Notched Sound Therapy for Tinnitus

What is notched sound therapy?

Notched sound therapy is a tinnitus sound protocol in which a broadband signal — typically white noise or music — is filtered with a narrow notch centered on the listener's tinnitus frequency. The removed frequency band prevents direct stimulation at the tinnitus pitch, while surrounding frequencies continue to drive the auditory cortex.¹

In practice, the listener first estimates their tinnitus frequency — for example, via a pitch-matching test — and then listens to audio with a ~1/3-octave-wide notch around that frequency for sessions lasting 30 minutes to 2 hours daily.

How does notched sound therapy work?

The leading mechanistic account is based on lateral inhibition and cortical plasticity. Neurons in the auditory cortex are tuned to narrow frequency bands and inhibit their neighbors. Driving neurons adjacent to the tinnitus frequency — without driving the tinnitus-tuned neurons themselves — is thought to increase inhibition onto the tinnitus-tuned population.²

Repeated exposure over weeks may then reshape the cortical representation of the affected frequency region, reducing the aberrant synchronous activity believed to generate the tinnitus percept.¹

What does the research say?

Notched sound therapy has been investigated in several small-to-moderate trials, mostly for tonal tinnitus without severe hearing loss. Evidence is mixed but consistent with a modest reduction in tinnitus loudness and annoyance in well-selected patients:

• Okamoto H, Stracke H, Stoll W, Pantev C. Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity. Proc Natl Acad Sci USA. 2010;107(3):1207–1210. PubMed ID: 20080545.
• Pantev C, Okamoto H, Teismann H. Lateral inhibition and habituation of the human auditory cortex. Eur J Neurosci. 2012;36(11):3489–3496. PubMed ID: 22928868.
• Stein A, Wunderlich R, Lau P, et al. Clinical trial on tonal tinnitus with tailor-made notched music training. BMC Neurol. 2016;16:38. PubMed ID: 26987755.

Notched therapy is not a cure. Effect sizes are modest, and response varies. It is most plausible as a complement to other evidence-based approaches.

How long should I listen?

Published protocols generally use 1–2 hours per day for several weeks to months. Shorter sessions of 30–60 minutes are a sensible starting point, especially when you are new to the format. Consistency matters more than intensity: daily short sessions are preferable to occasional long ones.

The tool above offers 15, 30, 45, and 60-minute sessions with an automatic 3-second fade-out so the audio does not cut off abruptly at the end.

Can I use this with other treatments?

Yes. Notched sound therapy is considered complementary to established approaches:

• Cognitive behavioral therapy (CBT) — the most robustly supported intervention for tinnitus distress.
• Tinnitus retraining therapy (TRT) — combines sound enrichment with directive counseling.
• Hearing aids — for patients with measurable hearing loss; amplification itself often reduces tinnitus prominence.

See our overview of tinnitus treatments for a broader comparison. Do not discontinue any prescribed treatment in favor of this tool.

Frequently asked questions

Do I need my frequency match first?

For best effect, yes. You can estimate your tinnitus pitch with the free frequency test and then return here — the matched frequency will be pre-filled via URL parameter. If you already know your frequency from an audiologist, you can enter it directly.

Does it work with any headphones?

Yes. Over-ear or in-ear headphones with reasonable frequency response are preferred. Laptop or phone speakers are usable but tend to roll off at both low (under 150 Hz) and very high (above 10 kHz) frequencies, which can blur the notch.

Is this a medical device?

No. This tool generates sound for informational and wellness purposes only. It is not a medical device and does not treat, cure, or diagnose tinnitus.