Sound therapy for tinnitus passes a placebo test

A new clinical trial adds useful evidence about sound therapy for tinnitus. Researchers in France studied adults with bothersome tinnitus and mild hearing loss. After 12 weeks, people using sound therapy through hearing aids said tinnitus affected their daily life much less, and their scores improved more than those of a group using placebo devices.

What sound therapy is and why this trial matters

Sound therapy means adding sound so your tinnitus has less quiet to stand out against. It can come from hearing aids, from small ear-level devices that make a soft, steady sound (called sound generators), or from apps and bedside speakers. The aim is to reduce how much attention the tinnitus takes up. Some people find it easier to fall asleep with some sound in the room.

Sound therapy is often one of the first things an audiologist suggests. The research behind it has been harder to read. A 2018 Cochrane review of eight trials found that people using these devices improved. None of those trials compared a device with a placebo or with no device, so it was hard to say how much the sound itself was helping. The new trial was designed to answer that question.

How the trial worked

The study enrolled 145 adults at tinnitus centers across France, and 128 completed it. Everyone had heard tinnitus in both ears, or in the middle of the head, for at least three months. They had mild hearing loss in both ears, and their tinnitus caused at least a moderate level of difficulty on a standard questionnaire.

Each person was fitted with hearing aids and placed by chance into one of three groups.

• Placebo group. The devices passed sound through without making it any louder.
• Sound generator group. The devices played a soft, steady sound.
• Combination group. The devices played a soft sound and made everyday sounds louder.

The patients and the doctors assessing them did not know who was in which group. Only the audiologists who programmed the devices knew. After six weeks, people in the two active groups could switch between settings to suit where they were and what they were doing. Every group received the same counseling about tinnitus and what tends to make it better or worse.

What the researchers found

The main measure was the Tinnitus Functional Index, a questionnaire about how tinnitus affects sleep, focus, mood, and daily life. A drop of 13 points or more is usually seen as a meaningful change.

After 12 weeks, average scores fell by about 21 points in the sound generator group and 18 points in the combination group. The placebo group fell by about 6 points. When asked how they felt overall, 88% of the sound generator group and 77% of the combination group reported a meaningful improvement, compared with 33% of the placebo group.

Sleep, anxiety, and mood scores improved in all three groups, with no clear difference between them. People in the placebo group improved a little too, which suggests that counseling, time with a clinician, and expectations may play a part in how people feel during tinnitus care.

What the results mean for you

The researchers describe this as one of the first trials of its kind to test sound therapy through hearing aids against a placebo, with neither patients nor assessors knowing the groups. It gives firmer support to a kind of care that many tinnitus clinics already offer.

A few points help keep the results in proportion.

• The results come from adults with long-term, bothersome tinnitus and mild hearing loss in both ears. They may not carry over to people with normal hearing or with more hearing loss.
• Treatment lasted three months, so the study cannot say how long the benefit lasts.
• Once people could choose their own settings, plain amplification made up more than half of their use. The authors see the results as support for a flexible, personal approach to sound therapy.

One detail stands out. Average hearing in the study was close to the normal range, and some participants might not have been offered hearing aids based on a hearing test alone. If tinnitus bothers you and you have been told your hearing loss is too mild to treat, that is worth raising with an audiologist.

Something you can try tonight

You can start with sound you already have at home. A fan, a radio turned low, or an open window all add gentle background sound, and some people find evenings and bedtime easier with it. Some people find added sound settling and some find it irritating, so it is worth trying before buying anything.

Find a tinnitus clinic near you

A tinnitus clinic can check your hearing, listen to how tinnitus shows up in your days and nights, and help you choose between sound therapy, counseling, and other approaches. Every clinic listed on Tinnitus Support treats tinnitus, and each profile shows which treatments it offers. Search your city in our clinic directory to find care close to home, or read more in Understanding tinnitus.