Tinnitus activity in the limbic system and autonomic nervous system, thus increasing tinnitus awareness and annoyance. There are two types of tinnitus: "subjective tinnitus" and "objective tinnitus". Tinnitus is usually subjective, meaning that there is no sound detectable by other means. Subjective tinnitus has also been called "tinnitus aurium", "non-auditory" or "non-vibratory" tinnitus. In very rare cases tinnitus can be heard by someone else using a stethoscope, and in less rare – but still uncommon – cases it can be measured as a spontaneous otoacoustic emission (SOAE) in the ear canal. In such cases it is objective tinnitus, also called "pseudo-tinnitus"
Tinnitus retraining therapy significantly bothered by it. However, some of the problems caused by tinnitus include annoyance, anxiety, panic, and loss of sleep and/or concentration. The distress of tinnitus is strongly associated with various psychological factors; loudness, duration and other characteristics of the tinnitus are secondary. TRT may offer real although moderate improvement in tinnitus suffering for adults with moderate-to-severe tinnitus, in the absence of hyperacusis, significant hearing loss and/or depression. Not everyone is a good candidate for TRT. Factors associated with suitability for TRT and predisposing for favorable outcome are: lower loudness of tinnitus, higher pitch of tinnitus, shorter duration of tinnitus