What Is Notch Therapy And Can It Improve Tinnitus?

older man using headphones for notch therapy

Tinnitus can be persistent, loud, and stressful to deal with. While there is currently no cure for tinnitus, there are large amounts of research being done and the future looks promising. But for now, behavioral therapy, treatment of underlying medical issues, and sound therapy are all extremely helpful options.

One type of sound therapy is called notch therapy. It uses the process of “notching” your specific tinnitus frequency and playing the sounds around it instead of matching the pitch. Notch therapy is not a very well known treatment option, but when used correctly, it can be a useful and effective tool for tinnitus treatment. 

Can notch therapy be used for tinnitus?

What Is Notch Therapy?

Let’s discuss how notch therapy works. As briefly mentioned above, notch therapy is a type of sound therapy that filters an audio signal to take out the small band of frequencies (or pitches) around the one that matches your tinnitus. Removing these frequencies creates a “notch” in the frequency output of the audio. 

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When this audio signal is played back to you, the neurons from your auditory nerve and brain that match the frequency of your tinnitus aren’t stimulated by this incoming sound. This neuron inhibition process is called lateral inhibition. It is the process in which a neuron’s activity is inhibited while its neighbors are stimulated and excited. 

Lateral inhibition has had mixed results for tinnitus reduction. When the neurons in the brain are inhibited by this process, tinnitus has at times become softer or less bothersome. It must be noted, that it is never recommended to use notch therapy in isolation. It should only be used as part of a comprehensive tinnitus treatment, like the protocol performed by Treble Health audiologists.

Types Of Notch Therapies For Tinnitus

Tailor-made notched music training (TMNMT) is a type of notch therapy. It uses notched music to inhibit tinnitus neural activity, while also providing a relaxing and pleasant sound to reduce the emotional response to tinnitus. Tinnitus itself isn’t physically harmful, but our response to it can be. Reducing tinnitus-related stress is key to managing it. 

TMNMT was developed in 2009 by a team of German researchers. Their study analyzed this treatment for 12 months. Users listened to their usual type of music, but with a filter notching out their tinnitus frequency. They listened for one to three hours a day. The results showed a significant reduction in tinnitus loudness and reduced activity in the auditory brain areas that correspond with their tinnitus frequency. 

Notched noise therapy is another type of notch therapy. It uses sound with a broad frequency range, such as white or pink noise, with the tinnitus frequency band filtered out. Similar to the music-based TMNMT, patients listen to this noise for a few hours a day over a period of months. 

There are apps and programs that can be used for notch therapy, and they use either user-selected music or noise as the sound stimulus. Options include Tinnitracks, AudioNotch, and TinnitusNotch. 

Notch therapy can also be provided directly through Signia hearing aids. Their type of notch therapy filters out the tinnitus frequency band from a sound and applies it to the amplification of hearing aids. This may be an easier way for some to try notch therapy. 

Click here to start a risk-free trial of Signia hearing aids for tinnitus with Treble Health.

Usually, when a hearing aid amplifies an incoming sound, it is programmed to increase the volume of every frequency band based on the hearing loss of the user. With notch therapy, it increases the volume of every frequency except for the frequency band around the tinnitus. Therefore, you won’t hear sounds amplified in the frequency of your tinnitus while wearing these hearing aids. You’ll be able to hear better in general while having continual notch therapy.

A Notch Therapy Story

To show you how notch therapy actually works, we want to introduce you to Jay (name changed for privacy). Jay started having tinnitus and hearing loss after a motorcycle accident that caused a brain injury. He discovered that his previous experience with meditation and other relaxation techniques helped his tinnitus, but he wanted something more. 

So, Jay decided to talk to his audiologist about starting to use hearing aids. At the same time, he initially used a general tinnitus sound therapy program, although he was nervous to do any of it due to the hyperacusis (loud sound sensitivity) he also experienced. He did mixed results at first and felt very distressed. He found the sounds from the hearing aid to be cluttering his thoughts and he had difficulty with over-monitoring his tinnitus. 

He was fitted with a Signia hearing aid from Treble Health that had notch therapy built in. After only four weeks of using it, he saw a large change. He had a happier mood, reduced anxiety, felt calmer, was able to concentrate again, and said his tinnitus improved a great amount.

In just four months, his tinnitus rating went from moderate to mild. After a year, his tinnitus was almost completely gone. “When the hearing aid is out, when it is quiet if I really listen to try and hear the tinnitus, it is present just very softly in the background,” Jay said. Notch therapy was only one thing of many he was doing, but it seemed to make a difference.

How Well Does Notch Therapy Work?

Notch therapy unfortunately does not appear to work for everyone, and the evidence is not clear as to why this is. One study did show some improvement over a long-term period, but it wasn’t clear if there was a real difference between the two types of sound therapies used. Patients listened to both notch therapy sound and unfiltered music. The group who had notch therapy had a reduction in their tinnitus during the follow-up period, but not initially. This conflicting result means more research is needed. 

Another study compared notch therapy through a hearing aid with just a regular hearing aid. It didn’t find any improvement for tinnitus-related distress after 12 weeks. Overall, there wasn’t a real difference between the two groups. However, some of the people who used notch therapy did have a significant improvement in their tinnitus. Why some people benefit and others don’t is unknown at this time.

Lastly, an additional study found that when looking at a longer time frame of using notch therapy, there was a significant improvement in tinnitus-related stress. This was true at the six-month point after the start of treatment, suggesting that the improvement from notch therapy can take quite some time to work. However, more research needs to be done to determine exactly how long it will take to start working.

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