What is notched sound therapy?

How the notch works

A “notch” is a filter that cuts out a thin band of frequencies from an audio signal. In notched sound therapy, that band is centred on the frequency that best matches your tinnitus — often a high-pitched tone or hiss.

The reasoning comes from how the auditory system adapts. Neighbouring nerve cells tend to inhibit one another; by feeding the brain rich sound everywhere except at your tinnitus frequency, the theory is that the surrounding activity is stimulated while the tinnitus region is not, gently reducing its prominence over weeks and months.

What the research shows

The best-known study, by Okamoto and colleagues (2010), found that chronic tinnitus patients who listened to their favourite music with a notch cut around their tinnitus frequency reported lower tinnitus loudness, alongside reduced auditory-cortex activity at that frequency. It was, however, a small pilot — eight people in the notched group.

Since then the evidence has stayed limited and mixed: recent systematic reviews disagree on whether the notch adds any benefit beyond simply listening to pleasant music, and effects, where seen, are usually modest and clearer for rated loudness than for overall distress. Clinical guidelines treat sound-based approaches as a reasonable option to try, not a proven treatment, and rate cognitive behavioural therapy more highly for tinnitus distress. None of them cure tinnitus.

Who it may help — and who it may not

Notching depends on having a clear, matchable tinnitus pitch. It tends to fit some people better than others:

• May suit: a steady, tonal tinnitus at a frequency you can match reasonably well.
• Less suited: pulsatile tinnitus, very broadband “static”, or tinnitus with no clear pitch.
• Precision matters: the closer the notch sits to your true frequency, the more targeted it can be.