Tinnitus sound treatment and notched sound therapy: what the evidence says

Sound therapy uses sound, such as soft noise, nature sounds, music or hearing aids, to make tinnitus less noticeable or easier to live with. Many people find it comforting, but good quality studies have not shown that it reduces tinnitus more than no device or simple information. Notched sound, a newer variant, has mixed results.

Last reviewed: 28 October 2026

By the Tinnitus Haven editorial team. Sources are listed at the end of the page.

This guide is general information, not medical advice. If your tinnitus is new, one-sided, pulsing or comes with hearing loss or dizziness, see a doctor.

What is sound therapy for tinnitus?

Sound therapy, also called sound treatment, can work in several ways: by partly covering the tinnitus with a pleasant sound, by helping you get used to it, by distracting you, and possibly by giving the hearing parts of the brain more input after hearing loss^[1]. Common sources are^[1]:

tabletop or smartphone sound generators, often used for relaxation or sleep
wearable sound generators that sit in the ear like hearing aids
hearing aids, which make outside sounds louder and can make tinnitus less noticeable for people with hearing loss
combination devices that amplify sound and generate sound in one
everyday sources such as a radio or a fan

The NHS advises against total silence, because listening to soft music or sounds may distract you from the tinnitus^[2].

Does sound therapy work?

The honest answer is that the evidence is limited and mostly of low quality:

A 2018 Cochrane review found eight trials with 590 people using hearing aids, sound generators or combination devices. No trial compared these devices with no device, placebo or information alone, so the review found no evidence that they work better than those options. Symptoms improved with every type of device, but without a proper comparison it is not possible to say how much of that came from the device^[3].
The UK guideline (NICE, 2020) could not make a recommendation for or against sound therapy and asked for more research^[4].
The US guideline lists sound therapy as an option clinicians may offer for persistent, bothersome tinnitus^[5].
The German S3 guideline advises against sound therapy and noise generators as treatments for chronic tinnitus, because there is no evidence that they work^[6].

Hearing aids are a separate case. NICE recommends offering them to people with tinnitus whose hearing loss affects communication, and advises against them for people with tinnitus but no hearing loss^[4]. The German guideline also recommends hearing aids for chronic tinnitus with hearing loss^[6].

What is notched sound therapy?

Notched sound, often called tailor-made notched music, removes a band of frequencies around your tinnitus pitch from music or noise. The idea is that taking the tinnitus frequency out of what you hear could calm overactive nerve cells in the brain's hearing areas^{[7, 6]}.

To set it up you first estimate your tinnitus pitch. Keep in mind that NICE advises against pitch and loudness matching as a way to assess tinnitus clinically^[4]. In an app, a pitch match is a personal starting point for shaping sound, not a medical measurement.

Does notched sound reduce tinnitus?

The results are mixed:

An early study with 8 people per group reported lower tinnitus loudness after 12 months of listening to notched music than with a placebo version^[7].
A larger double-blind randomised trial with 100 people found no effect on its main outcomes. Loudness ratings were lower in the notched group at follow-up, but tinnitus distress did not improve^[8].
A 2024 meta-analysis of three studies found no significant difference in tinnitus distress between notched music and ordinary music^[9].
A 2025 meta-analysis of 14 randomised trials with 793 people reported modest improvements with notched music compared with conventional music after three months^[10].
The German S3 guideline concluded that notched music does not work better than normal, unchanged music and advises against using it as a treatment^[6].

In short, notched sound is not a proven way to reduce tinnitus. If you enjoy listening to it and it helps you relax, that is a reasonable personal choice, as long as the volume stays comfortable.

How can I use sound sensibly?

Keep the volume comfortable. Loud noise is one of the things that can make tinnitus worse^[4].
Choose sounds you like. Rain, waves or soft music are common choices for relaxing or falling asleep^[1].
See sound as one tool among several. For distress, cognitive behavioural therapy has stronger evidence^[11]; read our guide to CBT for tinnitus. Tinnitus retraining therapy combines sound with counselling; see our TRT guide.
Get your hearing checked. If you have hearing loss, hearing aids may help^[4]; see hearing aids and tinnitus and checking your hearing at home.
Be wary of promises. There is no cure for tinnitus, so a product that claims to silence it for good is overselling^[1].

Tinnitus Haven brings sound therapy, a hearing check and CBT-based lessons together in one calm iPhone app, coming soon to the App Store. Learn more about Tinnitus Haven.

Sources

National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Tinnitus. 2023.
NHS. Tinnitus. NHS website, 2024.
Sereda M, Xia J, El Refaie A, et al. Sound therapy (using amplification devices and/or sound generators) for tinnitus. Cochrane Database of Systematic Reviews, 2018.
National Institute for Health and Care Excellence (NICE). Tinnitus: assessment and management (NG155), Recommendations. NICE guideline, 2020.
Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus. Otolaryngology, Head and Neck Surgery, 2014 (AAO-HNSF).
Mazurek B, Hesse G, Sattel H, et al. S3 Guideline: Chronic Tinnitus. German Society for Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC). HNO, 2022. English version of the German AWMF guideline 017/064 (2021).
Okamoto H, Stracke H, Stoll W, Pantev C. Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity. PNAS, 2010.
Stein A, Wunderlich R, Lau P, et al. Clinical trial on tonal tinnitus with tailor-made notched music training. BMC Neurology, 2016.
Efficacy of tailor-made notched music training for primary tinnitus: a systematic review and meta-analysis. American Journal of Otolaryngology, 2024.
Jiang W, Zheng Y, Zheng C, et al. The efficacy of notched music therapy vs conventional music therapy for chronic subjective tinnitus patients: a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology, 2025.
Fuller T, Cima R, Langguth B, et al. Cognitive behavioural therapy for tinnitus. Cochrane Database of Systematic Reviews, 2020.