of attention
Turn on the Lights!Turn on the Lights!
This is the same lit candle, but with the lights on
The contrast between the candle and the room has been reduced
The candle is just as bright as before, but attracts less attention because now there is other light in the room along with the candle
This is the same lit candle, but with the lights on
The contrast between the candle and the room has been reduced
The candle is just as bright as before, but attracts less attention because now there is other light in the room along with the candle
Same Candle – Different BackgroundsSame Candle – Different Backgrounds
This same idea works for tinnitus…
Imagine “Tinnitus” in a Quiet RoomImagine “Tinnitus” in a Quiet Room
The tinnitus is the only The tinnitus is the only “sound”“sound”
There is sharp contrast There is sharp contrast between the tinnitus and between the tinnitus and the quiet roomthe quiet room
The tinnitus naturally The tinnitus naturally attracts a lot of attentionattracts a lot of attention
Turn on the Sound!Turn on the Sound!
Same tinnitus, but in a background of sound
The contrast between the tinnitus and the quiet room has been reduced
The tinnitus is just as loud as before, but attracts less attention because of the background sound
Same tinnitus, but in a background of sound
The contrast between the tinnitus and the quiet room has been reduced
The tinnitus is just as loud as before, but attracts less attention because of the background sound
Same Tinnitus – Different BackgroundsSame Tinnitus – Different Backgrounds
Spend a few moments listening to your tinnitus in quiet
Then, with the background sound turned on, notice the reduced contrast
Reducing contrast makes it easier to ignore your tinnitus
Spend a few moments listening to your tinnitus in quiet
Then, with the background sound turned on, notice the reduced contrast
Reducing contrast makes it easier to ignore your tinnitus
Tinnitus Contrast ActivityTinnitus Contrast ActivityLet’s try it!
click icon to play soundclick icon to play sound
Background Sound:Things to RememberBackground Sound:Things to Remember Tinnitus is less likely to get your attention when you
add background sound You might not notice background sound helping you
right away—that doesn’t mean it’s not helping you Using constant background sound over weeks or
months can help you get better at ignoring tinnitus Never use sound that is irritating or annoying to you
to manage your reactions to tinnitus
Tinnitus is less likely to get your attention when you add background sound
You might not notice background sound helping you right away—that doesn’t mean it’s not helping you
Using constant background sound over weeks or months can help you get better at ignoring tinnitus
Never use sound that is irritating or annoying to you to manage your reactions to tinnitus
JanetJanet
Janet keeps a tabletop fountain running on her desk The background sound from the fountain makes it easier
for her to ignore her tinnitus This is an example of using background sound
Janet keeps a tabletop fountain running on her desk The background sound from the fountain makes it easier
for her to ignore her tinnitus This is an example of using background sound
Interesting SoundInteresting Sound
What is it? Sound that keeps your attention Sound that involves active listening Some examples include talk radio, audio books,
interesting music, dynamic speeches How can it help?
Shifts your attention away from your tinnitus When can it help?
When you do not need to concentrate on something else
When you want to relax or sleep
What is it? Sound that keeps your attention Sound that involves active listening Some examples include talk radio, audio books,
interesting music, dynamic speeches How can it help?
Shifts your attention away from your tinnitus When can it help?
When you do not need to concentrate on something else
When you want to relax or sleep
Interesting Sound: Things to RememberInteresting Sound: Things to Remember We’re all different!
Some sounds (e.g., talk radio) are more interesting to some people, and less interesting to others
Your job is to find sounds that are interesting to you It might take time and patience to find the sounds that
are most interesting and helpful for you Never use sound that is irritating or annoying to you
to manage your reactions to tinnitus
We’re all different! Some sounds (e.g., talk radio) are more
interesting to some people, and less interesting to others
Your job is to find sounds that are interesting to you It might take time and patience to find the sounds that
are most interesting and helpful for you Never use sound that is irritating or annoying to you
to manage your reactions to tinnitus
PatrickPatrick
Patrick talks to his friends on the telephone to keep his mind off of his tinnitus
This is an example of using interesting sound
Patrick talks to his friends on the telephone to keep his mind off of his tinnitus
This is an example of using interesting sound
To help you come up with ideas for choosing sounds… To help you come up with ideas for choosing sounds…
You can use Environmental Music Speech
You can use Environmental Music Speech
Environmental SoundEnvironmental Sound
Sounds of nature Moving water Beach sounds Forest sounds Animals Wind Storms
and more…
Sounds of nature Moving water Beach sounds Forest sounds Animals Wind Storms
and more…
Manmade sounds Masking noise Electric fan noise Shower sound Aircraft noise Wind chimes Traffic noise Radio static
and more…
Manmade sounds Masking noise Electric fan noise Shower sound Aircraft noise Wind chimes Traffic noise Radio static
and more…
MusicMusic
There are many styles of music We all have our preferred styles Any music that is neutral or pleasant can be used to
manage tinnitus – as long as it is not too loud
There are many styles of music We all have our preferred styles Any music that is neutral or pleasant can be used to
manage tinnitus – as long as it is not too loud
SpeechSpeech
Speech can be used as part of your plan to manage tinnitus
There are many kinds of speech, and we react differently depending on the type of speech and the situation
Some examples: Talking on the phone Listening to an audio book Listening to a lecture
Speech can be used as part of your plan to manage tinnitus
There are many kinds of speech, and we react differently depending on the type of speech and the situation
Some examples: Talking on the phone Listening to an audio book Listening to a lecture
Nine Combinations of Sound to Manage Reactions to TinnitusNine Combinations of Sound to Manage Reactions to Tinnitus
You Have Now Finished This ModuleYou Have Now Finished This Module
Next let’s take a closer look at an example Next let’s take a closer look at an example
BobBob
Listening to talk radio helps Bob get his mind off of his tinnitus at night This helps him get to sleep
This is an example of using interesting sound Tip: It’s best to NOT use the TV for this as the flashing
images can prevent you from falling asleep
Listening to talk radio helps Bob get his mind off of his tinnitus at night This helps him get to sleep
This is an example of using interesting sound Tip: It’s best to NOT use the TV for this as the flashing
images can prevent you from falling asleep
Won’t Interesting Sound Keep Me Awake?Won’t Interesting Sound Keep Me Awake? Interesting sound can be a powerful way to get your
mind off of your tinnitus This helps some people relax enough to fall sleep It might not be helpful for others
Be open to using sound in surprising or unusual ways to manage your reactions to tinnitus!
Interesting sound can be a powerful way to get your mind off of your tinnitus This helps some people relax enough to fall sleep It might not be helpful for others
Be open to using sound in surprising or unusual ways to manage your reactions to tinnitus!
Another Sleep Challenge for BobAnother Sleep Challenge for Bob
Listening to talk radio helps Bob get to sleep when he goes to bed at night
However, he wakes up in the middle of the night and has trouble getting back to sleep because of his tinnitus
He does not like to listen to interesting sound in the middle of the night
What did Bob do?
Listening to talk radio helps Bob get to sleep when he goes to bed at night
However, he wakes up in the middle of the night and has trouble getting back to sleep because of his tinnitus
He does not like to listen to interesting sound in the middle of the night
What did Bob do?
Bob’s SolutionBob’s Solution
Keeping a fan running all night long reduces the contrast between Bob’s tinnitus and the quiet of his bedroom
The reduced contrast helps Bob stay asleep all night long
Keeping a fan running all night long reduces the contrast between Bob’s tinnitus and the quiet of his bedroom
The reduced contrast helps Bob stay asleep all night long This is an example of This is an example of
using background soundusing background sound
Develop a Sound Plan That is Easy to DoDevelop a Sound Plan That is Easy to Do
Your first Sound Plan should be easy to do and practical for you
Use sounds and devices that you already have As you try the Plan, you will learn what helps the
most You will get ideas about how to improve your Plan
Your first Sound Plan should be easy to do and practical for you
Use sounds and devices that you already have As you try the Plan, you will learn what helps the
most You will get ideas about how to improve your Plan
Write Down Your Sound PlanWrite Down Your Sound Plan
What will you use for background sound _ _ _ _ _ _ _ _ (examples include Sound therapy,
fan, fountain, etc.)
What will you use as an interesting sound _ _ _ _ _ _ _ _ (examples include audio book, talk
radio, Music therapy, etc.)
What will you use for background sound _ _ _ _ _ _ _ _ (examples include Sound therapy,
fan, fountain, etc.)
What will you use as an interesting sound _ _ _ _ _ _ _ _ (examples include audio book, talk
radio, Music therapy, etc.)
