Tinnitus neuromodulation research
This page summarizes key research behind sound-based neuromodulation for tinnitus, including notched-sound therapy, acoustic coordinated reset (CR) neuromodulation, residual inhibition, and stress-reduction approaches. It is informational only and not medical advice.
1. Notched sound / notched music therapy
Notched sound therapy plays pleasant audio (often music or noise) with a “notch” removed around the person's tinnitus frequency. The goal is to reduce over-activity of neurons tuned to that frequency over time (lateral inhibition).
- Early work showed that tailor-made notched music could reduce tinnitus loudness and related auditory cortex activity after weeks of daily listening (Okamoto et al., 2010).
- Later randomized trials found that notched music can help some patients, but does not always clearly outperform ordinary music for everyone (Therdphaothai et al., 2021).
- Recent systematic reviews suggest notched music / sound therapy is a promising, non-invasive option for a subset of people, but more high-quality trials are still needed.
2. Acoustic coordinated reset (CR) neuromodulation
Acoustic CR plays brief tones around the tinnitus frequency in a specific timing pattern, aiming to “desynchronize” overly synchronous brain activity linked to tinnitus.
- Real-world and clinical studies have reported reductions in tinnitus loudness and handicap scores after weeks to months of daily CR sound therapy in many patients (Hauptmann et al., 2015).
- EEG and modelling work shows CR patterns can weaken pathological network connectivity in tinnitus models (Silchenko et al., 2013).
- Reviews conclude that CR neuromodulation is generally safe and well tolerated, with many patients reporting improvement, but results vary and larger independent trials are still required.
3. Residual inhibition & coloured-noise masking
Many people notice that tinnitus becomes quieter for a short time after listening to another sound. This effect is called residual inhibition (RI).
- RI is thought to occur when external sound temporarily overrides abnormal activity in the auditory system; after the sound stops, tinnitus can remain reduced for seconds to minutes in some people.
- Coloured noises (white, pink, brown) distribute energy differently across frequencies. Deeper sounds such as brown noise are often reported as especially soothing and useful for “masking” high-pitch tinnitus and for sleep-onset.
- Reviews of sound therapy report that regular, comfortable sound exposure can reduce tinnitus distress for many people, especially when combined with education and counselling.
4. “Phase cancellation” versus brain-based mechanisms
In acoustics, phase cancellation means playing an opposite (“anti- phase”) sound wave to physically cancel an external sound. Subjective tinnitus is different: it is generated inside the brain, not in the air in front of the ear.
- Because tinnitus is a neural signal, there is no external sound wave that can be physically “cancelled” by playing an opposite phase signal. Noise-cancelling headphones can reduce outside noise, but they do not erase tinnitus and can even make it more obvious in very quiet environments.
- Several clinical studies have tested “phase-shift” or phase-cancellation style tone therapies. When properly controlled, these approaches generally do no better than ordinary tones, and in a few cases have even increased perceived loudness for some users.
- Modern tinnitus apps therefore focus on neural modulation mechanisms instead: lateral inhibition (notched sound), residual inhibition, and rhythmic entrainment, rather than literal acoustic cancellation.
5. Brain rhythms, stress and CBT-based support
Tinnitus is not only a hearing issue; it is strongly linked to attention, stress and the brain's rhythmic activity.
- EEG studies suggest that many people with bothersome tinnitus show reduced calming alpha activity (around 8–12 Hz) and increased fast gamma activity in auditory areas. Sound that is gently modulated at about 10 Hz may help “entrain” more normal alpha rhythms in some users.
- Cognitive-behavioural therapy (CBT) and related approaches (such as acceptance-based and mindfulness-based therapies) have a strong evidence base for reducing tinnitus distress even when the sound itself does not disappear. They work by changing the way the brain interprets the tinnitus signal and by reducing arousal.
- Short “micro-calm” exercises—breathing, muscle relaxation, brief reframing prompts—are increasingly used in apps to help users break the stress–tinnitus cycle in day-to-day life.
What this means for CalmTinnitus
CalmTinnitus is inspired by these neuromodulation approaches. The app first helps you match your tinnitus pitch using a guided calibration with octave-check and loudness matching. That stored frequency is then used to drive the sound modes.
The core modes in CalmTinnitus are designed to line up with the research above:
- Brown Noise Masking (for immediate calm) – deep, coloured-noise masking designed to support residual inhibition and provide fast relief for many users.
- Notch-style & CR-style neuromodulation – sound patterns that reduce energy around your matched tinnitus frequency and introduce gentle 10 Hz amplitude modulation to encourage healthier brain rhythms.
- Stress-reduction (CBT micro-calm) – short in-app exercises that apply CBT-style and mindfulness principles to help reduce anxiety and re-train attention away from the sound.
- “Play your own audio” support – many people prefer relaxing music, podcasts or nature sounds. CalmTinnitus is designed so that you can combine its sound strategies with the audio content that feels most comforting on your device, where supported.
Research shows that regular, comfortable use over time is more important than any single session. Results vary between individuals, and no sound app is a guaranteed cure — but for many people, sound-based training plus stress-reduction tools are a helpful part of long-term tinnitus management.