In this section we explain the science behind AudioNotch and answer some Frequently Asked Questions.
- What is Tinnitus?
- What is Tailor-Made Notched Sound Therapy?
- How Do I Use AudioNotch?
- Can Tailor-Made Notched Sound Therapy Help Me?
- How accurately do I have to tune?
- Any tips for users who are having difficulty finding their tinnitus frequency?
- Are there different types of Notched Sound Therapy?
- Is there a difference between sound therapies?
- How well does Notched Sound Therapy work?
- How long does Notched Sound Therapy take to work?
- Are the effects permanent?
- Why must I re-check my tinnitus frequency during treatment?
- Where is the scientific evidence?
- How does it work?
- What is the recommended treatment plan?
- How loud should the therapy be?
- What are the risks of AudioNotch?
- What support does AudioNotch provide?
- Does the use of mp3s compromise the treatment?
What is tinnitus?
Tinnitus is a common medical condition that affects millions of people worldwide, and presents as a persistent ringing in the ears. (8) It’s typically triggered by noise-induced hearing loss, and often causes a great deal of distress in many patients. (4,5,6). Current evidence indicates that it occurs due to a reorganization of the connections in your brain. (7,9,10)
What is Tailor-Made Notched Sound Therapy?
Tailor-Made Notched Sound Therapy is a tinnitus treatment that lowers the volume of your tinnitus, and in doing so, reduces the pain and distress caused by the disease. There is no tinnitus cure, however Tailor-Made notched sound therapy is a tinnitus treatment that can offer relief. It takes two forms: Tailor-Made Notched Music, or Tailor-Made Notched White Noise.
It is created by taking either music or "white noise", and removing sound energy—"notching it out"—at the same frequency of your tinnitus tone. (2) It is believed to target the auditory neurons that cause your tinnitus, reducing their activity. (2)
Sustained listening to this therapy lowers the volume of your tinnitus, alleviating the considerable suffering caused by this terrible illness. (1,2,3) It is designed to be used as a long term treatment of the course of several months, but you are likely to notice a reduction in volume as quickly as several days into treatment. (3)
How Do I Use AudioNotch?
Step 1: Tune
Use our tuner to detect the specific frequency of your Tinnitus tone.
Step 2: Create
Upload your favorite music, or use our specially modified white noise. Use our Notching Algorithm to cut out sound energy from around your Tinnitus frequency.
Step 3: Listen
Listen to your Tailor Made Notched Music for an average of 1 hour daily. You'll notice a reduction in volume after several days of treatment and the volume will be further reduced over time. You can use any mp3 music player or your computer to listen to the therapy.
To see AudioNotch in action, check out the screencast below:
Can Tailor-Made Notched Sound Therapy Help Me?
Tailor made notched sound therapy is designed to help a certain group of Tinnitus sufferers:
- People with a tonal tinnitus. Tonal tinnitus sounds similar to a "peep" or a "whistle".
- Try to match the sound of your tinnitus with the computer-generated tone from our tuner app; the therapy is only effective if you're able to closely match the tone.
- People who have less than moderate hearing loss (i.e. less than 35dB)
- People with Tinnitus that has no known secondary cause other than noise exposure (i.e. medication overdose, buildup of earwax, hypertension, etc.).
If you hear a persistent noise in one or more ears, please speak to your doctor to determine the cause of your tinnitus.
How accurately do I have to tune?
We do have some tolerance built into our procedure. The notch width is actually based on the average frequency selectivity of a person, and is two equivalent rectangular bandwidths (ERB). The ERB is dependent on frequency, so if your tinnitus frequency is 10,000 Hz (10 kHz), the ERB is about 1000 Hz, which means you’d have to get within a 1000Hz of your true tinnitus frequency (ERB = 107.94*f +24.7 = 107.94*10 + 24.7 = 1104 Hz). Many people notice a (small) immediate drop in the volume of their tinnitus upon listening to white noise for 2 minutes when the therapy has been correctly tuned. I would recommend registering for the trial and seeing if this works for you, using the white noise player (which can be set to repeat) on the listen page.
Any tips for users who are having difficulty finding their tinnitus frequency?
When using the AudioNotch tuner to locate the frequency of your tinnitus, try to alternate between listening to the computer generated tone, and your own tinnitus tone. When you are getting close to your own tinnitus tone, the computer-generated tone should "meld" into your tone.
Additional studies have verified the efficacy of the AudioNotch tuning procedure. To read more, check out our blog post on the subject.
Are there different types of Notched Sound Therapies?
Yes. There are two kinds of Tailor-Made Notched Sound Therapies, and AudioNotch supplies both to its customers:
Tailored Notched Music
- This is where we take a song of your choice, and notch out a segment of sound energy centred around your tinnitus frequency.
- Users typically enjoy listening to their own music. Studies have shown that enjoyable music releases dopamine in the brain, and likely improves cortical plasticity (your brain's ability to change its connections).
- Limited to persons with a tinnitus frequency under 8 kHz (8000 Hz).
Figure 1: Tailor-Made Notched Music frequency plot, made by AudioNotch
Tailored Notched White Noise
- This is where we take specially modified white noise, which sounds like static, and notch out a segment of sound energy centered around your tinnitus frequency.
- Users often enjoy listening to white noise since it tends to quickly fade from their attention, allowing them to focus on other tasks.
Figure 2: Tailor-Made Notched white noise frequency plot, made by AudioNotch
Is there a difference between sound therapies?
Yes. There are differences in what type of patients the therapy is effective in.
Regular Tailored Notched Music:
- Was found to work in patients whose tinnitus frequency is less than 8 kHz (does not work if tinnitus frequency is greater than 8 kHz) (3)
Tailored Notched White Noise:
- Was found to work in patients whose tinnitus frequency is 1-13 kHz (1)
Figure 3: Suggested therapies, based on tinnitus frequencies
How well does Notched Sound Therapy work?
It's impossible to predict the specific percentage reduction in tinnitus volume that a specific patient will experience. We can, however, provide the average reduction in volume that was observed during the experiments conducted by researchers.
Regular Tailored Notched Music
- Was found to reduce Tinnitus volume by an average of approximately 20% after five days of therapy, listening at 3, 6, 6, and 3 hours daily over those five days (3)
- Was found to reduce Tinnitus volume by an average of approximately 17% after six months of therapy (on a different treatment regimen of listening for 2 hours daily (2) )
- Was found to reduce Tinnitus volume an average of approximately 27% after twelve months, listening for 2 hours daily (2)
Tailored Notched White Noise
- Was found to reduce Tinnitus volume by an average of 12 dB (75%) after one month of listening 1.5 - 3 hours daily (1)
- Was found to reduce Tinnitus volume by an average of 15 dB after seven months of listening 1.5 - 3 hours daily (1)
How long does Notched Sound Therapy take to work?
We've reproduced the graph of volume reduction from Lugli, 2009 (1) which illustrates the average volume reduction seen in patients. WWN refers to Notched White Noise Therapy, and the other two lines represent control treatments (i.e. non-notched white noise). As can be seen, a gradual volume reduction should be expected, which increases with months of therapy.
Figure 4: Average volume reduction from notched white noise therapy (WWN) vs. control
Are the effects permanent?
The data needed to answer this question isn't available yet. This therapy has only recently been discovered and there haven't been multi-year follow-up studies done on patients. Patients who were successfully treated have not been followed for a long time period (i.e. five years) after treatment.
In general, it is believed that the more hours you spend listening to the therapy and the more weeks you spend using it, the greater the effect will be, and the more permanent the changes will be. (4)
If you only use the therapy for a very short, intense period of time (a couple of days), the volume reduction will not be persistent and will at least partially reverse. (3) As such, its important to spend several months listening to the notched sounds. This therapy has only recently been discovered and there haven't been multi-year follow-up studies done on patients.
It's possible that if you totally stop using the therapy (after listening to the therapy for several months), your tinnitus volume reduction will be partially reversed (or even completely reversed, although this is unlikely). Fortunately, if this occurs, you can simply re-initiate the therapy and reduce your tinnitus volume once again.
Why must I re-check my tinnitus frequency during treatment?
Over the course of several months of treatment, it is possible that the frequency of your tinnitus will shift one or more times. This is normal, and may occur as a response to treatment.
If the "notch" does NOT line up with your tinnitus frequency, then the therapy will NOT work. The "notch" must line up with your tinnitus frequency in order to see a therapeutic benefit.
Therefore, we recommend retesting (using our tuner app) your tinnitus frequency multiple times during your course of treatment. We have recommended once a week testing for the first month of treatment, and once every two weeks for the months following that.
In order to assist users in implementing the AudioNotch tinnitus treatment, we’ve offered a simple recommended Treatment Plan based on the scientific evidence available thus far.
Where is the scientific evidence?
Tinnitus sufferers should rightfully be skeptical of any treatments claiming to cure tinnitus, many of these claims are made without any scientific evidence. Furthermore, even treatments with scientific support are often based on small studies that require more follow-up research. Tailor-Made Notched Sound Therapy is based on several experiments conducted by two independent groups of European researchers. We encourage our customers to review the original scientific evidence that AudioNotch is based on. We have also included a link to a critical review of Notched Sound Therapy. In summary, the evidence for Notched Sound Therapy is provisional, but promising, and larger scale studies will be needed to make more definitive conclusions about its efficacy. In the mean time, we have sought to make this promising therapy available to patients now, in an effort to help them. For your convenience, we have included links for these papers below. AudioNotch Inc. is an independent company, and we are unaffiliated with any of the scientists who have completed this research.
Regular Tailored Notched Music Therapy:
Tailored Notched White Noise>
Reviews of the Field of Notched Sound Therapy:
How does it work?
Please refer to the How it Works section of our site for a simplified technical explanation of our treatment. The scientific explanation is complex but we’ve tried to translate it into understandable terms using certain visualizations.
For those of you with a greater degree of knowledge in neuroscience, please consult the peer-reviewed scientific papers we have linked to above. Under the "Discussion" section of each paper you’ll find a technical explanation of the proposed mechanism of our treatment. (1, 2) Briefly, a combination of lateral inhibition and subsequent changes in the auditory cortex via cortical plasticity appear to be implicated. (2) Selectively stimulating the auditory neurons that don’t produce the tinnitus frequency appears to laterally inhibit the auditory neurons that do produce the tinnitus frequency. (2) Sustained lateral inhibition rewires the connections between neurons in the auditory cortex so that the baseline level of inhibition increases (even when users aren’t listening to the music). (2) Therefore the tinnitus volume decreases.
What is the recommended treatment plan?
The AudioNotch Treatment Plan accounts for the fact that a user’s tinnitus frequency may shift during the course of treatment.
As such, it is necessary to periodically re-detect (i.e. "tune") one’s tinnitus frequency to ensure that the notch lines up correctly with the tinnitus frequency. The notch must line up with the tinnitus frequency for the therapy to work. Therefore, treatment consists of a repetitive cycle:
Figure 4: The recommended AudioNotch treatment plan
Treatment Plan: (for either Music or White Noise)
When listening, please be careful to keep a comfortable volume! High volume listening may damage your hearing and worsen your tinnitus! Try to spread listening out over the day (i.e. different sessions during morning, afternoon, and night). We recommend dividing the listening time into three 20 minute sessions in the morning, afternoon, and evening.
Week 1: Listen for 1 hours a day for seven days. Re-tune every other day.
Week 2-4: Listen for 1 hours a day. Re-tune once a week.
Week 4 - 6 months: Listen for 1 hours a day. Re-tune bi-weekly.
We recommend that you use headphones that block out external environmental noise, such as noise-cancelling headphones or in-ear headphones.
- Re-initiate therapy if, after a prolonged cessation of therapy, your tinnitus volume increases again.
- Some users find that immediately after listening to the therapy, there is a slight increase in volume. This is known as a Zwicker tone, and is temporary. Overtime, you should notice a net decrease in volume.
How loud should the therapy be?
As before, when listening, please be careful to keep a comfortable volume! High volume listening may damage your hearing and worsen your tinnitus. That being said, listen to the sound therapy at approximately the volume of your tinnitus.
What are the risks of AudioNotch?
In rare cases, listening to Tailor-Made Notched Sound Therapy can temporarily increase the baseline volume of your tinnitus. This is temporary and reversible with cessation of therapy. Your "baseline" tinnitus volume is the volume of your tinnitus at rest with no external sound input other than ambient noise from a regular environment. There are multiple possible explanations:
- Incorrect detection of tinnitus frequency, resulting in a "Notch" that does not overlay the user’s actual tinnitus frequency.
- Listening to Notched Sound Therapy at an unsafe volume level (exceeding 85 dB), as any loud noise can exacerbate tinnitus if it is too loud.
- Some users have correctly detected their tinnitus frequency and listen at a safe volume level, and despite this, they experience an increase in the volume of their tinnitus. This may be due to a psycho-acoustic phenomena known as a "Zwicker tone". Furthermore, it may be due to differences in the particular pattern of tinnitus that these individuals have compared to those users who do benefit from listening to the therapy.
If this occurs to you while you are using Tailor-Made Notched Sound Therapy, take the following steps:
- Verify that the therapy is in fact not working. For example, we had a user report indicating that immediately following a session of Notched Sound Therapy, his tinnitus volume would temporarily increase, however, he still experienced a net decrease in his baseline tinnitus volume, resulting in an overall decrease in tinnitus volume.
- Verify that you have correctly detected your tinnitus frequency (to the best of your ability) and that you are not listening at an unsafe volume level.
- If the above steps fail, stop listening to Notched Sound Therapy. After a rest period, your baseline tinnitus volume will return to its normal level. Then, request a refund as per our normal refund policy (this policy allows for a refund within 30 days. In our experience all events of temporary increase in baseline tinnitus volume have occurred within the first 30 days of therapy).
This complication occurs at a low rate. We currently estimate it at 5%. and periodically re-assess our internal data to update this figure. Most importantly, it is reversible upon cessation of the therapy.
What support does AudioNotch provide?
AudioNotch provides support via e-mail for the duration of the subscription. Typically, we reply within one business day to all support queries. AudioNotch also has technical support available from Monday to Friday 9 AM - 5 PM EST (English only).
Does the use of mp3s compromise the treatment?
No. While AudioNotch distributes Tailor-Made Sound Therapy as MPEG-3 files, we have taken care to ensure that the sound is of the utmost quality, and is entirely effective for all users. Using mp3 files allows us to support the widest range of playback devices for the largest number of tinnitus sufferers.
From a more technical perspective, we ensure that for patients with a high frequency tone (i.e. over 8000 Hz), no low-pass filtering occurs in the mp3 encoding. For those with a high frequency tone, we also encode using a high bitrate of 320kbps. Due to signal processing theory, an increased bit rate is not necessary for indiviudals with a lower frequency tone.
- Lugli M, Romani R, Ponzi S, Bacciu S, Parmigiani S (2009) The windowed sound therapy: a new empirical approach for an effective personalized treatment of tinnitus. Int Tinnitus J 15:51-61.
- Okamoto H, Stracke H, Stoll W, Pantev C (2010) Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity. Proc Natl Acad Sci U S A 107: 1207-1210.
- Teismann, H., Okamoto, H., Pantev, C. (2011). Short and intense tailor-made notched music training against tinnitus: The tinnitus frequency matters. Plos ONE, 6, 1-8.
- Eggermont, J.J., Roberts, L.E. (2004). The neuroscience of tinnitus. Trends in neurosciences, 27, 676-82. N
- Rajan, R. (1998). Receptor organ damage causes loss of cortical surround inhibition without topograhic map plasticity. Nature Neuroscience, 1, 138-143.
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- Heller AJ (2003) Classiﬁcation and epidemiology of tinnitus. Otolaryngol Clin North Am 36:239–248.
- Saunders JC (2007) The role of central nervous system plasticity in tinnitus. J Commun Disord 40:313–334.
- Rauschecker JP, Leaver AM, Muhlau M (2010) Tuning out the noise: limbic-auditory interactions in tinnitus. Neuron 66: 819–826.