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Author: admin | 20.10.2014 | Category: Ringing In The Ears Causes

Choosing the correct sound to use in sound therapy can often have a significant impact on treatment outcomes. There are multiple tinnitus management protocols that have aided people in finding some relief of their tinnitus. One of the greatest challenges in working with the tinnitus population is that everyone is different.
Searchfield et al1 pointed out that sounds used for sound therapy can vary in their temporal, spectral, and emotion-evoking characteristics, and that individual differences can influence the effectiveness of specific sounds over others.
Times have changed, and in recent years tinnitus has moved more to the forefront of our industry, as it appears to be a growing concern for many people. With what appears to be a growing number of people and a concommitant need for these clinical services, having solutions that meet the demands of patient individuality is paramount for successful implementation of sound therapy.
It has been shown that broadband stimuli, such as white noise, is an effective sound for managing tinnitus. Although broadband sounds have helped many people in tinnitus management, it is not a one-size-fits-all remedy, and therefore many people habituate to the broadband noise. Henry et al5 showed that some people prefer to listen to computer-generated dynamic sounds that enhance short-term variations in amplitude over traditional broadband noise stimuli. Sound classification can even change from each tinnitus management plan, as well as from person to person.
Regardless of the category name, not everyone will classify the same sounds as interesting or calming.
For example, if you ask a tinnitus patient if they prefer broadband noise or chimes, they may not prefer either sound; however, if forced to choose because of the technology limitation, they may say they prefer to listen to broadband noise over chimes on a regular basis. Having the flexibility to offer sounds that the patient prefers and accepts can be one of the key first steps of successful sound therapy. To expand the flexibility of our tinnitus sound generator (TSG), Nature Sounds options have been added as alternative sounds to the white noise generator in the ReSound Aventa® fitting software (Figure 1).
This patented technique makes it possible to play sounds directly from data stored in the hearing aid memory without need for connection to an external device. Similarly, an independent study by SenseLab asked listeners to rate their preferences of 13 different sound stimuli (unpublished study: “Listening test on tinnitus relaxation sounds,” SenseLab, Horsholm, Denmark, 2014).
The overall conclusion was that selected synthesized versions of the natural sound recordings seem to be the optimal choice for general tinnitus relaxation sounds. Nature Sounds can be activated within the Tinnitus section of the ReSound Aventa fitting software.
The ReSound Relief app also offers tinnitus information to support counseling concepts and provides beneficial tips for those suffering from tinnitus.
For tinnitus sufferers without hearing loss, the app can also be used simply by plugging in a set of headphones. Just as we all prefer a different dessert after dinner, or a different genre of movie on a Saturday night, the individuality and variance of sound preference within the tinnitus population is an important aspect.

With the flexibility of today’s technology, we have the opportunity to offer an almost endless array of sounds that can be selected by individuals themselves. With the flexibility of today’s technology, we have the opportunity to provide an almost endless array of sounds that can be selected by individuals themselves, offering a range of tinnitus solutions that allow for true personalization. The majority of these protocols emphasize that, as tinnitus is a perception of sound, therapy should be an essential part of the treatment.
View someone’s music list on their phone or tablet—the chances of having another person with the exact same playlist are highly unlikely. In the past, people suffering from tinnitus have had limited sound therapy options, which has made it challenging to find the flexibility and personalization suggested by many tinnitus management protocols. ReSound’s Nature Sounds™ options and the ReSound Relief™ app for tinnitus are designed to expand upon our core sound therapy platform, which offers flexible controls such as frequency shaping, amplitude modulation, and Environmental Steering™.
Reavis et al6 found that modulated sounds—particularly low-rate amplitude tones with a higher carrier frequency in the tinnitus pitch range—were the most effective in reducing tinnitus loudness.
Progressive Tinnitus Management (PTM) classifies sounds into 3 different categories: soothing, interesting, and background sounds.
And although one person might categorize broadband and chimes as soothing background sounds, someone else might classify them as disturbing and irritating.
Henry et al5 found that air and water sounds used in sound therapy caused the least amount of annoyance to the subjects. The project included recordings and editing of sounds, elicitation of attributes and a listening test with normal hearing and hearing impaired assessors. Each sound is a broadband stimulus extracted with the natural amplitude modulations of the respective environment. The ReSound Relief™ app offers users the ability to introduce sounds into their sound therapy beyond what is inside their hearing instrument. It allows users to create personalized soundscapes that integrate auditory, visual and tactile cues to help distract them from focusing on their tinnitus.
In addition, it can record usage of the app, enabling users to automatically monitor the sounds they use the most. Thus, independent of the hearing loss configuration, this is a very valuable tool for people with tinnitus. By offering flexible tinnitus solutions that allow for true personalization, we can rest assured that William Cowper’s words still ring true today: variety is the spice of life. If this cherished phrase is indeed true, then it seems unlikely that the approximately 15 million people in the United States who have clinically treatable tinnitus will all find relief using the same treatment. Therefore, how people perceive their tinnitus will influence how they feel and, in turn, react to their tinnitus. The sounds we listen to, whether they are by choice or by-products of a particular environment, vary significantly from person to person. A basic white noise generating instrument or a set of headphones and a walkman were some of the more flexible options in the past.

This does not diminish the merits of broadband noise stimuli, but rather acknowledges that they do not provide relief for everyone—and emphasizes the need for more flexible solutions. Again, these results demonstrate the variance in preferences for individuals with tinnitus. They were created by applying modulation extraction derived from recordings of actual water sound environments. These sounds were preferred over the other options, including narrow-band and broadband stimuli, as well as other nature-inspired sounds.
The tested material included noise, a synthesized tonal sound, and a selection of natural sounds. From these results, ReSound selected the 6 top-rated sound files from among the 13 evaluated for Nature Sounds (Figure 1). In an internal trial, “Breaking Waves” was the most-preferred sound, with comments such as “pleasantness” and “least irritable” reported by subjects.
The large bubbles represent soundscapes and the smaller empty bubbles can be popped fora relaxing tactile exercise. These include environmental sounds, music, personal imported sounds, as well as guided relaxation exercises. Each soundscape can be personalized by name, mood color, and a layering of multiple sounds. Sounds from the app can be streamed to ReSound LiNX2 hearing instruments and combined with amplification to compensate for potential hearing loss. The sounds we prefer to listen to can even vary according to specific factors such as mood, time of day, or location, to name a few. Both original recordings and synthesized versions of these natural sounds were based on modulation extraction.
Up to five sounds can be layered in any individual soundscape by using the sound mixer (Figure 3).
As a majority of tinnitus suffers also have some degree of hearing loss, this is the optimal solution.
Just as the tinnitus perception can vary greatly from one person to another, so too can the sounds people prefer to use in sound therapy. The stimuli were presented over headphones to the assessors in random order from the SenseLabOnline software for listening tests.

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