Ear plugs can be a useful tool for protecting hearing and reducing tinnitus intrusion. There are many styles of ear plugs ranging from foam plugs to custom molded ear plugs for specific activities. But ear plugs can be improperly or over-used such that they actually worsen tinnitus. So, when should you use ear plugs and how can they help instead of hinder tinnitus? Oto presents everything you need to know about ear plugs and tinnitus.
Alexandra Costlow, Au.D.

Alexandra Costlow, Au.D.

Medically Reviewed by
Audiologist and Tinnitus Specialist
December 9, 2021

Tinnitus & Ear Plugs: How To Use Ear Plugs To Help Tinnitus

Ear plugs can be a useful tool for protecting hearing and reducing tinnitus intrusion. There are many styles of ear plugs ranging from foam plugs to custom molded ear plugs for specific activities.

But ear plugs can be improperly or over-used such that they actually worsen tinnitus.

So, when should you use ear plugs and how can they help instead of hinder tinnitus? Oto presents everything you need to know about ear plugs and tinnitus.

Can Ear Plugs Cause Tinnitus?

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Nearly anyone who has experienced bothersome tinnitus has wondered if using ear plugs could help to stop or at least soften their tinnitus. Usually after inserting ear plugs, people notice that their tinnitus isn't better, but rather it is actually worse.

Although the natural inclination is to want to plug up the ears, this not surprisingly makes tinnitus worse as it reduces the amount of environmental sound that can reach the ears and mask the tinnitus.

We refer to tinnitus as noise inside of the head whereas environmental sound is considered external. When there is a lack of external sound, internal noise (i.e. tinnitus) tends to be more noticeable.

Essentially, there is a balance of internal noise and external noise and when that scale is tipped towards internal noise, tinnitus becomes more noticeable and potentially bothersome. As such, ear plugs cut out some degree of external noise and make internal noise more noticeable.

In cases where there is tinnitus and hearing loss, it's important to address the hearing loss with hearing aids (or medically or surgically when indicated) to restore as much normal hearing as possible.

In cases when hearing levels are normal and tinnitus is bothersome, a tinnitus masker can be a useful tool for filling the soundscape with ambient sound that masks or blends with the tinnitus to make it less noticeable.

How To Use Ear Plugs Properly

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A good rule of thumb for ear plugs is to carry them with you in case you need them, but only use them if truly needed as over-use can lead to reduced sound tolerance, hyperacusis, and tinnitus.

But, how do you know if sound is harmful? We think of sound as a dose and according to the National Institute for Occupational Safety & Health (NIOSH), a person is expected to be able to tolerate 85dB of sound for up to eight hours before it could damage their hearing permanently. For every additional 3dB of sound, the safe exposure time is halved such 88dB would be so considered safe for up to four hours, and 91dB would be considered safe for up to two hours, and so forth.

Foam ear plugs are a convenient and inexpensive way to protect your hearing. It's important to use them properly: how to use foam hearing protection.

It's important to only use hearing protection on an as-needed basis as overuse can lead to reduced sound tolerance and a temporary uptick in tinnitus symptoms.

This is because use of ear plugs can result in a reduced range of sound that travels along the auditory pathway from the ear to the central nervous system. The central nervous system adapts by increasing central gain, which is the ability to sense soft sound.

Generally the tinnitus subsides once the ear plugs are removed, but sound sensitivity and hyperacusis can take more time to recover. Over time, the central nervous system recoups its ability to tolerate a fuller range of sound.

Ear Plugs And Sound Sensitivity

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Some people fear that everyday sounds, such as a door closing or an indicator beeping, may damage their hearing or make tinnitus worse. This is referred to as phonophobia, or fear of sound.

Phonophobia is different from reduced sound tolerance or the clinical form of sound intolerance, hyperacusis, in that there is a psychological component that affects the person's ability to complete tasks of daily living such as housework, running errands, traveling to work or school, or enjoying social gatherings.

An audiologist can test your ability to tolerate the full range of sound and determine if you have reduced sound tolerance or hyperacusis. Similarly, an audiologist can advise you regarding your tinnitus and whether it might be related to improper use of ear plugs.

It can be useful to know where to find professional tinnitus help in the event that you notice any of these symptoms:

  • Inability to tolerate everyday sounds such as a door closing, kitchen utensils, traffic, or other common sounds that other people find tolerable
  • Fear of everyday sounds
  • Bothersome tinnitus that interferes with daily activities such as sleep, work, school, concentration, or relaxation

An audiologist can determine if you have reduced sound tolerance, clinical hyperacusis, or phonophobia. Phonophobia and hyperacusis are distinct disorders that require different management plans.

Phonophobia can lead to over-use of ear plugs which then leads to reduced sound tolerance and potentially hyperacusis. These conditions can significantly affect quality of life but there is hope for improved quality of life.

Similar to CBT for tinnitus, cognitive behavioural therapy (CBT) techniques can be a powerful tool for identifying triggers; reframing them as neutral or positive as opposed to negative; and changing thoughts and behaviour surrounding fear of sounds.

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Ear Plugs To Help Tinnitus

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There are situations where ear plugs are warranted to protect hearing and reduce the intrusion of tinnitus: when sound is harmfully loud such as at a concert, sporting event, while using power tools, riding motor vehicles, or other loud hobbies or activities. No matter what they are for, ear plugs should never hurt or cause discomfort, and they should feel secure in the ear.

To have custom ear plugs made, consult an audiologist who can examine the ear, make an impression, select the optimal ear piece and features, and provide education regarding how to insert, remove, and clean the ear piece.

There are a variety of ear plugs that are specially tailored for specific listening situations.

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For musicians, custom musician ear plugs reduce sound equally across the frequency spectrum such that music retain high fidelity of spectral components (i.e. bass and treble). Musician ear plugs can come with a variety of attenuation levels, generally ranging from 9dB (mild), 15dB (moderate), and 25dB (significant) attenuation.

In-ear monitors also offer sound attenuation as well as direct streaming of sound from an audio source for good fidelity on stage. Generally these are used by professional musicians.

Swim Plugs

Swim plugs are useful for preventing water from entering the ear canal during showering, bathing, swimming, or other activities that involve water. If you worry about getting water in your ears, consider an over the counter swim plug or custom swim plug that is specifically molded for your ears.

The most important aspects of swim plugs are that they fit the ear securely and comfortably, and that they actually prevent water from entering the ear canal.

If you don't prefer to use swim plugs for bathing or swimming, you can pat dry the outer ear with a towel to keep it healthy and dry. For otherwise healthy ears, a small amount of moisture isn't harmful and will dry on its own.

Best Ear Plugs For Sleeping

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Ear plugs can be a great tool for people who want to reduce environmental noise that can't otherwise be eliminated (such as noisy neighbours or street noise). They also empower the user with a sense of control over their ability to reduce bothersome noise and get restful sleep.

Westone's custom sleep plugs can attenuate sound by 37-39dB. An impression of the ear must be cast by an audiologist who will order the sleep plugs through Westone or another ear piece manufacturer.

For an inexpensive and easy solution, try Mack's Ultra Soft Foam Earplugs, which reduce sound by as much as 33dB and are available for purchase on Amazon. Foam earplugs can also be purchased at most pharmacies and at other retail locations.

If tinnitus is your concern (as opposed to reducing noise), consider using a tinnitus pillow or a white noise machine. It's also helpful to practice good sleep hygiene and reference how to sleep with tinnitus.

Noise Cancelling Ear Plugs

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For people who want to reduce the intrusion of a noisy environment during waking hours, noise cancelling ear plugs can be a good solution. Technically, noise cancelling ear plugs work two ways:

  1. Blocking sound from entering the ear canal (referred to as passive noise cancellation), such as foam ear plugs
  2. Producing a pleasant, non-interesting background sound to mask bothersome environmental sounds (referred to as active noise cancellation)

Examples of ear buds that use active noise cancellation (in addition to some degree of passive noise cancellation) include:

Bose QuietComfort Noise Cancelling Ear Buds feature touch control, controllable noise cancellation, and recharge-ability

Sennheiser Momentum True Wireless 2 earbuds offer a convenient and discreet wireless ear bud option for noise cancellation

An important consideration regarding noise cancellation is that it should be used on an as-needed basis as over-use (i.e. all or most of the time) can lead to increased tinnitus and sound sensitivity complaints. In addition to ear buds, there are also noise cancelling headphones for tinnitus.

Join Oto

Learn how to reduce the impact of bothersome environmental noise and tinnitus using CBT techniques. The Oto app also features:

  • Meditation, breathing, and visualisation exercises to promote relaxation
  • Bedtime tools such as sleep sounds and stories, mindfulness for sleep, sleep preparation, as well as dark mode to reduce visual stimulation while using the app at sleep times
  • A wide array of audio landscapes for sound enrichment, as well as ASMR
  • Sleep support

Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!

Tinnitus relief made simple with the Oto app digital therapy programme. Download today.

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