Tinnitus masker issues associated with use of tinnitus maskers: the "safe" level of continuous sound depends on the duration of the sound. For maskers worn continuously, or most of the day, a safe level is no more than 70db, in accordance with EPA maximum safe exposure level for 24-hour environmental sound. Maskers louder than 45db or so (the ambient background level of an average home living area) may start to interfere with understanding conversation (about 60db). Masking of high frequency tinnitus (>6,000hz) is difficult because of the resonance characteristics of the human ear as well as high frequency limitations of in-ear devices.
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