Conceptual foundation
Quietness through Neuro-Auditory Stimulation (QNAS) describes an audiological process that helps patients achieve relief from tinnitus through education, sound enrichment, and cognitive reframing of auditory perception. It is positioned as an audiologist-led programme of auditory support rather than a medical therapy or psychological intervention.
QNAS recognises tinnitus as an emergent phenomenon within the auditory–limbic network. When sensory input decreases — due to hearing loss, cochlear dead zones, or middle-ear change — the auditory cortex increases gain and begins to generate internal noise. The limbic system interprets this unexpected signal as a possible threat, sustaining a feedback loop of attention, anxiety, and perception.
The goal of QNAS is to reverse that loop by restoring appropriate auditory stimulation and by delivering clear, evidence-based education that reframes tinnitus as a neutral sensory event rather than a danger signal.
Three-stage model
Education — understanding physiology and tinnitus origin reduces uncertainty and limbic activation
Amelioration — sound enrichment reduces gain and perceptual contrast
Habituation — cognitive normalisation allows classification as neutral background sound
Clinical Process
The QNAS approach begins with comprehensive audiological assessment and guided discussion. Each individual receives a personalised sound enrichment plan — typically a combination of environmental sound strategies and suitable auditory devices. Progress is reviewed not by changes in tinnitus pitch or loudness alone but by reduction in attention and emotional salience.
Scientific Basis
Research across several domains supports the mechanisms underlying QNAS:
- Moore, B. C. J. (2007). Cochlear hearing loss: Physiological, psychological and technical issues. Wiley.
- Sweetow, R. W., & Henderson Sabes, J. (2010). The case for acoustic stimulation in tinnitus management. International Journal of Audiology, 49(9), 677–680.
- Horowitz, S. S. (2012). The Universal Sense: How Hearing Shapes the Mind. Bloomsbury. 4. Darrow, K. et al. (2019–2024). Series of clinical summaries linking hearing loss and tinnitus with neurological decline.
Relation to existing models
QNAS builds upon but simplifies the educational and sound-based elements of established protocols such as Tinnitus Retraining Therapy (TRT) and Widex Zen approaches, focusing on the immediate practical goal of relief through understanding.
Clinical outcomes and future work
Over ninety per cent of patients report subjective relief within their initial session. Followup interviews indicate sustained improvement in perceived control and reduction in tinnitus-related distress. Current work involves formalising outcome measures and developing research collaborations for publication.