Tinnitus Treatment with Smartphones

This discussion should be prefaced with the statement that I have no actual research to make the suggestion that will appear here, but it is a great doctoral dissertation. This week at Hearing International will discuss the use of smart phones to treat tinnitus.

Smart phones have totally taken over our lives for many things, family communication, email, messages, bank accounts, videos, and other entertainment as well as many other things that are part of everyday life. For music we really do not even need records or CDs for music anymore, we just tune into iHeart Radio, or get Amazon Prime and connect the computer up to a home amplifier and play the songs of your generation. The phones are actually smarter than we are.

These devices generally come in a couple of different flavors, either Apple or Android. Until recently only the Apple phones connected up to most manufacturers’ hearing devices but hearing aids now connect to both types of phones. A few years ago, Hearing International did a blog on the use of smart phones with hearing devices, titled The Marriage of Bluetooth Hearing to Smart Phones but, at that time, we concentrated on the benefits of having the phone connection to the hearing impaired. Over the past few years, most of the big 6 hearing aid manufacturers connect to Apple phones and, lately, some even connect to Android phones without the intermediary devices. While the benefits of the used of smart phones are now routine for the hearing impaired, there is anecdotal evidence that smart phones connected to hearing aids might be of great benefit to those with tinnitus. In fact there is even evidence that for some patients smart phones’ not connected to hearing aids are of benefit for tinnitus.

Sound Therapy for Tinnitus

It is well known that about 50% of the patients that experience tinnitus can receive benefit from what audiologists have termed over the years as masking., which is part of a whole category of tinnitus treatments called Sound Therapy. The American Tinnitus Association (2018) describes sound therapy as the use of external noise to alter a patient’s perception of, or reaction to, tinnitus. Like other tinnitus treatments, sound therapies do not cure the condition, but they may significantly lower the perceived burden and intensity of tinnitus. Sound-based therapies function on four general mechanisms of action:

Masking: exposing the patient to an external noise at a loud enough volume that it partially or completely covers the sound of their tinnitus
Distraction: using external sound to divert a patient’s attention from the sound of tinnitus
Habituation: helping the patient’s brain reclassify tinnitus as an unimportant sound that should can be consciously ignored
Neuromodulation: the use of specialized sound to minimize the neural hyperactivity thought to be the underlying cause of tinnitus

There are many devices that offer different levels of sound therapy and, in the past, it was necessary to purchase a specific device to generate the specific type of therapy that was required for the particular type of sound therapy being conducted. These days, however, most hearing aid manufacturers have a tinnitus application within the circuitry of their devices which is controlled by the fitting software. These sound therapy applications are controlled and manipulated subjectively by the audiologist to provide the specific sound therapy necessary for the individual patient’s needs. While these programs work reasonably well for many people with hearing impairment, patients with minimal or no hearing loss need other treatments that are not necessarily associated with hearing instruments.

Tinnitus Applications for Smart Phones

Wise practitioners have increasingly been using smart phones for sound therapies. If the patient has hearing aids that connect to a smart phone there are many tinnitus applications which can be generated by their phone and sent directly to the patient’s hearing aids for use in covering the tinnitus or to distract them from the tinnitus. While hearing instruments are greatly beneficial for those with hearing loss, if the patient does not need hearing instruments, the smart phone offers unique benefits for sound therapy without the costs and stigma of hearing devices. Additionally the frequency rage of most hearing instruments are limited to about 10,000 Hz at best while wired or Bluetooth circumaural or insert headphones often have a substantially wider frequency range often 20-30,000 Hz, allowing sound therapies to be presented at higher frequencies. While habituation and neuromodulation techniques should arguably be monitored, if not conducted by audiologists, access to the masking and distraction procedures are readily available and can be self-managed for great success.

To access these sound therapy programs, go either to the Apple “App Store” or the Android “Play Store“. Once in the store go to search and type in: t i n n i t u s. There will be many sound therapy apps that come up. While most are free there are some complex, acoustically, and neurologically sophisticated programs that have costs associated with them. Try the free ones first, then move on to the others if necessary. While in my clinic we have had some good results from many of these applications. Note that sound therapy only works about half the time and may not work for your particular tinnitus. While not for everyone, the smart phone and tinnitus apps are certainly worth a try for those with bothersome tinnitus.