Tinnitus Maskers

1. What Is a Tinnitus Masker?

A tinnitus masker is a device that produces sound to make tinnitus less noticeable. Tinnitus is the perception of ringing, buzzing, hissing, or other noises in the ears when no outside sound is present. Learn more about tinnitus, its causes, and symptoms.

For many people, tinnitus becomes more noticeable in quiet environments, particularly when trying to fall asleep. A masker introduces gentle background sound, making the tinnitus less prominent and easier to ignore.

The purpose of a tinnitus masker is not to eliminate tinnitus, but to reduce how much it interferes with daily life.

Some maskers are small devices worn in the ears, similar to hearing aids. Others are bedside sound machines or smartphone applications. Even a simple fan can provide useful background sound.

2. How Do Tinnitus Maskers Work?

Tinnitus often develops when the hearing system is damaged or no longer sends normal sound signals to the brain. The cochlea (the hearing organ in the inner ear) may send fewer signals, particularly in people with hearing loss. The brain can respond by changing how it processes sound, which may contribute to tinnitus. Learn more about hearing loss.

In a quiet room, there are few outside sounds competing for the brain's attention. As a result, tinnitus can become more noticeable.

Tinnitus maskers work by introducing an external sound that competes with the tinnitus. This can help in two ways.

Masking: The external sound partially or completely covers the tinnitus, making it harder to hear.

Distraction: The external sound gives the brain something else to focus on, reducing the attention given to tinnitus.

Over time, some people also become less bothered by their tinnitus through a process called habituation (when the brain learns to pay less attention to a familiar sound). However, it has not been clearly established that masking devices themselves produce lasting habituation.

3. What Types of Tinnitus Maskers Are Available?

Several devices can provide sound masking. The most appropriate choice depends on the person's hearing, the severity of their tinnitus, and when they need relief.

Bedside Sound Machines

These devices produce continuous background sounds, such as rainfall, ocean waves, or white noise. White noise is a steady sound similar to the static heard on an untuned radio.

They are particularly useful for people whose tinnitus becomes bothersome when trying to sleep. A small bedside speaker can provide enough background sound to make tinnitus less noticeable without disturbing sleep.

Wearable Tinnitus Maskers

Wearable maskers are small electronic devices placed inside or behind the ear. They look similar to hearing aids but produce gentle sounds instead of primarily amplifying outside noise.

These devices can be useful for people who need relief throughout the day, particularly when working in quiet environments.

An audiologist or audioprosthetist (a hearing healthcare professional) can help select and adjust the masking sound to make it comfortable.

Hearing Aids With Built-In Maskers

Many modern hearing aids include a tinnitus sound generator. These devices combine two functions: they amplify outside sounds to improve hearing and can produce additional background noise to make tinnitus less noticeable.

For people who have both hearing loss and tinnitus, properly fitted hearing aids are often the first device to consider.

In many cases, simply improving hearing makes tinnitus less noticeable. The additional masking feature may not always be necessary.

Smartphone Apps and Everyday Sounds

Several smartphone applications offer white noise, rainfall, wind, ocean sounds, and other background noises. These sounds can be played through a speaker or headphones.

Other everyday options include a fan, an air purifier, or soft background music.

There is no convincing evidence that expensive masking devices consistently provide better results than simpler sound sources. For many patients, a basic sound machine is sufficient.

4. What Sounds Are Best for Masking Tinnitus?

There is no single sound that works best for everyone. Some people prefer a continuous noise, while others find natural sounds more relaxing.

Common options include:

• White noise: A steady, static-like sound containing a wide range of frequencies.
• Pink noise: A softer-sounding type of noise with less emphasis on high-pitched frequencies.
• Nature sounds: Rainfall, flowing water, ocean waves, or wind.
• Soft music: Gentle instrumental music or other relaxing sounds.

The best sound is usually one that is pleasant, easy to tolerate, and does not require much attention.

Patients often ask whether the masking sound should match the pitch of their tinnitus. In most cases, this is unnecessary. Comfort and personal preference are more important than trying to match the exact tinnitus frequency.

5. How Loud Should a Tinnitus Masker Be?

One common mistake is increasing the masking sound until the tinnitus disappears completely.

Although complete masking can provide temporary relief, it is not always necessary. For some people, the level required to completely cover their tinnitus can be uncomfortable.

A better starting point is to use a gentle background sound that makes tinnitus less noticeable without overpowering other sounds.

For example, imagine hearing your tinnitus while sitting in a silent bedroom. Turning on a fan may not eliminate the tinnitus completely, but it can make the ringing blend into the background. This may be enough to help you relax or fall asleep.

This approach is called partial masking, and it is often a practical way to use sound therapy.

The sound should remain at a safe, comfortable volume. Prolonged exposure to loud sounds can damage hearing and potentially worsen tinnitus. Masking should never interfere with conversations, alarms, or other important environmental sounds.

6. Do Tinnitus Maskers Really Work?

Sound masking can provide meaningful relief for some people, particularly while the masking sound is playing. However, the scientific evidence supporting a lasting reduction in tinnitus is less convincing.

A 2018 Cochrane review, which examined studies of hearing aids, sound generators, and combination devices, found insufficient high-quality evidence to determine whether one type of device was more effective than another.

The 2024 U.S. Department of Veterans Affairs and Department of Defense clinical guidelines support the use of therapeutic sound as a self-management option for tinnitus, although the strength of the recommendation is weak because the available evidence remains limited.

In practical terms, this means that sound therapy is reasonable to try, but its benefits vary from person to person.

Maskers are most useful for managing the perception of tinnitus while the sound is playing. They should not be presented as a treatment that permanently removes tinnitus.

Some patients find that masking improves sleep and concentration. Others experience only minor relief, while some notice no benefit.

7. Who Is Most Likely to Benefit From a Tinnitus Masker?

Sound masking may be particularly helpful for people whose tinnitus:

• Becomes more noticeable in quiet surroundings.
• Interferes with falling asleep.
• Makes reading, working, or concentrating difficult.
• Improves when other background sounds are present.

For patients with hearing loss, hearing aids may be more appropriate than a standalone masker because they restore access to everyday sounds while also making tinnitus less noticeable.

People with hyperacusis (increased sensitivity to everyday sounds) may find some masking sounds uncomfortable. In these cases, sound therapy should be introduced carefully, often with guidance from a hearing healthcare professional. Read about hyperacusis and sound sensitivity.

Not everyone needs a dedicated masker. If tinnitus is mild and does not affect sleep, concentration, or daily activities, treatment may not be necessary.

8. How Should You Start Using a Tinnitus Masker?

For most patients, the simplest approach is to begin with an inexpensive source of background sound before purchasing a specialized device.

Start by choosing a pleasant, continuous sound, such as gentle rainfall or a fan. Adjust the volume until the tinnitus becomes less noticeable while the background sound remains comfortable.

Use the sound during situations when tinnitus is particularly bothersome. This may be while reading, working, relaxing, or preparing for sleep.

A bedside speaker is generally more practical than wearing earbuds throughout the night. It also avoids the discomfort that can develop from prolonged use of devices inside the ears.

If sound masking provides relief, it can become part of a daily routine. If there is little improvement, simply increasing the volume is unlikely to be the solution.

A hearing healthcare professional can help determine whether a different sound, wearable device, or hearing aid would be more appropriate.

9. Are Tinnitus Maskers Enough to Treat Tinnitus?

Tinnitus maskers are only one of several options used to manage tinnitus. To learn more about the tinnitus treatment recommendations from the American Academy of Otolaryngology, read this article.

When tinnitus remains bothersome, other evidence-based treatments may be recommended.

Hearing aids: They can improve both hearing and tinnitus symptoms when hearing loss is present.

Cognitive behavioural therapy (CBT): This is a structured therapy that helps people change how they react to tinnitus. It has stronger evidence for reducing tinnitus-related distress and improving quality of life than masking devices alone.

Education and counselling: Understanding tinnitus and learning practical ways to manage it can reduce the frustration and concern associated with the condition.

Sound masking can be combined with these approaches when appropriate. It is not a substitute for treating an underlying hearing problem or other medical condition.

10. Final Thoughts: Are Tinnitus Maskers Worth Trying?

Tinnitus maskers offer a simple, non-invasive way to make ringing or buzzing in the ears less noticeable. They can be particularly helpful in quiet environments and at bedtime, when tinnitus often becomes more difficult to ignore.

However, masking devices do not cure tinnitus, and their long-term benefits remain uncertain. The goal is to make tinnitus less intrusive, not necessarily to make it disappear completely.

For many patients, starting with a simple background sound is reasonable. Those with persistent or troublesome tinnitus should undergo a hearing evaluation, with ENT consultation when appropriate. Identifying hearing loss or another underlying condition, together with selecting the right management strategy, offers the best opportunity for lasting improvement in quality of life.

11. References

1. Sereda M, Xia J, El Refaie A, Hall DA, Hoare DJ. Sound therapy (using amplification devices and/or sound generators) for tinnitus. Cochrane Database of Systematic Reviews. 2018;12. https://doi.org/10.1002/14651858.CD013094.pub2
2. Department of Veterans Affairs and Department of Defense. VA/DoD Clinical Practice Guideline for Tinnitus. 2024. Read the clinical guideline.
3. Tunkel DE, Bauer CA, Sun GH, et al. Clinical Practice Guideline: Tinnitus. Otolaryngology–Head and Neck Surgery. 2014;151(2 Suppl)–S40. https://doi.org/10.1177/0194599814545325
4. National Institute for Health and Care Excellence (NICE). Tinnitus: Assessment and Management. NICE Guideline NG155. 2020. https://www.nice.org.uk/guidance/ng155