Recent evidence has suggested that amplitude modulated tones might have some advantages over broadband noise.


Fifty-six subjects listened to S-Tones at a carrier frequency matched at the tinnitus pitch (amplitude modulation rate of 40 Hz) and to broadband noise. Subjects rated their tinnitus loudness before, during, and after a 120-s duration masker.


The results suggested that S-Tones were generally more effective at reducing tinnitus loudness than noise. In about one third (21/56) of the subjects, there was no significant effect from any masker. In other subjects, 54.3% (19/35) showed a greater reduction for the S-Tones, 20% (7/35) showed a greater reduction with the noise, and 25.7% (9/35) showed similar performance between the 2 stimuli. The S-Tones showed a statistically significant benefit (p < .01) versus noise at reducing the patient's tinnitus perception. Using low-level stimuli that were rated much softer than the subjects' baseline tinnitus, the S-Tones reduced the tinnitus loudness by 1.9 times the amount that noise did (about 28% on average, whereas the noise reduced the tinnitus by about 15%).


S-Tones at the tinnitus pitch-match frequency are more likely to be effective than broadband noise at reducing tinnitus loudness.


  • Andersson, G., & Lyttkens, L. (1999). A meta-analytic review of psychological treatments for tinnitus.British Journal of Audiology, 33, 201–210.
  • Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties.Journal of Consulting and Clinical Psychology, 56, 893–897.
  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.Clinical Psychology Review, 8, 77–100.
  • Bentler, R. A., & Tyler, R. S. (1987, May). Tinnitus management.ASHA, pp. 27–32.
  • Coelho, C., Witt, S., Ji, H., Hansen, M., Gantz, B., & Tyler, R. (2013). Zinc to treat tinnitus in the elderly: A randomized placebo controlled crossover trial.Otology & Neurotology, 34, 1146–1154.
  • Coles, R. R. A. (1987). Tinnitus and its management.In D. Stephens, & A. G. Kerr (Eds.), Scott-Brown's otolaryngology (Vol. 2, pp. 368–414). London, United Kingdom: Butterworth.
  • De Ridder, D., Vanneste, S., Engineer, N., & Kilgard, M. (2014). Safety and efficacy of vagus nerve stimulation paired with tones for the treatment of tinnitus: A case series.Neuromodulation, 17, 170–179. doi:10.1111/ner.12127
  • Folmer, R. L., & Carroll, J. R. (2006). Long-term effectiveness of ear-level devices for tinnitus.Otolaryngology—Head and Neck Surgery, 134, 132–137.
  • Folmer, R. L., Martin, W. H., Shi, Y., & Edlefsen, L. L. (2006). Tinnitus sound therapies.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 176–186). New York, NY: Thieme.
  • Hallam, R. S. (1989) Tinnitus—Living with the ringing in your ears. New York, NY: HarperCollins.
  • Hallam, R. S., & McKenna, L. (2006). Tinnitus habituation therapy.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 65–80). New York, NY: Thieme.
  • Hatanaka, A., Ariizumi, Y., & Kitamura, K. (2008). Pros and cons of tinnitus retraining therapy.Acta Oto-Laryngologica, 128, 365–368.
  • Hazell, J. W. P. (1987). Tinnitus masking therapy. InJ. W. P. Hazell (Ed.), Tinnitus (pp. 96–117). London, United Kingdom: Churchill Livingston.
  • Henry, J. L., & Wilson, P. H. (2001). The psychological management of chronic tinnitus: A cognitive-behavioral approach. Boston, MA: Allyn & Bacon.
  • Henry, J. L., & Wilson, P. H. (2002). Tinnitus: A self-management guide for the ringing in your ears. Boston, MA: Allyn & Bacon.
  • Jastreboff, P. J. (1995). Tinnitus as a phantom perception: Theories and clinical implications.In J. Vernon, & A. Moller (Eds.), Mechanisms of tinnitus (pp. 73–87). Boston, MA: Allyn & Bacon.
  • Jastreboff, P. J. (1998). Tinnitus the method of Pawel J. Jastreboff.In G. A. Gates (Ed.), Current therapy in otolaryngology–head & neck surgery (6th ed., 90–95). St. Louis, MO: Mosby.
  • Jastreboff, P. J., & Hazell, J. W. P. (1993). A neurophysiological approach to tinnitus: Clinical implications.British Journal of Audiology, 27, 7–17.
  • Kuk, F. K., Tyler, R. S., Russell, D., & Jordan, H. (1990). The psychometric properties of a tinnitus handicap questionnaire.Ear and Hearing, 11, 434–442.
  • Liang, L., Lu, T., & Wang, X. (2002). Neural representations of sinusoidal amplitude and frequency modulations in the primary auditory cortex of awake primates.Journal of Neurophysiology, 87, 2237–2261.
  • Mohr, A.-M., & Hedelund, U. (2006). Tinnitus person-centered therapy.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 198–216). New York, NY: Thieme.
  • Pan, T., Tyler, R. S., Ji, H., Coelho, C., Gehringer, A. K., & Gogel, S. A. (2009). Changes in the Tinnitus Handicap Questionnaire after cochlear implantation.American Journal of Audiology, 18, 144–151.
  • Reavis, K. M., Rothholtz, V. S., Tang, O., Carroll, J. A., Djalilian, H., & Zeng, F. G. (2012). Temporary suppression of tinnitus by modulated sounds.Journal of the Association for Research in Otolarygology, 13, 561–571.
  • Searchfield, G. (2006). Hearing aids and tinnitus.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 161–175). New York, NY: Thieme.
  • Searchfield, G. D., Kaur, M., & Martin, W. H. (2010). Hearing aids as an adjunct to counseling: Tinnitus patients who choose amplification do better than those that don't.International Journal of Audiology, 49, 574–579.
  • Sweetow, R. W. (2000). Cognitive Behavior Therapy and tinnitus.In R. S. Tyler (Ed.), Tinnitus handbook (pp. 297–311). San Diego, CA: Singular.
  • Tyler, R. S. (2006a). Neurophysiological models, psychological models, and treatments for tinnitus.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 1–22). New York, NY: Thieme.
  • R. S. Tyler (Ed.). (2006b). Tinnitus treatment: Clinical protocols. New York, NY: Thieme.
  • R. S. Tyler (Ed). (2008). The consumer handbook on tinnitus. Sedona, AZ: Auricle.
  • Tyler, R. S., & Babin, R. W. (1986). Tinnitus.In C. W. Cummings, J.-M. Fredrickson, L. Harker, C. J. Krause, & D. E. Schuller (Eds.), Otolaryngology—Head and neck surgery (Vol. 4, pp. 3201–3217). St. Louis, MO: Mosby.
  • Tyler, R. S., Gehringer, A. K., Noble, W., Dunn, C. C., Witt, S. A., & Bardia, A. (2006). Tinnitus activities treatment.In R. S. Tyler (Ed.), Tinnitus treatment: Clinical protocols (pp. 116–132). New York, NY: Thieme.
  • Tyler, R. S., Oleson, J., Noble, W., Coelho, C., & Ji, H. (2007). Clinical trials for tinnitus: Study populations, designs, measurement variables, and data analysis.Progress in Brain Research, 166, 499–509.
  • Vernon, J., & Meikle, M. (2000). Tinnitus masking: Theory and practice.In R. S. Tyler (Ed.), Handbook of tinnitus (pp. 313–356). San Diego, CA: Singular.

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