Tinnitus masker sensation level (SL), is how much louder the tinnitus is above the ambient noise of the environment. By raising the ambient level of noise (playing white noise into the ear), the apparent loudness of tinnitus is reduced. The noise level is close to and usually somewhat louder than the perceived loudness of the tinnitus. The generated noise is designed to be a calming, less intrusive sound than the ringing or hissing of tinnitus. Depending on the loudness of the noise, tinnitus may be fully or partially masked. Tinnitus masking cannot reduce or eliminate tinnitus, only reduce awareness of it. The
Tinnitus stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual. Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness. Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive