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 masker amplitude determines the degree of masking achieved. In some cases, the required masking amplitude is so high as to cause discomfort to the user of the sound generator, and the tinnitus is therefore considered unmaskable. The frequency and other characteristics of tinnitus can vary over time, and the shifts can be temporary or permanent. They may also be cyclical. Therefore the optimal tinnitus mask may need to be adjusted periodically, within days, hours, or even minutes. So a fixed recording (i.e. CD, DVD or audio file) of a tinnitus mask is not a very efficacious application. There are also safety