natural sounds such as ocean surf, rainfall or synthetic sounds such as white noise, pink noise, or brown noise to help the auditory system become less sensitive to tinnitus and promote relaxation by reducing the contrast between tinnitus sounds and background sound. More advanced software based tinnitus maskers can use a combination of natural and synthetic sounds or a filtered noise generator tailored to mask the specific frequencies at which the tinnitus signal is experienced. Some sufferers require masking at all times. These people may employ wearable hearing aids which amplify ambient sound, generate low level wide band sounds such as white noise, or combination devices that mix both functions into one device. A standard hearing aid may be used for tinnitus masking; the tuning and amplification characteristics are different than when one is used in compensation for hearing loss. A study by Jalilvand in 2015, showed that hearing aids instead of tinnitus maskers used to amplify sounds helped with the perception of tinnitus for veterans with blast-induced tinnitus. Sound generators (masking devices) have received Class II approval from the FDA. However, they are considered to be "experimental, investigational, or unproven" therapies. In-ear headphones Bose Sleepbuds II comes with an app that streams white noise (and soundscapess, and ambient music). Vibration maskers There is one report of a bone conduction vibration masker that transmits a 60 Hz fundamental with adjustable harmonics up to 1000 Hz. A commercial device based on the phenomenon (Aurex3) was approved by the FDA. High frequency audio and ultrasonic bone conduction maskers A new development in tinnitus management is the use of high audio (10–20 kHz) or ultrasonic (20–100 kHz) via bone conduction. Efficacy A 2012 Cochrane Review stated the available studies do not show strong evidence of the efficacy of sound therapy including tinnitus maskers in tinnitus management. Clinical practice Audiologic Tinnitus Management (ATM) is a clinical protocol for management of tinnitus involving counselling and sound therapy including tinnitus maskers. Research Neural Plasticity and Cortical Remapping tinnitus is associated with cortical reorganization after hearing loss. Alternatives Transcranial magnetic stimulation has been used with limited success in treatment of tinnitus. Tinnitus retraining therapy uses a partial form of sound masking in conjunction with counselling See also Auditory masking Neurologic music therapy Speaker pillow References External links American Tinnitus Association, Sound Therapies British Tinnitus Association, Everything You Need To Know About Sound Therapy Audiology Psychoacoustics