Retraining Ears With Tinnitus
It's commonly called ringing in the ears, but for millions of people who suffer tinnitus, the sound that plagues them may instead be a buzz or hiss or chirp or high-pitched whistle.
An estimated 50 million Americans hear those phantom sounds continuously, although for most it's just an annoyance. But for 12 million people, the incessant noise becomes debilitating enough to seek medical help, according to the American Tinnitus Association.
They can suffer sleep deprivation or depression. Tinnitus can ruin family relationships. Occasionally, it even pushes sufferers to suicide.
There is no cure -- and tinnitus is on the rise, due in part to ear damage from our increasingly noisy society. Loud noise is a chief culprit in tinnitus, as anyone whose ears have rung at least temporarily after a rock concert can attest.
But an Emory University professor says many patients can retrain their brains to recognize their ear-ringing as no more annoying than the refrigerator humming in the background of your home.
It's called tinnitus retraining therapy, and the key is using other faint sounds, sometimes called "white noise," to adjust how patients' brains perceive and react to the abnormal sound.
"It's very simple," explains Pawel Jastreboff, who introduced the approach in the early 1990s but now, as director of Emory's new tinnitus center, is training numerous doctors to use it. "All of our senses, including hearing, are based on contrast from background....If you introduce another sound, then the first sound seems to be not as loud."
He fits severe patients with small hearing aid-like devices to deliver faint sounds, like running water or a low hum, for up to 18 months. Over that time, their brains are supposed to become so used to focusing on the new sounds that they're not paying attention to the ringing.
Doctors don't understand what causes tinnitus. But they do know that the most common trigger is loud noise, like an explosion, a concert or pulsating boom box, a plane taking off, lawn mowers and other power tools.
Even one-time exposure to a really loud noise commonly causes temporary tinnitus. But chronic exposure risks persistent ringing in the ears. Experts say the best protection is prevention -- turn down the volume or wear earplugs.
But tinnitus isn't a novelty of the super-loud 20th century. It's been described for hundreds for years. And it can be a side effect of numerous medications, or the consequence of a blow to the head or an ear infection.
Scientists are studying an area of the brain called the auditory cortex that helps process signals from the ears and behaves abnormally in tinnitus sufferers, in hopes of understanding what makes the ringing continue.
But Jastreboff says for now, "it's possible to help really a majority of patients" with sound therapy.
Patients who have a strong emotional response to the ringing seem to suffer most, so he teaches them about how the brain rocesses sound and ways to cope, helping them to relax.
Then Jastreboff introduces sound therapy. Some people try to mask tinnitus with louder noise, but he stresses very faint sounds, too low to interfere even with a telephone conversation. "You'll never achieve habituation if you block tinnitus," he contends.
In fact, the noise is so faint some people forget they're wearing the devices. "I've had some people jump in a swimming pool and make a total mess of their sound generators," Jastreboff said.
The patient's severity determines the sound. Some succeed with hearing aids to amplify everyday sounds over the ear ringing. But the majority get the behind-the-ear sound generators, emitting just enough noise for the brain to sense.
Jastreboff has published studies suggesting the approach helps up to 80 percent of patients get significant relief. Studies from Britain and Australia also suggest it helps, although not quite as much.
Written By Lauran Neergaard