
A music-lover's guide to tinnitus - thirdsun
https://www.residentadvisor.net/features/2985
======
amluto
The article repeats points like this quite a few times:

> I like hearing my music at loud volumes, as everyone does.

I don't think this is true. A lot of people like going to the kinds of events
that have loud music, but I've seen a _lot_ of people who don't like the
volume. One obvious example: most of the weddings I've been to recently turn
into dance parties, and the volume creeps its way up and up. As this happens,
a lot of the guests start moving farther from the speakers, off the dance
floor, and eventually out of the room. Dancing: lots of fun. Ear-splitting
volume: not necessarily.

At my wedding, we picked a great band and kept the music at a comfortable
level, and most of the guests danced the whole time and even the non-dancing
guests clustered around the dance floor. I can't prove causation, but I bet
the tolerable volume had a lot to do with it.

So maybe the real solution is for people to start trying to figure out why the
norm for concerts is to have the volume painfully loud. It's possible that
guests just might enjoy them more with quieter music.

~~~
jdietrich
Our perception of loudness is highly subjective and we quickly acclimatise to
loud music. Music sounds superficially better at louder volumes, hence the
notorious loudness war in music production [1]. This is one of the big risks
of using headphones - it's easy for the volume to creep up to dangerous levels
if you're not worried about disturbing the neighbours.

Sound engineers often suffer from a significant degree of noise-induced
hearing loss. Hearing loss is highly dose-dependent, so working with live
sound equipment on a daily basis is far more damaging than going to the
occasional loud concert. As a result, they tend to set the house volume too
loud. Noise-induced hearing loss affects the high frequencies first, so live
sound is often extremely shrill and trebly to compensate. Those engineers who
don't have noise-induced hearing loss have made a habit of wearing ear
protection, which has basically the same effect.

The unfortunate solution is to wear ear protection to any amplified live music
event. I recommend the Etymotic ER-20xs [2]. You'll hear a better, more
balanced sound at a much safer volume level.

[1]
[https://en.wikipedia.org/wiki/Loudness_war](https://en.wikipedia.org/wiki/Loudness_war)

[2][https://www.etymotic.com/consumer/hearing-
protection/er20xs....](https://www.etymotic.com/consumer/hearing-
protection/er20xs.html)

~~~
pbhjpbhj
Is there any reason not to use a decibel meter to set up volumes. And perhaps
to use computer assistance to balance instrument volumes and profile the
sound. Seems like a couple of mics around a room and you could adjust to get
the best sound for the whole room rather than [just] the sound desk? I'd guess
they're doing that already at big concerts.

It seems very like colour profiling to me. Graphic designers seem to match to
objective standards though, whilst sound techs seem instead to use their own
perception at the time?

~~~
jdietrich
Here in the UK, it's common for venues to have automatic sound limiting
devices - exceed a certain threshold and power to the PA system is
disconnected [1]. These systems are a source of constant frustration for
engineers, performers and clients.

The problem is that good live sound is highly dynamic. If you ran the PA at
exactly 85dBa all night, it would sound very flat and unengaging. You want to
push the volume during lively upbeat songs and bring it back down for an
intimate ballad, you want a bit of a lift during the chorus, you want natural
crescendos and diminuendos. Really good engineers can maintain this sense of
dynamism while keeping the overall levels under control by using time-averaged
metering, but systems capable of that are quite costly.

Achieving a consistent volume level throughout the venue is much easier said
than done. Normal loudspeakers follow the inverse square law, so the sound
will be much louder close to the PA system. You can't just put a bunch of
speakers all over the room, because you'll get weird phase effects - sound
moves at about one foot per millisecond, so additional speakers tend to cause
very unpleasant delay and comb filtering effects [2]. This can be mitigated by
the use of electronic delay compensation for the additional relay speakers,
but not eliminated entirely.

The inverse square law can be evaded by using a line array loudspeaker system
[3]. Theses systems use multiple loudspeakers in a phased array, which
produces a cylindrical rather than spherical wavefront. Line arrays give a
much more even distribution of sound and also reduce the amount of energy that
is reflected from the ceiling and floor, providing a much clearer sound with
more accurate transient response. Historically, line arrays have been
expensive and difficult to configure, so they have been confined to large
venues and high-end touring systems. Compact integrated line array systems are
now available from many manufacturers, so hopefully we should see an
improvement in the general standard of live sound over the coming years.

[1] [https://noiselimiters.co.uk/scx-noise-limiter-and-
contactor-...](https://noiselimiters.co.uk/scx-noise-limiter-and-
contactor-p-79.html?osCsid=fc0a2fa66d393ae79ff236ae5b6723dc)

[2]
[https://en.wikipedia.org/wiki/Comb_filter](https://en.wikipedia.org/wiki/Comb_filter)

[3]
[https://en.wikipedia.org/wiki/Line_array](https://en.wikipedia.org/wiki/Line_array)

~~~
pbhjpbhj
> If you ran the PA at exactly 85dBa all night, it would sound very flat and
> unengaging. //

I was thinking more having an RMS max target dBA/dB(SPL) and a cut-off above
that to limit instantaneous volume rather than requiring a particular level
for the night.

I'm in the UK; I know a little about phase effects having set up a few room
level PAs (5 instruments, 3 mics, 6 speakers, single board; that sort of
size). However, I'm not familiar with large set-ups as I've only attended
smaller concerts of the order of 100s-1000s of people.

------
jdc0589
as a metalhead and frequent concert-goer, this is something I am INCREDIBLY
careful about. I'm one of those people that already has a hard time hearing in
environments with background noise for some reason.

1\. earplugs at shows or anywhere with sustained loud sound are critical.
Disposable foam earplugs are a last resort. If you are a frequent concert-
goer, do yourself a favor and AT LEAST get a pair of Eymotic ETY-Plugs or
something similar ($13, [https://www.amazon.com/ETY-Plugs-Fidelity-Earplugs-
Standard-...](https://www.amazon.com/ETY-Plugs-Fidelity-Earplugs-Standard-
Frost/dp/B0015WJQ7A)). They will fit way better, isolate more sound, and sound
a TON better; you will still be able to enjoy the show, I promise.

2\. If you go to shows a lot, get custom plugs made; just do it. Price will be
$80-$200, including getting professional molds made by an audiologist, but it
is worth it. I can not even feel mine when they are in my ears, the fit is
that good (mine are from 64 Audio, they have a 20% off sale a few times a
year).

3\. If you spend a lot of time with headphones, be really careful about
keeping the volume low. If something sounds too faint, just leave it for a few
minutes; a lot of they time your ears adjust and that lower volume you thought
was too faint is actually just fine or maybe even still too loud.

4\. I acknowledge how ridiculous of a suggestion this is price wise, but if
you spend hours a day with headphones on, consider custom molded IEMs. Yes,
they are expensive as shit (anywhere from ~$250 to infinity dollars), but they
will seal in your ears perfectly. This gives you much better isolation from
ambient sound in your environment, so you can listen to music at MUCH lower
volumes comfortably. On average, sound quality is MUCH better than the
headphones/earbuds you were using before too.

Do not fuck about with your hearing.

~~~
asteli
I've tried a few different attenuator earplugs, and the most compelling I've
found are the Earasers. ($40 [https://www.amazon.com/Earasers-
HEM001-Musicians-Plugs-Mediu...](https://www.amazon.com/Earasers-
HEM001-Musicians-Plugs-Medium/dp/B00E2D9HAA/?th=1) ). They're very comfortable
and low-profile. If you're the kind of person who prefers not to advertise
that they're using earplugs (silly I know, but a consideration for a lot of
people), these are great, because they're basically invisible when in use.

And +1 on the custom earmold. I use mine routinely. I do use the earasers when
attending shows with a moshpit, as it's possible to have the filters get
dislodged and lost in the fray.

~~~
jdc0589
How do they attenuate lower bass frequencies? Granted, its pretty
tough/impossible for an earplug to do at concert volumes, but my only
complaint about most plugs is the lows aren't attenuated as much as everything
else.

------
probably_wrong
> As one RA employee puts it, dance music is "not made to be played to people
> wearing earplugs. When you put them in it's never going to sound the same."

This seems to me very similar to the reasons people give to avoid using
condoms. And helmets. And smoking.

I think putting hundreds of young people in a room guaranteed to give you
hearing loss is madness. But then again, I was always boring.

~~~
lfam
A good club sound system doesn't actually need to be very loud. It will still
be loud enough that long-term exposure will cause hearing loss, but not loud
enough that you would be shocked when you walk in the room.

Unfortunately, a sound system of that quality is extremely expensive and
requires skilled workers to operate each night, so only clubs in places that
allow clubs to operate openly and make money can afford it.

If a city doesn't allow clubs to stay open all night, or if the police crack
down on drug use, the clubs go underground and don't make any money (or won't
invest it in equipment that may be confiscated). Then, they use lower-quality
equipment that must be played too loud in order to fill the space, and don't
hire sound engineers to operate the system properly and safely.

~~~
whatshisface
>operate

How do the accoustcs change from one day to the next?

~~~
ehnto
Also it changes from one track to the next. These days it's normally not that
big of a deal because we have hit some kind of concensus about a good mix in
most genres. But it will still change between genres. What's best for one
isn't for another.

The technitian might also be key to keep the DJ in check. Nothing is worse
than the sound of a clipping mixer because the DJ is inexperienced and thinks
louder is better.

~~~
ovao
It's not always lack of experience: there's a mantra among some DJs that if
you "aren't redlining you aren't headlining". I'm not a proponent of it, but
I've heard the expression used more than a few times in the past couple years.

One of the most respected DJs in the Chicago footwork/juke scene always clips,
at all times. It's apparently a thing.

~~~
ehnto
You're right I could definitely see it working for juke and as a style for
some other genres.

------
flavio81
As a drummer && music-lover && audiophile myself, I always stress out to other
people the importance to protect ones' hearing. For me, hearing is an even
more important sense than vision and I think good old Ludwig van Beethoven
would agree with me (and Stevie Wonder -an idol of mine- too.)

I really can't understand how loud people can put the music on social
gatherings like parties, weddings, etc. I _do_ like loud (circa 90-96 dB
A-weighted) music, but only if the following conditions are met:

\- The sound system reproduces the music with good tonal balance and very loud
distortion

\- _This loud level won 't last more than 15 minutes_

\- The music is good :)

There is, at least in my country, some sort of obsession with adding music at
all places. Like if music was necessary for any container with more than one
human being...

Wear earplugs, friends!! I use the cheap orange 3M ones, made of foam, and,
while they do change the freq response of your ear, it doesn't do it on a too
obnoxious way.

From the article i found this:

> Finally, custom-moulded "musicians'" earplugs offer high sonic precision
> suitable for professional use.

I didn't know about this. This is great advice.

~~~
Nexxxeh
Have you tried the middle ground, like the ER-20xs recommended elsewhere in
this thread? I like the Ear Peace HD's, but Alpine MusicSafe Pros are great
too. They're so much better than the cheap foam ones, but aren't anywhere near
as expensive as the moulded professional ones.

------
hfkeysrdhf
I'd like to point out that, sadly, not all tinnitus is caused by hearing loss.

My tinnitus started despite being young and having subjected myself to far
fewer loud noises, including concerts, than the average person. My doctor
believes that mine is likely due to a neurological issue, but that we will
never know the true cause. To satisfy our own curiosity (and determine if we
could attempt to treat it with steroids, which is possible during the few
weeks after the onset of tinnitus induced by hearing loss), we had my hearing
tested. As expected, absolutely no hearing loss.

As others have said, I felt suicidal during those first few weeks. Thankfully,
I've since learned to live with it.

~~~
goeric
Mine was came after attempting to pop my ears during a very bad ear infection.
I was trying to relieve the pressure, as I have done a lot, but because of the
bad ear infection it was actually making it worse. The pain was so bad and it
felt like my ear was never going to pop. Eventually, the pain subsided but at
that exact same time, in place of the pain, was a ringing.

My ENT said the tinnitus was most likely caused by the bad ear infection and
tried to assure me that me trying to pop my ears didn't have anything to do
with it, but I can't help but feel like that wasn't the case, as I made the
pain so much worse.

Anyways, agreed with others here that the first few months were the worst, and
now it's mostly unnoticeable unless I actively think about it, drink a lot, or
leave a loud environment.

~~~
pbhjpbhj
"pop ears" = equalise pressure, like you do on an aeroplane flight.

Just in case people aren't familiar with the idiom.

------
topher6345
My first year of music school, I was fortunate enough to be exposed to the
research of Dr. Marshall Chasin - an audiologist in Toronto.

His research on hearing loss, in particular hearing loss of musicians,
deserves wide exposure for anyone considering making a career out of using
their ears.

From one of his publications I use the following as a rule of thumb:

80db * 40hrs/week = permanent hearing damage

83db * 20hrs/week = permanent hearing damage

86db * 10hrs/week = permanent hearing damage

91db * 5hrs/week = permanent hearing damage

94db * 2.5hrs/week = permanent hearing damage

Further reading from Dr. Chasin:
[http://www.marshallchasinassociates.ca/hearing_articles.htm](http://www.marshallchasinassociates.ca/hearing_articles.htm)

~~~
alok-g
How to I map db to the volume on a smartphone?

~~~
tim333
There are apps. I just tried "Decibel Meter" by Xiangyi Liu on my iphone.
Free. Seems to work.

Update - just tried it. 90-100db on the tube (Victoria line), 102 when they
make announcements, 60db in the park, 25 in my room.

------
falcolas
Anecdata time - my tinnitus is way worse when my shoulders/upper back are
tensed up. If I can get those to calm down, so does the tinnitus. The normal
level is simply drowned out most of the time, but when I'm tense, I can "hear"
it quite clearly and loudly.

The "head thumping" thing from a few months back also grants a short reprieve
from normal levels of tinnitus, but it's definitely a temporary thing. It also
appears to have no triggers that relate to sound, and is not associated with
abnormal hearing loss so far (I've lost more high frequencies than average for
my age, but nothing between that threshold and ~25hz).

~~~
Bakary
In some cases tinnitus is also linked to TMJ syndrome.

------
dmalvarado
I've posted this before, but it's worth mentioning as often as the topic comes
up.

My wife has meniere's disease, so we need to protect her hearing in all
moderately loud situations, (bars, music venues, movies). In advance of SXSW
one year, I bought her a pair of these:
[http://amzn.to/2gK8qZv](http://amzn.to/2gK8qZv)

"Musician's earplugs", so-to-speak, they attenuate all frequencies more evenly
than standard foam plugs would. In effect just turning down the volume of the
world a bit, not muffling it.

I don't have meniere's, but do get drained by bars and loud music. I hate to
seem lame by wanting to leave a party/bar early, so I bought a pair for myself
recently. They're just fantastic. Highly recommend.

~~~
bvinc
I was diagnosed with MD and I figured out what was causing it. I know that MD
is a giant umbrella of different causes, but there's a small chance that my
story could help her. Have her check it out, along with this study.

My story:
[https://www.reddit.com/r/Menieres/comments/5ip7eq/i_was_diag...](https://www.reddit.com/r/Menieres/comments/5ip7eq/i_was_diagnosed_with_menieres_disease_and_later)

An interesting study:
[https://www.ncbi.nlm.nih.gov/pubmed/22253033](https://www.ncbi.nlm.nih.gov/pubmed/22253033)

~~~
dmalvarado
Thank you very much. I'll show this to her.

------
derekp7
I've started getting the ringing in the ears a few years ago. However, it gets
more pronounced when I twist my neck certain ways -- and it seems to let up a
bit by stretching my neck in a different direction. Seeing as how I also have
periodic neck pain, I wonder if pinched nerves there are contributing to the
tinnitus symptoms? Also, there are some days on the drive home from work where
the tinnitus is completely gone -- but it comes back strong the next morning,
especially if it feels that I didn't have a good sleeping position.

~~~
jahewson
Tight muscles in the face, jaw, and neck, and shoulders are the most likely
culprit. It's almost certainly not nerves. For me it was "forward head"
posture which needed to be corrected through strengthening exercises and a
careful reassessment of my desk work and driving positions. I'd highly
recommend visiting a good upper cervical chiropractor.

------
tim333
>Remember: the tinnitus might have started in the ear, but it lives in the
brain.

I'm not sure that's true in most cases. There's a NIH paper where they looked
at 151 cases where the auditory nerve was cut and "Complete relief of tinnitus
was achieved in 101 patients."
[https://www.ncbi.nlm.nih.gov/pubmed/7671835](https://www.ncbi.nlm.nih.gov/pubmed/7671835)

Not that you'd really want that as a treatment.

------
sparkzilla
Somewhat ironically, tests are being conducted to use MDMA/Ecstasy as a
possible cure for tinnitus.

[1] [http://mixmag.net/read/scientists-have-completed-trials-
atte...](http://mixmag.net/read/scientists-have-completed-trials-attempting-
to-cure-tinnitus-with-mdma-news)

------
tim333
You know one of the smartphone makers could prevent a lot of tinnitus by
having software that detects if you've been exposed to a lot of 100db+ and
pops up a warning suggesting taking it easy or using earplugs. People often
don't figure there's a problem until it's too late and you've got tinnitus
which you can't really fix.

------
glitcher
The article links to
[http://www.notchtherapy.com/](http://www.notchtherapy.com/) which looks very
interesting. I plan on following the steps outlined there to create a custom
notch filter for my tinnitus frequency.

Has anyone here played with this technique before?

~~~
abrichr
Check out [http://www.audionotch.com/](http://www.audionotch.com/)

------
magnetic
I've had severe Tinnitus for over a year due to a degenerative disease
damaging my hearing and causing hearing loss. It's been hell, and it still is.
It's unlikely to get better with time since the disease is known to make
progress and worsen things. No wonder suicide ideation is so high among T
sufferers:
[http://journals.lww.com/thehearingjournal/Fulltext/2016/0700...](http://journals.lww.com/thehearingjournal/Fulltext/2016/07000/Suicidal_Ideation_Among_Patients_with_Chronic.6.aspx)

------
ogig
"I suddenly lost the hearing on one ear and it got replaced by a strong and
permanent tinnitus. I quantify it as strong based on my talks with others with
tinnitus. What worked for me was stop fighting and start loving it. Now it's a
perma mantra. Some somatic malfunction that enables me to ear the hum inside
of me or whatever poetry works for you. Try it maybe."

Related re-post from here:
[https://news.ycombinator.com/item?id=13140256](https://news.ycombinator.com/item?id=13140256)

~~~
1001101
Yeah, I've got it bad. 25 years of techno/D&B with 1MW (really) sound systems
in enclosed spaces. Ear protection sometimes. Ruptured an eardrum once. I was
surprised to read about some of the _really_ negative reactions to it. Mostly,
it's like white noise to me and I'm able to ignore it, but whenever it's
bothering me, I think back to some of the good times I had getting it :)

------
Tade0
One thing to remember about earplugs is to not overuse them. Earplugs lock
moisture inside the ear and that in turn can cause infections and/or highly
increased earwax discharge.

~~~
zzzzzzzza
your mileage may vary, my brother will get an ear infection after a half a day
with earplugs. I can wear earplugs 4+ hours a day every day a year no
problems.

------
conception
I've always had tinnitus since I was a child and just thought the world was
like that. A trick popped up on Reddit to temporarily, and perhaps for some
with regular application, cures it for a short time.

[https://www.youtube.com/watch?v=2yDCox-
qKbk](https://www.youtube.com/watch?v=2yDCox-qKbk)

Thump the back of your head like that with your ears covered well about 40
times and enjoy the silence.

~~~
thisone
I've had ringing as long as i can remember. My mother's description, she has
it too, when a doctor told her it wasn't normal always stuck with me 'oh i
just liked hearing the pretty music'

Thankfully that's what it's always been to me. The ringing is the meaning of
silence and the notes are not at odds with each other.

When I realised that other people didn't hear the ringing when it was silent,
I was a fair bit shocked.

------
sbuccini
Additional reading that provided much needed (for me, at least) scientific
context around the condition:
[http://www.newyorker.com/magazine/2017/04/03/high-tech-
hope-...](http://www.newyorker.com/magazine/2017/04/03/high-tech-hope-for-the-
hard-of-hearing)

------
poikniok
Does anybody know what the dB level of macbook speakers playing at max volume
is? I am curious to know if playing music at max volume through them while
sitting about 2-3 feet away from them can damage hearing.

~~~
tim333
Probably depends on the model. Maybe try downloading a phone app and testing
it. I don't think my 11.6" Air makes enough sound to do damage at 2'. Using
the Earpods at max I notice some increased tinnitus though.

------
ZeusNuts
Buy earplugs with a small case you keep on your keychain and take everywhere.

The best earplugs are the ones you use!

