The second pillar is sound — both correcting the hearing loss that sits underneath most tinnitus, and using gentle background sound to lower its contrast. For the many people with some hearing loss, a hearing aid is often the single highest-yield step.
Because most tinnitus rides on hearing loss, amplifying real-world sound does two things at once: it restores the input the brain was missing (easing the central gain that drives tinnitus) and it raises the background so the tinnitus stands out less. For people with even mild loss it's frequently the most effective single intervention — and it fixes the communication difficulties at the same time. Evidence ●●●●○
The goal is never total silence — quiet makes tinnitus louder by contrast. Environmental sound (fans, nature tracks, apps), dedicated maskers, and notched or broadband sound reduce how much it stands out and support habituation. The evidence on any specific method is modest and mixed, but sound enrichment is safe, cheap, and widely helpful — especially at night, when the room goes quiet. Evidence ●●●○○
Combination hearing aids build a sound generator into the aid, pairing amplification with masking. For severe-to-profound hearing loss, cochlear implants frequently reduce tinnitus substantially as a welcome side effect of restoring auditory input. Both are specialist routes, considered when simpler steps aren't enough. Evidence ●●●○○
Any hearing loss? Trial a hearing aid first
If your audiogram shows any loss, a hearing-aid trial is the most reliable device we have for tinnitus — and unlike the exotic options, it also lets you hear people again. Correct the input before chasing anything fancier.
The Tinnitus Guide