Tinnitus Retraining Therapy
Tinnitus cannot always be treated, but you can learn to adjust and ignore it through TRT therapy. TRT employs counseling and sound therapy methods that may make your tinnitus less noticeable by habituation and making you adjust more easily to its presence.
TRT counseling sessions focus on the neurophysiological model of tinnitus, with an aim of neutralizing negative associations participants have with it and setting realistic goals to combat tinnitus habituation.
Sound Masking Devices
Masking therapy uses ambient noises to diminish the contrast between your tinnitus and its surroundings, such as music, natural white noise or speech, and your auditory background. This form of retraining therapy for tinnitus can be particularly helpful in work environments as it allows employees to focus more efficiently without interruption from other coworkers’ conversations that are out of earshot.
Sound masking devices come from various manufacturers and can be designed specifically to your acoustical challenges, incorporating features like paging and music. One popular choice is Biamp Tesira which offers multiple sound options to meet all of your requirements.
Studies evaluating the combined use of amplification and sound generation to treat tinnitus have produced inconsistent findings. One RCT found no difference between amplifying alone compared to combined aids (Dos Santos et al, 2014) while PTM recommends including partial or complete masking devices as part of its habitation process (Henry et al, 2006b).
Another study revealed that patients who combined tinnitus-specific information and relaxation techniques experienced greater improvement compared to those who didn’t use these approaches. Tinnitus retraining treatment approaches were associated with improved quality of life and reduced distress/depression levels as well as an increase in perceived control over their condition.
Other studies have also revealed the efficacy of tinnitus retraining on short-term effectiveness for both normal hearing patients and those with impaired hearing. Participants enrolled in an eight-week program which provided group education sessions with an audiologist as well as devices like an audiometer to assist their tinnitus retraining journey – this device measured distress and handicap in addition to improving symptoms by three months – although its effect gradually diminished throughout 18 months.
The UK Department of Health’s Good Practice Guide (2009) recommended making sound therapy available to patients experiencing bothersome tinnitus; however, no detailed recommendations were provided on candidate evaluation and fitting (Tunkel et al, 2014).
Bimodal therapy uses sound to lessen the contrast between your tinnitus and its surrounding environment, and its presence. It accomplishes this through auditory stimulus which does not mask or drown out tinnitus but rather alleviate any negative emotional responses you might have to it. These may include environmental noise, ear level sound generators (SG), hearing aids or combinations thereof; this decision will depend on your initial diagnostic evaluation as to which type will best meet the demands and limitations of lifestyle and hearing loss.
Tinnitus Sound Therapy differs from traditional approaches in that it aims to change your brain’s response to your tinnitus or hyperacusis by teaching it how to ignore it just like other sounds in your environment, like traffic noise or refrigerator beeping. This is achieved by stimulating somatosensory neural pathways responsible for perceiving touch, body position, pressure pain sensations through either specialized devices or exercises.
An effective tinnitus retraining program typically combines counseling sessions and physical training sessions in order to help identify its source, its relationship to other health conditions such as stress, sleep disorders, depression or traumatic head injuries as well as TMJ disorders (temporomandibular joint disorder). Counseling also offers ways for managing and living with your tinnitus so it does not consume so much of your emotional energy.
Lenire neuromodulation device, the first bimodal tinnitus treatment to go through an FDA De Novo clinical trial, demonstrated that many treatment compliant participants experienced improvement in tinnitus symptoms that lasted well past 12 months post-treatment.
The TENT-A1 study11 demonstrated that both synchronized sound and tongue stimulation paradigms and wideband noise-free stimulation approaches delivered comparable improvements in tinnitus symptom severity. Within arm comparisons of different bimodal neuromodulation parameter settings at 6 weeks demonstrated significant decreases in THI and TFI scores (with Cohen’s d values exceeding 0.8, which corresponds with moderate to large effect sizes).
Behavioral therapy helps individuals learn to deal with tinnitus by changing the way they think and act. It may be used alongside masking or retraining devices or as an independent treatment approach.
Cognitive behavioral therapy for tinnitus involves two parts: functional analysis and skills training. At functional analysis, you and your counselor examine the connections between your thoughts and behaviors; for example, if social situations become awkward because of how loud your tinnitus is, your counselor can teach you techniques such as relaxation training that focus on breathing techniques and mental concentration to change those thought patterns and decrease social avoidance. Skills training teaches techniques for dealing with various situations as they arise such as relaxation training which emphasizes breathing exercises as well as mental concentration techniques like relaxation training techniques which focus on breathing techniques as well as relaxation training which promotes breathing exercises as relaxation training exercises to help with anxiety management during these events.
At times, patients can have unconscious dysfunctional thoughts that drive negative behaviors and are hard to identify. These thought patterns may make their distress related to tinnitus seem justifiable and lead to avoidant behavior; for instance, staying up late watching television as an avoidant behavior due to difficulty sleeping due to their condition could negatively impact sleep quality, overall functioning, as well as increase depression risk.
Tinnitus Retraining Therapy (TRT) is an innovative behavioral therapy method that teaches individuals to block out tinnitus with external noise sources like white noise machines or soothing music, gradually leading the brain to disregard it as just another sound source. Studies show TRT’s effectiveness among over 75% of individuals.
Though TRT works, its precise effects remain unclear, experts believe it’s due to how it alters how your brain perceives tinnitus as just another everyday noise and not something urgent or important.
Tinnitus retraining may not be available at every audiologists’ office, but you may still find providers online using resources like Psychology Today or GoodTherapy. Pugh recommends asking your audiologist for a referral of someone familiar with cognitive behavioral therapy for tinnitus patients.
Tinnitus Retraining Therapy (TRT) combines counseling and sound therapy techniques to help people overcome the annoying and distracting sounds characteristic of tinnitus. TRT programs typically last 12-24 months, starting with an interview and medical examination to identify its cause; then counseling with either an ear, nose and throat doctor (otolaryngologist) or hearing specialist called an audiologist will help better understand your tinnitus symptoms while beginning its habituation process.
TRT counseling sessions aim to identify triggers that lead to symptoms of tinnitus such as ringing in the ears and devise ways of avoiding them, along with strategies to manage them effectively. Counseling also seeks to change negative thought patterns about tinnitus into realistic, positive ones which may assist with managing its condition more successfully.
At TRT’s sound therapy stage, patients wear a device behind their ears that emits masking or white noise at levels below that of their tinnitus in order to create background noise in order to help make it less bothersome and focus on other sounds, such as conversations and music. This approach may make your tinnitus less bothersome so you can concentrate more fully on conversations or music instead of hearing any ringing in your ears.
As an adjunct to masking tinnitus, patients may also receive low-level sound generators or tinnitus suppression hearing aids to reduce contrast between their tinnitus and external noise. These devices may be supplied by your audiologist or tinnitus-retraining specialist and come as either standalone devices or in tandem with counseling sessions.
Tinnitus Retraining Therapy has been shown to work for around 80% of patients. Results may begin to appear as soon as three months, although habituation with TRT can take up to a year; patients must be willing to commit the time needed for this treatment, and be mindful of any delays caused by other therapies such as behavioral and cognitive techniques which may provide additional relief if required.