It’s 2 AM. You’re staring at the ceiling. All you want is to sleep, but that persistent ringing, buzzing, or hissing in your ears just won’t quit. This frustrating scenario is all too common. The connection between sleep disorders and tinnitus is something I see almost every day in my audiology practice.
It’s a draining cycle. The tinnitus makes it hard to fall asleep. The lack of sleep seems to make the tinnitus even louder and more intrusive the next day. You feel tired, stressed, and stuck.
"As a recent graduate who’s achieved stage four habituation, I cannot thank Treble Health enough for getting me to the finish line."
"As a recent graduate who’s achieved stage four habituation, I cannot thank Treble Health enough for getting me to the finish line."
– Louis
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Tinnitus is often connected to other challenges, especially anxiety, depression, and sleep disorders (Izuhara et al., 2013). In fact, trouble sleeping is the most common issue. Studies show it affects up to 60% of people with tinnitus (Aazh et al., 2019). When you have a sleep disorder, it can make the distress from tinnitus feel much worse. This also leads to feeling tired and drowsy during the day (Li et al., 2022). Anxiety, which is also linked, often appears as constant worry, fear, and avoiding certain activities. These feelings can seriously impact a person’s daily life (Craske and Stein, 2016).
Why Is Tinnitus Louder at Night?
A question I get all the time is, “Why is my tinnitus so loud when I’m trying to sleep?” Many of my patients report this, and it makes perfect sense. Think about your bedroom. It’s usually the quietest place in your house, especially when you’re trying to sleep.
During the day, your brain is busy processing all the sounds around you. The sound of traffic, people talking, the hum of your computer. These sounds help to “mask” or cover up the tinnitus. But when you lie down in a quiet room, all those external sounds fade away. When there is little to no other sound to focus on, that ringing or buzzing becomes the main event. It’s difficult, if not impossible, to ignore.
Is There a Link Between Sleep and Tinnitus?
The short answer is a definite yes. Think of it as a two-way street. Bothersome tinnitus can be a major risk factor for developing poor sleep. At the same time, disrupted sleep is a well-known risk factor for worsening the distress and frustration caused by tinnitus.
This isn’t just a feeling. Research is very clear on this. In fact, studies have shown that sleep disorders are incredibly common among those with tinnitus. Some research, like a 2018 study by Aazh and Moore, highlights that a large percentage of tinnitus patients report significant sleep problems. This strong link between sleep disorders and tinnitus means that treating one often requires treating the other.
What is the Connection Between Sleep Apnea and Tinnitus?
When we talk about sleep disorders, one of the biggest culprits is sleep apnea. Specifically, Obstructive Sleep Apnea or OSA.
Sleep apnea is a very common condition. It’s when your breathing repeatedly stops and starts while you sleep. The most obvious sign is often loud, disruptive snoring, but the person may also wake up choking or gasping for air. This leads to very poor, fragmented sleep and can cause serious daytime sleepiness and other health problems.
So, what does this have to do with tinnitus? The link is stronger than many people think.
Research on Sleep Apnea and Tinnitus
A large-scale study from Taiwan looked at over 130,000 patients. It found that the risk of tinnitus was significantly higher in patients with sleep disturbances. The risk was especially high for those with sleep apnea. Their odds of having tinnitus were 1.36 times higher than those without sleep apnea.
More recent research confirms this. A 2023 study using US data (NHANES) concluded that Obstructive Sleep Apnea is a risk factor for developing tinnitus.
Why Does This Happen?
Researchers have a few main theories about why sleep apnea and tinnitus are linked.
- Oxygen Deprivation: This is the primary theory. When you stop breathing during an apnea episode, your body’s oxygen levels drop. This happens over and over, all night long. This repeated loss of oxygen can, over time, damage delicate cells throughout your body, including the sensitive hair cells in your inner ear. This damage could be one reason tinnitus starts or gets worse.
- The Snoring Factor: Another idea is simpler. It’s about noise. Sleep apnea is often associated with very loud snoring. We know that frequent exposure to loud noise is a major risk factor for hearing issues and tinnitus. It’s possible that being exposed to that loud snoring, night after night, could contribute to the problem.
- Stress on the Body: Sleep apnea puts a huge amount of stress on your entire system. This constant stress and poor sleep can fire up your nervous system, making you more aware of and distressed by a tinnitus sound.
Is Tinnitus Connected to Insomnia?
Tinnitus and insomnia are very strongly connected in what audiologists often call a “vicious cycle.” Tinnitus can easily trigger insomnia because when you lie down in a quiet room, the ringing or buzzing sound becomes much more noticeable, causing stress and making it difficult to fall asleep.
What is the Connection Between Insomnia and Tinnitus?
This is the classic “vicious cycle.” Tinnitus and insomnia are very strongly connected. Tinnitus can easily trigger insomnia because the sound becomes so noticeable in a quiet room, causing stress that makes it hard to fall asleep.
This lack of sleep then makes the tinnitus feel worse. When you’re fatigued, your brain is less able to cope with the sound and perceives it as louder and more distressing.
This is extremely common. A 2023 study from Saudi Arabia looked specifically at insomnia in chronic tinnitus patients. The results were striking. Out of 434 participants with tinnitus, a staggering 62.7% reported suffering from insomnia because of their tinnitus. Many of these individuals reported taking over 40 minutes to fall asleep.
This shows how crucial it is to address sleep when treating tinnitus. Alarmingly, the study also noted that insomnia was often untreated in these patients. This is a huge missed opportunity, as successfully managing insomnia can also help reduce the distress from tinnitus.
Which Disorder is Associated with Tinnitus?
While apnea and insomnia are the main two, other sleep issues are also part of the picture.
Obstructive Sleep Apnea
Researchers used a large set of data from the United States (NHANES 2005-2020) to see if there was a real connection between Obstructive Sleep Apnea (OSA) and tinnitus. They discovered a clear and significant association. Even after adjusting for other factors, the link was strong. This study’s findings indicate that having OSA makes you more likely to develop tinnitus, confirming it as a definite risk factor.
General Sleep Deprivation
Even if you don’t have a diagnosed disorder, just getting insufficient sleep can be a problem. A 2022 study in The Laryngoscope found that negative sleep patterns were significantly associated with bothersome tinnitus. This included things like getting less than 8 hours of sleep or just reporting general trouble sleeping. Interestingly, this connection remained even after accounting for hearing loss. This suggests the relationship between poor sleep and tinnitus is likely contributed by central processes in the brain, not just an issue in the ear itself.
Parasomnias
This is a less common and less-studied category. Parasomnias are abnormal behaviors that happen during sleep, such as sleepwalking or sleep terrors. While research here is rare, some studies have noted a possible connection. This suggests there may be shared pathways in the brain related to stress and anxiety.
How You Can Start Sleeping Better (Even With Tinnitus)
Reading all of this might feel discouraging, but I want you to feel hopeful. Understanding this connection is the very first step to breaking the cycle. The goal is to manage both the sleep and the tinnitus. You can do this!
One of the best places to start is with good “sleep hygiene.” This is just a term for building healthy habits that set you up for a successful night’s sleep.
We have a lot of resources at Treble Health to help you with this exact problem.
- Blog Guides:
- For practical tips on making your bedroom more sleep-friendly, check out 8 Ways To Sleep Peacefully With Tinnitus.
- We also have a great guide on Sleep Hygiene Practices For Tinnitus Patients.
- For specific nighttime strategies, don’t miss The Best Ways To Reduce Tinnitus At Night.
- Helpful Videos:
- If you’re more of a visual learner, I’ve recorded some videos on this exact topic. You can watch 3 Techniques for Sleeping With Tinnitus for some immediate ideas.
- I also have a video on How to Get Good Sleep with Tinnitus that covers more ground.
You Don’t Have to Face This Alone
The relationship between sleep disorders and tinnitus is complex, but it is not a life sentence. It is a cycle that can be managed and, in many cases, broken. Whether it’s insomnia, sleep apnea, or just general poor sleep, addressing your sleep health is a critical part of managing your tinnitus. And likewise, managing your tinnitus can lead to the restful sleep you deserve.
You don’t have to figure this out by yourself. Our team of audiologists at Treble Health specializes in creating personalized plans that help people just like you find relief. We understand the connection between sleep and tinnitus, and we’re here to help you find strategies that work for you.
Book a free 20-minute telehealth consultation today to get expert guidance, explore treatment options, and take real steps toward better hearing and a better quality of life.
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