Masking or notched therapy: what is better for tinnitus?

Sound is the first practical help against tinnitus — but "sound therapy" means two very different things. Let us tell them apart, so we can choose the right tool for the right purpose.

Masking: covers the noise

Masking adds a pleasant sound over the tinnitus — rain, white or pink noise, nature sounds — so the ringing stands out less. The advantage is that it works immediately and is excellent for falling asleep. The disadvantage: the effect lasts only while playing; once it stops, the ringing returns, because masking does not change the cause.

What the data say: a large Cochrane review of 8 studies with 590 people does not find masking superior to placebo or standard audiological care, and the quality of evidence is low. This does not make it useless — it remains a valuable tool for temporary relief and for sleep.

Notched: removes your frequency

The notched approach does the opposite of masking. First the exact pitch of your tinnitus is identified, then it is removed from the sound you hear — like taking a key off a piano. The goal is not to cover the noise momentarily, but to reduce the "feed" of the overactive neurons, so that neighbouring neurons inhibit them (lateral inhibition).

What the data say: in the study by Okamoto and Pantev (PNAS, 2010), regular listening to individually filtered music leads to approximately 30% less ringing after 12 months, with a measurable reduction in hyperactivity in the auditory cortex. It is an approach that targets the cause, not just the symptom.

Which for whom

• For immediate relief and sleep — masking with a soft sound at low volume.
• For a lasting result with tonal tinnitus (with a clear pitch) — the notched approach, regularly, with months of patience.

The best is actually to combine them: a notched sound that is also pleasant to listen to in the evening. This is exactly what we have built into AURALIS — the test finds your frequency, and the sounds remove it, without losing their gentleness.

In short

Masking hides the noise now; the notched approach works on the cause over time. Do not choose "either/or" — use masking when you want quiet immediately and notched when you seek a lasting change.