Tinnitus and Zen

Tinnitus & Zen - Purpose of the presentation

Why refocus on the Zen feature?

What is tinnitus and how is it treated?

What evidence do we have on Zen and tinnitus?

A Zen study – by Robert Sweetow and Jennifer Henderson Sabes (UCSF)

/ Do hearing aid wearers find Zen tones relaxing?

/ Does a Zen tone background reduce tinnitus annoyance and stress?

Summary – what to remember

Why refocusing Zen?

The purpose of refocusing on Zen is to show

The use of Zen for relaxation purposes

Knowledge about documentation on benefits of Zen

The use of Zen as a tool for tinnitus treatment

- from hearing aid users to tinnitus patients

Evidence based audiology - a scientific approach

What exactly is tinnitus?/ The sensation of sound that is not

audible to others

/ Not a disease in itself but a symptom of a range of underlying diseases

/ All kinds of sounds – not only ringing

/ Can problably be caused by damage anywhere in the auditory system

(Vernon & Moeller, 1995, Henry et al., 2008)

Odds of having Tinnitus

(Vernon & Moeller, 1995)

Most common difficulties attributed to tinnitus

/ Sleeping problems

/ That the tinnitus is persistent

/ Speech understanding

/ Despair, frustration, depression

/ Annoyance, irritation,

inability to relax (stress)

/ Concentration

Tyler and Baker 1983

Stress and tinnitus - a constant fight or flight response

Threat

Release of stress hormones

Fast reaction possible

Threat vanished

Stress hormone levels back to normal

Tinnitus management procedures

Counselling

Sound Therapy

Cognitive Strategies

No tinnitus treatment without counselling!

Current sound treatments

Personal devices Other sound sources

Hearing aids Noise generators

Maskers Music

Combination instruments

Everyday sounds

Sound therapy purposes

Distraction

Masking (covering up)

Habituation

Cognitive Therapy

CounselingSound Therapy

Presented at ACAud Congress 2009Data submitted for publication, JAAA

Robert Sweetow &

Jennifer Henderson SabesUniversity of California, San Fransisco

A Zen study

A Zen study - questions

/ Do hearing aid wearers find Zen tones relaxing?

/ Does a Zen tone background reduce tinnitus annoyance and stress?

A Zen study – protocol I

20 UCSF subjects (aged 34-85), mild-to-moderately severe hearing loss.

/ 14 subjects with tinnitus as their primary problem (tinnitus > 1 year, seen previously in clinic for counseling more than 3 month prior to study)

/ 6 hearing impaired persons with mild or no tinnitus

A Zen study – protocol II

The study included 5 visits:

Visit 1: Use of music questions, THI, TRQ, Sleep Questionnaire, Asses your stress inventory etc. Hearing aid fitting.

Visit 2: Determine preferred Zen setting, concentration test, instruction in using Zen (15 minutes per day).

Visit 3 (1 month later) + 4 (3 months later) + 5 (6 months later): Repeated questionnaires on tinnitus and stress etc.

A Zen study – results I

Zen Study - results I

Relaxing68%

Neutral18%

Tensing14%

A Zen study – results II

Like music, it is not expected that Zen is liked by everyone – and Zen is concequently not useful for tinnitus sufferers who dislike the tones

TH

I sc

ore

12 subjects: effetcs of tinnitus milder after 6 months - for 5 the improvement were significant

A Zen study – results III

Do hearing aid users find the Zen Relaxing?

• Yes, 86% found it easier to relax listening to Zen

Does Zen have a positive influence on tinnitus?

• Yes, for some of the subjects. 37% had better scores in THI and TRQ after 6 month of daily Zen use

Zen and tinnitus What to remember from this presentation

References/ Sweetow, R.(2009): Relaxation and Tinnitus. Presentation at

Australian College of Audiology National Congress 2009 (Data submitted for JAAA)

/ Henry, J. A., Trune, D. R., Robb, M. J. A., & Jastreboff, P. J. (2007). Tinnitus retraining therapy: Clinical guidelines. Plural Publishing Inc, 1-160

/ Henry, J. A., Zaugg, T. L., Myers, P. J., & Schechter, M. A. (2008). Using therapeutic sound with progressive audiologic tinnitus management. Trends in Amplification, 12(3), 188-209.

/ Tyler, R. S., & Baker, L. J. (1983). Difficulties experienced by tinnitus sufferers. Journal of Speech and Hearing Disorders, 48(2), 150-154.

/ Vernon, J. A. & Moeller, A. R. (1995). Mechanisms of Tinnitus. Allyn and Bacon. A Simon & Schulster Company. Needham Heights, MA 02194