The Truth About Noise-Cancelling Headphones and Tinnitus

In a world filled with the commotion of traffic, chatter, and technology, noise-cancelling headphones have become a popular way for people to enjoy their music or find some much-needed quiet. These devices, equipped with cutting-edge technology, offer users the ability to immerse themselves in their favourite tunes, audiobooks, or podcasts, effectively silencing the chaos of the outside world. But what happens when this sought-after silence becomes a source of concern?

For millions of individuals plagued by tinnitus, a relentless and often debilitating condition, the question of using noise-cancelling headphones isn't just a matter of preference – it's a serious health consideration. Does the quiet from these headphones help or make things worse?

We look into this question to understand the complex relationship between tinnitus and noise-cancelling headphones. Whether you're someone dealing with this condition or just curious, come along as we explore the science and facts of this compelling issue.

Understanding tinnitus: What is it and what causes it?

Imagine a persistent ringing, buzzing, or hissing sound that follows you everywhere, playing in your ears without any external source. This is the reality for those living with tinnitus, a complex and often misunderstood phenomenon.

Importantly, tinnitus is not just a single sound or sensation; it's a symphony of noises that can be constant or intermittent, soft or piercing. It's a condition that transcends mere annoyance, often becoming a relentless companion that affects every aspect of daily life.

What causes tinnitus?

The origins of tinnitus are as varied as its manifestations. Here's a closer look at some common causes:

How noise-cancelling headphones work

Noise-cancelling headphones function by employing a variety of techniques to either block out or cancel unwanted ambient sounds. Here's a simplified explanation:

• Active Noise Cancellation (ANC): These headphones utilise a technology called ANC. This involves using microphones to pick up external sounds, such as the din of vehicles or chatter. Subsequently, a counteracting sound wave is produced that is the exact opposite (or phase-inverted) of the detected noise. When these two sound waves collide, they cancel each other out, effectively "muting" the external noise.

• Passive noise isolation: In addition to ANC, noise-cancelling headphones often include features that physically block external sound, such as cushioned ear cups. This passive noise isolation works in tandem with ANC to create an even quieter listening environment.

Passive vs active noise cancellation: a quick comparison

Not all "noise-cancelling" headphones work the same way. The two broad approaches are passive isolation and active cancellation, and the difference matters when you're choosing a pair to live with tinnitus.

The science behind noise-cancelling headphones and tinnitus

The science behind noise-cancelling headphones is both intriguing and nuanced, proving useful in various settings for mitigating the impact of tinnitus. For instance, a 2013 study demonstrated that the use of such noise-reduction technology produced lower referral rates in a school hearing screening environment, suggesting their utility in controlled settings [1]. 

Moreover, the technology has been explored for its potential benefits in managing hyper-reactivity to auditory stimuli in children with autism spectrum disorder, as evidenced in a study by Ikuta et al. [2].

The versatility of these devices extends to medical settings as well. A 2017 study showed that active sound control delivered by such headphones significantly reduced noise exposure in a cardiac Intensive Care Unit (ICU) [3]. This suggests that it could be particularly useful for managing conditions like tinnitus, where creating a controlled auditory environment can be beneficial. 

The link between noise-cancelling headphones and tinnitus

The scientific literature largely supports the notion that noise-cancelling headphones can be an effective tool for managing tinnitus for many people. However, it's worth noting that individual experiences can vary considerably. While the technology is generally designed to offer relief by tuning out intrusive sounds, there were instances where some found that their symptoms actually exacerbated.

For instance, a 2014 study explores the impact of listening to high-volume music through headphones and its association with permanent tinnitus and other health issues, including depression, anxiety, and suicidal thoughts [4]. The findings revealed that approximately 10% of the participants reported experiencing permanent hearing-related symptoms like tinnitus. 

Hence, the relationship between noise-cancelling headphones and tinnitus is not universally positive or negative; it is contingent on the individual's unique auditory health profile. By delving into both sides of the argument, we hope to provide a balanced perspective that allows you to make an informed decision on whether these headphones are right for you.

How can noise-cancelling headphones make tinnitus worse

Noise-cancelling headphones may exacerbate tinnitus for several reasons: 

• Auditory contrast: The silence produced by these headphones might amplify the internal sounds, turning a soothing experience into a tormenting one. This phenomenon is known as the "contrasting effect". However, it's important to note that this notion remains an area of active investigation and discussion rather than a definitively established fact.

• Psychological factors: Anxiety and focus can play a significant role in the perception of tinnitus. If an individual is worried that noise-cancelling headphones will worsen their condition, this anxiety might actually heighten their awareness of the sounds.

• Auditory stress: Using headphones for extended periods can potentially lead to ear fatigue or even worsen pre-existing hearing issues, including tinnitus. Hence, any kind of overuse of ear-related devices can contribute to auditory stress, potentially aggravating the condition.

How do noise-cancelling headphones help tinnitus?

Now, let's take a look at how noise-cancelling headphones can prove beneficial: 

• Reduction of background noise: While some individuals find the silence created by noise-cancelling headphones makes their tinnitus more noticeable, there's another side to consider. For other sufferers, the reduction of ambient sounds can actually make the condition less intrusive. By creating a more controlled auditory environment, these devices can help some people focus better and become less aware of the ringing in their ears.

• Controlled sound exposure: Noise-cancelling headphones allow users to listen to music or other audio at lower volumes, as they don't have to compete with background noise. This controlled sound exposure can be beneficial, as it avoids further strain on the ears.

• Potential therapeutic use: Some studies and practitioners have explored the use of noise-cancelling headphones in conjunction with sound therapy for tinnitus [5]. By establishing a tranquil setting, these headphones can aid in providing targeted therapeutic sounds or distractions that may ease the symptoms.

• Psychological comfort: While some may find heightened sound contrast stressful, the ability to control one's auditory environment can provide psychological comfort and empowerment for others. Simply, having the option to "tune out" unwanted noises can reduce stress and anxiety.

Remember, the efficacy of noise-cancelling headphones in alleviating or exacerbating tinnitus appears to be a double-edged sword, with both potential benefits and drawbacks. Therefore, it is crucial to consult with a healthcare professional for a personalised treatment plan and perhaps even undergo a trial period to assess the impact of such headphones on your symptoms.

Tips for using noise-cancelling headphones safely and effectively

This section offers practical tips to help you use these headphones in a way that's both safe and effective.

Start with low volume

Begin with a low volume and gradually increase it to a comfortable setting. This approach helps prevent sudden or loud sounds that might cause further auditory strain. Exercise caution with volume settings, particularly during prolonged listening sessions, to safeguard your hearing health.

Take regular breaks

Regular breaks allow the ears to rest and can prevent overstimulation or discomfort. A common guideline is to follow the 60/60 rule. This involves listening at no more than 60% of the maximum volume for no longer than 60 minutes at a time.

Choose the right fit and technology

Select headphones with cushioned ear cups that fit well without causing pressure or pain. Different brands and models offer varying levels of noise reduction. Research and try different options to find what works best for your needs.

Monitor tinnitus symptoms

Pay attention to how your tinnitus responds to the use of noise-cancelling headphones. If you notice any increase in symptoms, consider adjusting your usage or consulting a hearing healthcare professional.

Keep the volume at a safe level

Sound is measured in decibels (dB). Normal conversation sits around 60 dB, and the World Health Organisation suggests keeping headphone listening below about 85 dB (roughly the level of heavy city traffic) to protect your hearing. A simple rule of thumb is the 60/60 guideline: no more than 60% of maximum volume for no longer than 60 minutes at a stretch. Because noise-cancelling headphones reduce background noise, they often make it easier to hear clearly at lower volumes, which works in your favour here.

Mind sleep use and hygiene

If you use headphones to help you drift off, make sure they're comfortable, and avoid wearing them all night so you stay aware of your surroundings. Clean your headphones or earbuds regularly, as ear infections can aggravate tinnitus symptoms.

Best headphones and earbuds for tinnitus

If you've decided noise-cancelling headphones might suit you, the next question is usually which ones to choose. It's worth being clear up front: no pair of headphones treats or cures tinnitus, and what feels comfortable varies a lot from person to person. Treat the list below as a starting point rather than a recommendation, and ideally try any pair within a return window so you can see how your own tinnitus responds.

What to look for

• Adjustable noise cancellation: being able to dial the level up or down (rather than all-or-nothing) makes it easier to avoid the very deep silence that some people find makes their tinnitus more noticeable.

• A transparency or "aware" mode: lets ambient sound back in so you're not completely sealed off from your surroundings.

• A comfortable, well-sealing fit: a good seal means you can listen clearly at lower volumes.

• Volume limiting: headphones or phone settings that cap output and warn you near unsafe levels help protect your hearing.

With those criteria in mind, here are some widely discussed options that people with tinnitus often ask about, including over-ear headphones and in-ear earbuds.

1. Nuheara IQbuds² MAX

The Nuheara IQbuds² MAX are wireless earbuds with active noise cancellation and an adjustable "world volume" that blends ambient sound with whatever you're listening to. The manufacturer markets them as a way to run sound-therapy apps on the go while staying connected to the outside world.

2. Bose Noise Cancelling Headphones 700

The Bose Noise Cancelling Headphones 700 offer 11 levels of noise cancellation, ranging from fully cancelling to fully transparent, so you can tune how much of the outside world comes through. They're rechargeable and use touch controls to change settings.

3. Bose QuietComfort earbuds

Bose's QuietComfort earbuds let you switch between a noise-cancelling mode and an "aware" mode that lets you hear what's happening around you, which is handy if you don't want to feel fully cut off.

4. Sony WH-1000XM3

Sony's WH-1000 series is consistently rated among the strongest performers for active noise cancellation by review outlets such as SoundGuys, and the WH-1000XM3 has been an Amazon's Choice pick. Later models in the same line carry over the adjustable ANC and transparency features.

5. Sennheiser Momentum True Wireless 2

The Sennheiser Momentum True Wireless 2 are a discreet in-ear option with active noise cancellation, for people who prefer earbuds to over-ear headphones.

6. Soundcore Life Q30

The Soundcore Life Q30 are a popular budget-friendly over-ear option with multiple noise-cancelling modes, for anyone who wants to try ANC without spending a lot.

What about hearing protection?

Noise-cancelling headphones aren't the only way to manage sound around tinnitus. Hearing protection is worth understanding too, though it's not as simple as "more is better", as overuse can actually work against you.

What is hearing protection?

Hearing protection refers to devices designed to reduce the level of sound reaching your ears, acting as a barrier against harmful noise. Alongside noise-cancelling headphones, common examples include:

• Earplugs: inserted into the ear canal to block external sound, available in foam, silicone, and custom-moulded versions.

• Earmuffs: fit over the whole outer ear to form a seal, reducing the noise that reaches the eardrum.

• Acoustic filters: specialist earplugs that lower the volume while keeping sound fidelity, often used by musicians.

The double-edged sword of hearing protection

While shielding your ears from genuinely loud noise is important, overusing hearing protection can ironically make tinnitus worse. Wearing earplugs during quiet, everyday situations can create a mild, temporary sense of reduced hearing, prompting your brain to work harder to pick up sound and potentially making your tinnitus more noticeable.

So if you've been using hearing protection to silence your tinnitus, it may be time to rethink. Reserve it for situations with genuinely harmful noise levels, such as concerts, sporting events, or power tools, rather than wearing it all the time. A simple gauge: if the ambient noise is loud enough to drown out other sounds, consider protection or moving somewhere quieter.

Foam earplugs are a useful, low-cost option to have on hand for sleep, concentration, or noisy environments. Custom-made earplugs for activities like shooting or performing music can be obtained through an audiologist, and there are also versions designed specifically for sleep.

Alternative solutions for managing tinnitus without using noise-cancelling headphones

While noise-cancelling headphones offer one avenue for managing tinnitus, they're not the only option available. Let’s take a look at some alternative solutions:

White noise machines and apps

• Masking tinnitus sounds: White noise machines or apps can create a soothing background din that helps mask the intrusive sounds, making them less noticeable.

• Customisable soundscapes: Many modern devices and apps offer various soundscapes, such as ocean waves or forest sounds, allowing individuals to find what works best for them.

Relaxation techniques

• Deep breathing and meditation: Practising deep breathing exercises or meditation can help reduce stress and anxiety, promoting overall well-being.

• Yoga and mindfulness: Engaging in yoga or mindfulness practices can foster relaxation and help individuals cope with the constant presence of tinnitus.

Lifestyle changes

• Dietary considerations: Reducing caffeine and alcohol intake can have a positive impact, as these substances may aggravate the condition for some individuals.

• Good sleep hygiene: Practising good bedtime habits, such as maintaining a consistent sleep schedule and creating a calming routine, can improve sleep quality, which may, in turn, affect tinnitus symptoms.

Professional help and treatment plans

• Cognitive Behavioural Therapy (CBT): Offering a compelling approach to tinnitus management, CBT addresses both the auditory and psychological aspects of the condition. Grounded in evidence-based practice, CBT provides personalised strategies to change negative reactions to tinnitus and empowers individuals with practical skills to tune out the ringing or buzzing. Its holistic focus on understanding and managing emotional responses, coupled with professional guidance, makes it a vital part of a comprehensive treatment plan.

• Consulting a doctor or audiologist: Seeking professional help ensures a thorough evaluation, which may include hearing tests and imaging studies, to rule out underlying conditions that could be contributing to your tinnitus. Based on this assessment, the doctor or audiologist can develop a holistic approach that may include medication, sound therapy, or even surgical options, depending on the severity and underlying cause of your tinnitus.

• Hearing aids: For individuals experiencing tinnitus as a side effect of auditory impairment, hearing aids can offer a dual benefit. Not only do they improve general hearing by amplifying external sounds, but they can also make the ringing in your ear less noticeable. Many modern devices come with tinnitus-specific features, such as sound generators that can play white noise or nature sounds as a distraction.

Community support

Support groups and forums: These platforms offer a safe space to share experiences, coping strategies, and even recommendations for healthcare providers who specialise in tinnitus management. The collective wisdom of a community can be a powerful tool, helping you to feel less isolated and more empowered in your journey towards better auditory well-being.

Oto's research-backed approach to tuning out tinnitus

Tinnitus can be a constant intrusion in daily life, disrupting work, relationships, and even sleep. Oto, a research-backed digital platform, is here to support those who experience this relentless distraction. Designed by a team that deeply understands tinnitus both personally and professionally, Oto's mission is to support individuals in managing tinnitus.

With Oto, users can access expert-crafted content designed to soothe the mind and reduce awareness of tinnitus. The platform offers comprehensive tools tailored for various aspects of daily life impacted by tinnitus, from sleep aids to focus-enhancing sounds. Unlike many other solutions, Oto combines the wisdom of doctors, ENT specialists, audiologists, and researchers, offering a research-backed approach to support tinnitus habituation. The app's simplicity ensures that even those who struggle with technology can easily navigate its features.

The guided audio program feels like speaking directly to a therapist, providing instant access to support anytime, anywhere. Moreover, the one-to-one program offers personalised support, adapting to each individual's needs and providing a highly tailored journey towards managing tinnitus.

With success stories and even a free consultation with an expert who understands your condition, Oto is a companion in your journey toward a more peaceful life. Download Oto today on your iOS or Android device and take the first step towards reducing awareness of tinnitus and supporting habituation.

Conclusion

The use of noise-cancelling headphones for tinnitus sufferers presents a nuanced picture with both potential benefits and drawbacks. While they offer the promise of control, comfort, and therapeutic applications, they also come with concerns about exacerbation of symptoms. 

As with any intervention for tinnitus, a personalised approach is key. Consulting with professionals specialising in hearing health, trying different models, and being mindful of one's unique needs and responses can help tinnitus sufferers make informed decisions.

In a landscape filled with various solutions, Oto stands out as a beacon of support, designed to support tinnitus management and reduce awareness of tinnitus. If you're ready to take a decisive step towards reducing awareness of tinnitus and supporting habituation, download the Oto app today.

FAQs

References

1. Lo, A.H.C., McPherson, B. Hearing screening for school children: utility of noise-cancelling headphones. BMC Ear Nose Throat Disord 13, 6 (2013). https://doi.org/10.1186/1472-6815-13-6 
2. Ikuta N, Iwanaga R, Tokunaga A, Nakane H, Tanaka K, Tanaka G. Effectiveness of Earmuffs and Noise-cancelling Headphones for Coping with Hyper-reactivity to Auditory Stimuli in Children with Autism Spectrum Disorder: A Preliminary Study. Hong Kong Journal of Occupational Therapy. 2016;28(1):24-32. doi:10.1016/j.hkjot.2016.09.001 
3. Gallacher, S., Enki, D., Stevens, S., & Bennett, M. (2017). Active noise control in a paediatric intensive care unit: A prospective randomised controlled trial. Intensive Care Medicine Experimental, 5(1), 32.
4. Vogel I, van de Looij-Jansen PM, Mieloo CL, Burdorf A, de Waart F (2014) Risky Music Listening, Permanent Tinnitus and Depression, Anxiety, Thoughts about Suicide and Adverse General Health. PLoS ONE 9(6): e98912. doi:10.1371/journal.pone.0098912 
5. Hoare, D. J., Searchfield, G. D., El Refaie, A., & Henry, J. A. (2014). Sound therapy for tinnitus management: practicable options. Journal of the American Academy of Audiology, 25(01), 062-075.