The Story of How We Helped Millions of People With Tinnitus

- If you can create a sound that is different than the tinnitus sound that the patient has, but it's similar in frequency, this can sometimes cause the mind to be distracted away and interrupt what is basically, because we're all in the computers, we can call it an auto complete cycle where the coding in the brain is just completing a sound. And maybe the neural wiring was affected days or weeks ago, months ago, and it keeps putting this sound out over and over. And so I thought, aha, well let's

try that. Let's try some different frequencies. What are some of the frequencies that viewers have tended at and create some sounds specifically to try to break this pattern by introducing a new sound? - I'm joined by my good friends Dale Snail. We're so excited to share some of these crazy, fun and wild stories along the way. We both crossed a hundred thousand subscribers on YouTube within the same month. And to honor this, we came together to record this video, which will share some of our fa

vorite stories and our most impactful insights along the way. Dale, I'm so happy to have you here. We're going to bring a lot of value. I have some personal stories prepared. What do you have for the Tinnitus community, Dale? - Oh, thanks, Dr. Ben. I've been an audio engineer for decades, and just coming into YouTube and building this community has been something I never thought so many people would connect to these videos, these sounds that I've created. And so that whole trajectory of building

this community, I would've never thought that back starting. My first posts were in 2009, but the first real noise that I posted was 2012, and that was a, a pink noise clip. And YouTube had just opened up the long play, so you could have a 10 hour video before that, everything was broken into 10 minute clips. So it was very hard to watch long form content. And at the time I thought the value would be for audio engineers who use pink noise to test equipment and to check their speakers, make sure

they're getting the ultimate frequency response. But then something happened in the comments where listeners started saying, Hey, this helps with insomnia. This helps with getting a better sleep, or helping me with noises that are distracting me while I'm studying, or little sister chewing when I'm eating dinner at the dinner table. All kinds of things. And so this was my introduction to noise masking through this sound. And again, YouTube very sophisticated in finding viewers that can find ben

efit from the content. And that's how we got to where we are today. Just following along with the community, building people coming in and listening to these sounds. What about you? How'd you get into this? - Yeah, I love that story. I mean, pink noise is so helpful for tinnitus. As audiologists, we learned that sound therapy is one of the tinnitus treatments in our toolkit, and pink noise is one of those standard sounds that helps a lot of people. So of course, when I saw your channel originall

y, I thought, whoa, this is pretty interesting. We have a sound engineer who's making some custom sounds to help people with tinnitus. And of course we connected since then. But if I look back to the beginning of my journey, I was working in a tinnitus clinic. I was seeing patients and a patient drove four hours to see me from Lake Tahoe, California, all the way to San Francisco, California. And the appointment that we completed at the tinnitus clinic could have been completed via telehealth. Th

at patient had already been to their local ENT doctor. They'd already been to their local audiologist. They had bothersome ringing in their ears, but they weren't given a clear treatment for it. So they did this long road trip, spent a night in San Francisco, and I realized this could have happened via telehealth. So fast forward a few years, I eventually felt ready to start making videos and sharing my expertise on tinnitus for anyone who wanted to listen, particularly for people who were tryin

g to self-manage this, to get some tools, to get some knowledge that their local doctors didn't present them. So the first story I want to share is right at the beginning where my first viewers were, my brother and my mom and I decided to host a live stream on YouTube. And in the comments there was maybe 10 people and I realized, okay, 60% of them are family and friends. I just invited as many people as I could who were in the audiology and tinnitus community to this live session educational ses

sion about tinnitus. And it was the beginning of the pandemic. So my YouTube channel journey really started at the beginning of the pandemic. I was living in an apartment in Berkeley, California. It was a cheap apartment, it was with roommates I didn't really like. And I moved there March 1st, 2020. And I moved there and I told myself, you know, I'm not going to spend that much time at home. I'm going to be out, I'm going to be with friends. I'm going to be, you know, out in the Bay Area, just,

you know, socializing a lot. I'm not going to be home that often. Well, you know, two weeks later, turns out I'm stuck at home single, no car in this apartment. My roommates kept some chickens next to my room. So outside of my little window, there was this little patch of dirt and there were chickens there. And sometimes they would make these hens would make noises. And that's, that's the origin of my YouTube channel, that those are the first videos that I made in my, in my bedroom next to these

chickens, essentially obsessed over YouTube and have made about three videos a week for the last four years since Dale, what were the next, what were the next stories you wanted to share from, from your journey here? Can we - Hear some of the chickens in those original - Videos? Yeah, let's play some of the chickens so the viewers can imagine themselves, you know, in, in this apartment. So cue the chicken noises. - You could those with some, with some noise. But I think that's an interesting ti

me to have started because telehealth took a huge advance forward in all forms of medicine. You know, doctors being able to check in with patients while they're not at the hospital. And then of course in education as well. And then we all, as viewers and consumers of content for entertainment education got up to speed. And so it was a great time to learn more about that. And just the ability of people to learn and pursue different interests through YouTube and Zoom calls discord, things like tha

t has really advanced. So good timing there with the pandemic, the thing about my original pink noise was I thought, okay, audiologists will will use it. And then these other people came into the fold. And so then I, I kind of posted some more of the classic noise colors and learn more about those. So we have brown noise, white noise, and then blue noise. And I listened to blue noise for the first time, and that's very high frequency focused noise. It has a slope of minus 60 B prov basically loo

ks like this ski slope. And I posted it and I thought, man, is anybody going to listen to this? This is, I thought, well, it's anecdotal, let's put it up just to show it as an example. And a bunch of people loved it. And some other YouTubers that are in the niche said, man, I don't know about this sound. You know, that were, they were doing mostly brown noise. And so that was kind of a fun thing. Was - It folks with tinnitus who loved it or just generally folks enjoyed - It? Well, that's who, th

at's when they started to really come in. Before that it was people that benefited from noise because they maybe had hyperacusis some people for tinnitus. But that's when really the community started to build through blue and purple violet noise. And I realized there's a camp of people that really like high frequency noise. And then there's another camp of people that listen to noise that, that like more low frequency noise. And so I, I accommodate both of them on my channel, but I found that th

ey do not always cross. So there's a lot of people that are soothed by the ominous brown noise and other people, somebody posted just the other day, this gives me the craziest dreams. I don't think I can listen to this. So it's very interesting how different minds are wired for different types of audio. And I've always thought of it as something similar to music where we have our favorite styles and genres of music and eras and you generally don't like everything. And so for some reason, certain

sounds, certain noises really strike a chord. So that's what really got it going. And then one day I was, I was road managing a band, a bluegrass band from the Bay Area and we were driving up to Oregon and I get a call and I pick it up while I'm driving and it's somebody calling about the channel and he, the violet noise and he says, Dale, can you make something a little bit higher? I need something higher. I need to go higher. It's like the price is right higher, higher, higher. So - Did he ha

ve tinnitus? Was he called? Did he tell you that it was because of Tinnitus? Yeah, he - Tinnitus guy and he found it. So this was the point where I realized that my channel was starting to go around through clinics and stuff and people would comment, oh, I found out about you through this tinnitus clinic. Or somebody called me once who had the musical sounds in their ear. And she says, yeah, my, my doctor just basically prescribed a couple of your sounds and informally. And so then I would run i

nto these people and sometimes I'd make audio custom for them or send them a compact disc. 'cause not everybody was online back then. And so I made a higher one that was very high frequency noise. And that really brought in a lot more people who are interested in noise masking. - So when folks hear you say the doctor prescribed the sound, they might think, what? But for me, that's actually commonplace. I'm usually the doctor who prescribes the sound, right, you're the sound engineer. That might

make the sound. But as the audiologist, that's something we do all the time, which is essentially sounds even funny to say it. We prescribe sound therapy in the same way that a physician might prescribe medication, - Right? And in fact, now there's even like psychiatrists that are prescribing different types of sound, like perhaps bilateral music and things like that. So there's a lot of things that sound has power to help with, but we're just now over the last few years starting to be able to q

uantify what these benefits are. - One thing I want to pick up on that story is that I was speaking with my brother. So I run Treble Health, the YouTube channel and the telehealth business with my brother Garrett. So we are both audiologists and we're both brothers and that's a pretty rare combination for us. And you know, we realize that what we're doing is that we work in the trust business. You know, healthcare is essentially a trust business where the doctors who have the best reputation are

the ones that the most patients want to see. The doctors who have the most training and the best success rate have the highest trust from from their patients. So the incentives aligned very well with providing this evidence-based, clear scientific information on YouTube. And as health professionals, there's a good amount of us who make YouTube videos. I see that those who are sticking with the science and providing that, that realistic information are the ones who have the most long-term succes

s and also integrity. You can take that and run with it and share a story. I think - That's a really good point, you know, because you'll see sometimes other channels, we'll just put up something that claims to be something that we know not to be true at this time. You know, just the research is not there yet, such as a cure by doing something or other. And I've always been very careful to just say, these might work, these might not work. And then the channel, the community itself becomes a bit

of a focus group where we can look through the comments and see what's working, what's getting views, and then create more content that is variations based on those type of of things. And we've done a little back and forth with the sounds I've designed for you where you've said, Hey, people have really liked this one, let's do something similar to that. And then we kind of narrow in on what will work. And again, it's just offering a lot of hope. Sometimes people come into the comments and they'r

e, they're call it medical wandering and we don't know if we can help them or not. And sometimes they find a discovery along the way, but they're going to learn and they're going to get support from other viewers in the comments, which is another benefit to hanging out. And so a lot of my research was based on, I have tinnitus and from being a concert engineer, I've done, you know, national tours, tour Europe, you are exposed as an engineer. It's a little different than somebody who goes to a co

ncert because you're there for the soundcheck, you're in a loud vehicle, you're unloading, there's so much noise, you can't really escape the room during the event. So you're really tied to it. I've used earplugs for years, but I think this in combination with some other factors has created some tinnitus for me. So that's one of the reasons I was very interested in it. Flying is another element that, you know, make sure your ears rang. And I was doing a little research and I think I was on the a

TA site, the American Tinnitus Association, and I watched a podcast about a researcher who had talked about if you can create a sound that is different than the tinnitus sound that the patient has, but it's similar in frequency, this can sometimes cause the mind to be distracted away and interrupt what is basically, because we're all into computers, we can call it an auto-complete cycle where the coding in the brain is just completing a sound and maybe the neural wiring was affected days or wee

ks ago, months ago. And it keeps putting this sound out over and over. And so I thought, aha, well let's try that. Let's try some different frequencies. What are some of the frequencies that viewers have tended to set and create some sounds specifically to try to break this pattern by introducing a new sound? And those were the first tinnitus specific videos that I created. And those really took up, it took months, maybe six months for those videos to really find an audience and then things star

ted to, to really lift on those. And then that became one particular topic and a huge part of the, the channel and I think is one of the things that linked our channels together over time. - Yeah. In the tinnitus world, I've learned that people care most about understanding the cause of their problem. What caused the, my tinnitus, some of our most popular videos and our most important videos are identifying different root causes, different strategies for how to identify them, where to go, which

doctor to see, what tests to get. Very important. Right. Now the other piece of it is the solution. So what are the different treatments that can actually provide relief for an individual and sound therapy being one of them, right? The unique thing about YouTube and this kind of platform is that this isn't social media. People are listening to a sound therapy to have some sort of therapeutic benefit. So it's, it's a tool, it's a physical tool, just like doing physical therapy is a tool to help r

estore the normal function. Using sound therapy is a tool to help restore normal function or provide some, some temporary relief when using it. That's a helpful framework to understand what is the cause of my tinnitus and what is the relative treatment that is most likely to get at the root cause. So that's definitely something I've learned as our channel grew from zero to a hundred thousand subscribers and 15 million views, is that there are real tools out there and are, you know, there's many

doctors who can also help you along with our channel to identify the root cause and get you some relief. - Dr. Ben, what are some of the cutting edge things you're finding out about contemporary tune this research and where we're going? I know there's been some, you know, like the neuro mod and different things. What are some strategies that you've seen recently that might give some of the listeners some hope or some ideas to - Yeah, on the research side, it comes down to the connection between

the small cells in the cochlea, the hearing organ and the auditory nerve. That particular area of the auditory system is sometimes responsible for something called hidden hearing loss. So for a percentage of people with tinnitus, they don't perceive a hearing loss or they get a hearing test and it came back normal. Well, that standard hearing test doesn't specifically look at the minute function of those cells, those very small inner ear cochlear hair cells and how they connect to the nerve. Res

earch has shown hidden hearing loss is an underdiagnosed problem. So people can experience ringing in the ears, people can experience hard time understanding voices in conversation when there's a lot of background noise. But then they get a hearing test and it's, and they say, ears are fine, but the person realizes my hearing's not fine. I either have this ringing or I can't hear as well as I used to. So researchers are getting closer to understand how we can use either, you know, biopharmaceuti

cals or neural stimulation to some degree to activate those nerves and try to reconnect them or potentially hair cell regeneration, which would assist with this. And that's a way to potentially develop new strategies for the hidden hearing loss. Other than that, there are some investigations into parts of the auditory brain called the dorsal cochlear nucleus and attempting to rewire that system with bimodal stimulation. That's still in the clinical testing mode in the United States where there's

been some benefits shown. However, it does not replace the standard mode of care with the sound therapy treatment plus the cognitive restructuring of thoughts. Generally speaking, that kind of approach is referred to as brain retraining or tinnitus retraining therapy, sometimes accompanied with cognitive behavioral therapy. So those are the two areas that I'm most excited about learning and following over time. - Fantastic. Yeah, I heard some things about some miswiring and the prefrontal corte

x can create tinnitus even though that's not a section of the brain that's generally associated with a lot of listening. Although we know that when you're, when you're listening to music, all the sections of your brain are firing, unlike any other stimulus, sensory stimulus with listening, it's really complicated. It's everything's going off in the mind all over the place. I think this is why we can listen to music and it can bring back so many memories, make us think about things from the past

or you know, even trigger smells, all kinds of stuff. It's really fascinating. So I think there's probably a long way to go with understanding this stuff and it's really neat that, that you can get these results with tinnitus, retrain therapies, noise masking, being part of that cognitive behavioral techniques and things like that. So that's exciting that, that the tried and true is, is getting results for a lot of, a lot of people. I'm excited about that. So many people come in and listen to pi

nk noise and they leave the wittiest comments and it just shows that there's people coming in for all kinds of reasons to listen to this. I think it's similar to people that want to listen to a fan. They just need a little noise to take away from distracting sounds in their environment, calm their mind. Probably it has to do with certain people's brains the way they're wired, where they, you know, lack attention or you know, A DHD, certain insomnia things. But some of these people must stay up l

ate thinking of comments to write because some of them are so hilarious. Like, you know, the, I think a common one is, you know, pink noise, I'd love that. I'm going to go see them live soon. Oh yes, pink noise was great and then somebody will come in, do you mean Pink Floyd? No, no pink noise. And this thread goes on with 90 comments about how much they love pink, pink noise. And they used to listen to it back in the day. But honestly I don't remember anybody listening to pink noise as a relaxa

tion technique electronically before, you know, maybe 10, 15 years ago there were some noise machines, but a lot of them were like the marpac, which is a fan inside of a machine and people would listen to that. So there's a lot, there mean tons of noise machines now. And so it's just fascinating to to see that whole world unfold and how our brains are soothed by sounds. And if it wasn't for YouTube creating 10 hour, 12 hour possible listening experiences, a lot of this wouldn't happen because be

fore this, a compact disc 80 minutes, it's about as much as you could get. Some DVDs could go longer. So streaming has really opened up this whole possibility of listening experiences and I would've never thought that some of these would be more popular than than rock and roll. - Yeah, that's great. In terms of the pink noise in various sounds, you know, one day I decided to test out posting some sounds on on my channel, partly inspired by seeing your videos, generally understanding that sounds

did help some of my patients. And I was recommending sound therapy treatment after all. So I tried, I decided to try something that was not in the textbooks of audiology tinnitus treatment. No one taught me this in school or in my residency program. It was about cricket sounds. And I think most doctors are skeptical when they first hear this. They think, oh what is this? Is this like the tapping behind the ears trick? Is this some, you know, 32nd tinnitus cure that the internet creates this hype

around but it doesn't actually do anything. But I learned differently. I learned that cricket sounds consistently certain kinds of these high pitch, somewhat modulating sounds when they're consistently used can help people focus. They can help with concentration during the daytime. They can help fall asleep and stay asleep at night. So I posted this 10 hour cricket sound and you know, fast forward two years and it has over a million views so that means a million times, just a lot, someone click

s that video to hear it and a lot of folks are using that consistently to fall asleep. If you have tinnitus and you haven't so much with cricket sounds, it's definitely worth trying. I think Dale, your channels does a great job at presenting a lot of different sounds. Sometimes I wonder, oh no, if someone has an anxious mind, they might be spending five hours going through every single sound and not sure which one helps them the most. However, I just, 'cause I know some of my patients, all right

, I know some of us have this kind of OCD mentality of there might be one sound buried in Dale's 300 sounds that I need to listen to and I'm going to find that that needle in the haystack that buried treasure. And that might be true, but generally speaking, for most people, using a handful of more popular sounds, including trying a cricket sound that can give someone a a toolkit of sound therapies that they can go back to. I'm curious, Dale, what you found in terms of, you know, obscure sounds,

maybe nature sounds that have surprised you in terms of helping, helping folks who have tinnitus who are here in our community. - I think the cricket sound is interesting because it, maybe it also conjures up memories or it has some primal link to our past, but it definitely soothes people and I think for some people that have a tinnitus sound in their mind that it's more of a noise and having something like that that's a modulating pitch can help with that. And just like some people like babbli

ng brooks and and water sounds, years ago I was in Australia and there was cicadas that were very loud and I recorded that and that became quite popular for some people just so they can remember that sweet summer sound and for other people for tinnitus. And so that cicadas has been quite popular. I've done it a couple cricket ones mine are fairly intense where I've stacked many layers of crickets. It's not, it would be like the crickets you might hear, I don't know, in the jungle or somewhere -

Very deep in the Amazon Dale's. Yeah, yeah. Sounds, bring your mind deep into the Amazon rainforest on a hot, hot humid night with a cacophony of crickets. - That's right because you know, like there's one island in Hawaii where the frogs are just over the top. Some sort of unnatural frog has come in and overpopulated in, - I lived on that island actually, it's called Big Island Hawaii. I lived on that island for a year. I worked as an audiologist there at a clinic and this is before I started t

he YouTube channel. And yeah, they had this particular frog called the coqui frog and it's an onomatopoeia because the sound of the frog is cooking, cooking, cooking, and they're an invasive species and they really thrive in the jungle. It's actually a very beautiful sound. But who knows, I might be surprised, perhaps some folks with tinnitus might they, maybe they haven't heard the cookie frog sounds. That's maybe something they're going to search on YouTube right now and I would encourage it.

But generally speaking, there's too much variation for someone to like really relax to it. It is a somewhat relaxing sound, but I, I don't think folks are going to turn it on to fall asleep so much. But in on the island at nighttime especially, there's a lot of these frogs making a lot of noises. - I think that it's sort of like opera music or hillbilly, you know, Appalachian music. There's certain people that love it and certain people that don't. And it might be partly 'cause it's conjuring up

memories, but I have seen that with this coqui frog where some people say, I love this sound. And other people say, you know, I stomp on these things when I get home from work. 'cause there's so many of them. So there's no one sound that's going to work for everybody, just like there's no one musical style. And so that's kind of the fun part and that's why I've made a few samplers that show the different types of noise to help people fast track to finding it so people don't go down a, I think t

here's 250 videos up there now, so, but I'm, I'm still trying different things. So there's like an orchestra, I've recorded 30 or 40 symphonies and I took the tuning up part when they play the A note at the beginning and I just layered those from all the orchestras and that, I don't know if that's necessarily for tinnitus, but it evokes a feeling, especially in certain musicians that the show's about to start this excitement. It's also the startup sound for the PS three. And so some people come

in from that and say, Hey, it's PS three startup sound, which I didn't realize at the time, or the startup sound of Sergeant Peppers for Beatles fans. But when it goes on for eight hours and it never stops and the crowd doesn't clap, when the maestro comes out and the concert starts, it creates this anticipation in your mind that it's triggered, but then you never arrive at that point. So these are just different fun ways that you can play with sounds to stimulate the mind in different ways. And

I never know what I'm going to get out, it's a box of chocolates, but they're fun to do that. And some of them, you know, find a little niche of people that enjoy them over time and that's why I keep making them weekly. Yeah, - I love that. Dale, one thing that I've heard from some folks, which I want to address head on, is that we want everyone here to find tinnitus treatment that works or progressively reduce their tinnitus over time to the point where they don't need to watch our videos, the

y don't need to listen to the sound therapy because they're better. I think folks sometimes are frustrated that, what do you mean that sound therapy treatment and tenderness, retraining therapy and habituation are the best treatments. We need something better. I think that we're in agreement, I'm personally in agreement and I know Dale is as well about, you know, supporting research, creating better treatments, creating a better understanding of the tinnitus brain relationship and what kind of m

edical methods we can use to improve tinnitus and perhaps have a treatment that can significantly reduce the volume for a certain subgroup of tinnitus patients. I mean, I believe that is very possible in my lifetime and there's lots of smart researchers working on it. It's a tough nut to crack. But I wanted to address that, that we're all here to reduce tinnitus. No one here wants to, you know, have bothersome tinnitus for years and years and years using the tools that you're learning between Tr

eble Health Channel, between the Dale Snail channel and the sound therapies. This can either make life easier during, during this stage, or it hopefully can also reduce your baseline level of tinnitus and help with sleep concentration, stress levels, anxiety and all that. So I know Dale, we're on the same team there and just wanted to really highlight that for everyone in the community. - That's right. 'cause listeners come and go. A lot of times you'll see people in the comments. I get used to

seeing some people commenting quite a bit and they'll say, yeah, it's, it's not a big deal anymore. I've come to terms with it and my tinnitus is now a two out of 10, so I'm not listening as often. And that is the goal actually, that people will not be listening in perpetuity. So yeah, we're definitely on the same page with that and I do believe that we're going to make some great strides in solving some of these issues over time. - Guys, check the links below. If you want to learn more about Tr

eble health, we have the free tinnitus quiz where you can get a better understanding of your symptoms. Dale Snail, where can folks find you and the great work that you're - Doing? Well, you can just go Dale Snail on YouTube or Dale Snail slash noise ambient. You can find my channel. There's lots of links in each video to downloads and my website and you can get more information there. But pretty much I'm just hanging out on YouTube. Thanks everybody for listening to the a hundred thousand Subs s

pecial here with Dr. Ben. - Amazing. We'll see you at 1 million. All right.