Notched sound / notched music therapy for Tinnitus: What Does the Evidence Show?
Sound Therapy
Current evidence
Music with your tinnitus frequency carved out — a modest, unconfirmed loudness effect in tonal tinnitus.
Evidence strength: Limited (2/5) · Tier 3 — experimental/emerging · Evidence independence: Primarily independent.
Music or noise filtered to remove a band around your tinnitus frequency, listened to for hours daily over months (tailor-made notched music training, TMNMT).
Did tinnitus loudness improve?
Limited. Münster trials: modest effects mainly on perceived loudness in tonal tinnitus; notch width didn't matter.
Did tinnitus distress improve?
None shown. Independent RCT (N=104, 6 months): THI difference 7.2 points favoring notched music — not statistically significant.
Loudness means the tinnitus percept itself became quieter (psychoacoustic matching or loudness ratings). Distress means questionnaire scores such as THI/TFI, sleep, anxiety or quality of life improved — the sound may be unchanged. A THI/TFI improvement is never evidence the tinnitus got quieter.
How strong is the evidence?
A plausible mechanism with mixed trials: 2/5.
Has the result been independently replicated?
Conflicting results. Okamoto 2010 positive proof-of-concept vs later independent negative/negative-leaning RCTs (Atipas 2021, Stein 2016).
What are the limitations?
- Larger controlled comparisons failed to reach significance
- Requires precise pitch matching and long adherence
What should patients know about safety?
Safety evidence: Strong. Safe at comfortable volume.
Is it available?
Regulatory status: Unregulated audio approach.
Availability: Apps/services (e.g., notch generators); DIY possible · Europe: Same · Cost (approx.): Free–$300
What the studies found
Notched music vs ordinary music: independent RCT
Therdphaothai J, Atipas S, Suvansit K, Prakairungthong S, Thongyai K, Limviriyakul S · Journal of International Advanced Otology · 2021 · N=104 · Double-blind RCT, 6 months
No significant THI difference between tailor-made notched music and ordinary music (N=104). The abstract notes a greater score reduction in the treatment group during the follow-up period — a secondary observation that does not alter the negative primary findings.
The Münster trials reported modest effects mainly on perceived loudness in tonal tinnitus.
Tailor-made notched music: proof-of-concept (loudness reduction)
Okamoto H, et al. · PNAS · 2010 · N=8 target vs 8 placebo-notched · Small controlled proof-of-concept, 12 months of regular listening
Reduced subjective tinnitus LOUDNESS (a genuine loudness outcome) and tinnitus-frequency cortical activity vs placebo-notched music — in 8 participants per arm.
The origin of the notched-sound hypothesis. Later, larger independent trials (Stein 2016 N=100 — negative on primary; Atipas 2021 — negative) failed to confirm, which is why replication is labeled 'Conflicting results'.
Tailor-made notched music training: double-blind RCT (negative on primary)
Stein A, et al. · BMC Neurology · 2016 · N=100 · Double-blind RCT, notched music 2 h/day × 3 months vs placebo; ISRCTN04840953
NO significant effect on any primary outcome. A late secondary loudness reduction at follow-up is hypothesis-level only.
The key independent non-replication of Okamoto 2010's notched-music effect at 12× the sample size.
Related treatments
- Sound therapy & masking — Widely used, low-risk, valued by many — but never proven better than placebo in controlled trials.
- Levo System (sleep-time sound matching) — FDA-cleared sound therapy played during sleep, matched to your tinnitus 'sound print' — one small positive…
- Neuromonics (and other discontinued cleared devices) — A once heavily marketed $5,000 'acoustic desensitization' program — FDA-cleared, weakly evidenced, now…
Evidence last reviewed: 2026-09-03 · Evidence included through: 2026-09-03 · Confidence: moderate. Open the interactive evidence profile.
This page summarizes published research for education. It is not medical advice; it cannot say what will work for any individual. Discuss treatment decisions with a qualified clinician.