Sleep Hygiene Practices For Tinnitus Patients

One of the most frequently reported problems from tinnitus patients is sleeping difficulty. From difficulty falling asleep, to difficulty staying asleep, to general decreases in sleep quality, many people with tinnitus struggle to practice ideal sleep hygiene and stay and fall asleep. Because better sleep is essential to everyone’s overall health and well-being, we have explored some of the best sleep hygiene practices for tinnitus patients to effectively achieve a better night’s sleep.

To understand why good sleep hygiene can be difficult when tinnitus is present, we must first recognize the way tinnitus causes sleep disturbances and negatively impacts an individual’s ability to fall or stay asleep, and how tinnitus works in general.

What Is Tinnitus?

The official definition of tinnitus is the perception of sounds of ringing, buzzing, hissing, or clicking, which can be heard in one or both ears. While this may seem simple enough, there are different definitions to describe tinnitus symptoms, and there are many effects of tinnitus that can accompany symptoms or appear to be symptoms themselves. These sounds are heard without an external source of the noise, and can be of differing severity. There is an 80/20 principle involving tinnitus symptoms: 80% of people with the condition are not functionally impacted by their symptoms, while the other 20% find it to be bothersome.

Understandably, when there are phantom sounds present, those with tinnitus can have trouble falling asleep. Even when someone is able to practice good sleep hygiene, the sounds of tinnitus can make it difficult to sleep, and sleep disorders can develop as a result. Although there are ways to improve sleep quality, including sound masking, there are not necessarily any guarantees to ensure that people with tinnitus will not have difficulty falling or staying asleep.

Why Is Sleep So Essential For Our Health?

Sleep plays a vital role in the health and well-being of every person on the planet. From the smallest child to the longest-living adult, sleep is essential to perform, feel through, and cope with daily life. At present, experts recommend 7 to 9 hours of sleep per night; those who sleep for fewer than 7 hours each night are more likely to develop ongoing health issues than those who sleep 7 or more hours each night.

The presence of sleep disorders and tinnitus can be daunting to maintain health, but fortunately, sleep habits can be relearned and improved to increase sleep quality and quantity, and enjoy the countless benefits of getting adequate amounts of sleep.

Why Is It So Hard To Fall Asleep with Tinnitus?

Many people with tinnitus report that tinnitus symptoms are more noticeable in quiet places or during quiet times than places or times when a lot of background noise is present. Bedtime is often the quietest environment people find themselves in, and is therefore the most likely place for tinnitus patients to experience a spike in symptoms, or a spike in the amount of anxiety experienced as a result of a potential tinnitus flare up.

At the end of the day, tinnitus patients frequently feel exhausted by battling with their tinnitus symptoms during the day. This can lead to feeling overtired, or a conundrum in which someone is restless and agitated as a result of being tired and unable to sleep, further preventing healthy sleep patterns. The distraction of tinnitus noises can make it difficult for a patient to ignore sounds and go to sleep. For some, staying asleep is the primary issue, while for others, falling asleep and staying asleep are not the issue, but getting good quality sleep is.

Simple Strategies To Address Sleep Problems Caused by Tinnitus

Learning how to effectively fall asleep and stay asleep can be a vital habit to develop when you have tinnitus. Although most tinnitus treatment options do not address sleep directly, sleep issues can exacerbate symptoms. Many people practice good sleep hygiene as a support to tinnitus treatment, potentially using the following tactics:

Create A Bedtime Routine

Good sleep hygiene begins with a routine. Going to bed at the same time every night can help tinnitus patients get one step closer to learning how to fall asleep and stay that way. When deciding on the ideal time to go to sleep, make sure you plan for 7 to 9 hours of sleep. Restful sleep is best achieved when a room is between 60 and 67 degrees Fahrenheit, and no light is visible.

If a sleeping partner is present, consider aligning your bedtime, so that you are not awoken by a partner coming to bed later in the night. Being woken up during sleep is one of the common complaints tinnitus patients have regarding night-time flare ups, and they may have difficulty falling asleep again without sound masking, white noise, or another intervention.

Reduce Stimulants Before Bedtime

Stimulants like the caffeine found in most sodas, teas, and coffee should be avoided 5-9 hours before bed to make sure the body has time to relax and prepare for rest. High-intensity exercise like running and aerobics can also negatively impact sleep hygiene, and make it more difficult to relax enough to get to sleep. Stimulants have been known to cause sleep disturbances, which can further impede successful tinnitus management overnight.

Reduce Blue Light Exposure

Blue light is the type of light given off by electronic devices like TVs, ebook readers, cell phones, and computers. It is also the type of light that is emitted in the early morning that essentially signals your brain to wake up. Blue light, then, has a tendency to impact the body’s biological clock (or circadian rhythm) by reducing the body’s ability to produce melatonin (a sleep hormone). This makes it difficult for bodies to understand that it is nighttime, and therefore time to fall asleep. The standard recommendation is limited blue light exposure for 2 to 3 hours before bedtime. If reducing or limiting exposure is not possible, blue light glasses can help block out some blue light and allow the body to recover from some of the exposure incurred.

Limit Screen Time

Avoiding electronic devices at night can be extremely beneficial to your sleep hygiene, not only by reducing blue light exposure, but also by improving mental health and clarity. Watching TV and scrolling endlessly through social media has been shown in studies to negatively affect an individual’s mood and mental status.

If, for instance, someone with tinnitus symptoms sees something that elicits a negative emotion right before bed, it can cause a spike in anxiety or a negative emotion. That, in turn, can trigger a fight or flight response, and raise negative emotions or trigger feelings of anxiety or depression. These feelings can create something of a vicious cycle, wherein negative feelings disturb sleep and lead to more severe tinnitus, and tinnitus leads to increases in anxiety and depression and subsequent trouble falling asleep.

Relax Before Bed Using Deep Breathing, Stretching, Or Meditation/Yoga

Relaxation exercises can be excellent to support restful sleep and decrease sleep deprivation. If poor sleep is an issue, consider trying progressive muscle relaxation exercises, yoga, deep breathing exercises such as box breathing, and meditation. These have all been shown to help your body both physically and mentally to get into a relaxed and restful mindset. Implementing these practices can help improve sleep, decrease the vicious cycle of increased symptoms and decreased sleep, and reduce the constant ringing in your ears.

Turn The TV Off When Sleeping

People with tinnitus frequently use the TV as a background noise when sleeping, as a way to overtake the sound of constant ringing. The sleep timer function may be used to turn a TV set off after a set time frame, after they have likely already fallen asleep. Unfortunately, a TV is not exactly ambient noise, and can cause further sleep disturbances. Why? Ultimately, it comes down to the type of noise provided by TV. TV sounds are not constant; instead, they are highly dynamic, which makes it difficult for the brain to find a relaxing steadiness to the sounds being heard. Light and audio can also be distracting.

If a TV’s audio is on, your brain is likely passively listening to what is on the television, and it may be disrupting your mood and causing reactions you may not be aware of. When the sleep timer goes off, the loss of background noise can actually cause you to wake up.

Bodies are built to passively listen to the environment in which we sleep, for safety. Our sense of hearing is the only sense that is active 24/7. If something in the environment changes while we sleep, we can be alerted to wake up and get out. The same is true of people with tinnitus, and addressing chronic tinnitus with a TV on frequently has the opposite effect of the desired result. A steady, constant, and soothing sound is more appropriate for and beneficial to improve sleep with tinnitus. Nature sounds, white noise, and more are the preferred background noise suggested for tinnitus.

Use Sound Therapy ALL Night While Sleeping

Using a table top sound generator or ear level generator, like a sleep headband, you can program soft, soothing, constant sound masking all night to your bedroom environment. The best sounds to utilize include white noise, brown noise, ambient music (without lyrics), nature sounds, and calming sounds, as you might find in a spa. Playing these sounds at a soft, consistent level can help soothe your brain and body and help you get to sleep. From free apps that play basic sound therapy, to more comprehensive apps with custom sound therapy tracks (like our Treble Web App!), there are many ways to employ nature sounds and other soothing sounds to ease into sleep.

Additional Treatments For Tinnitus

A hearing professional, such as an audiologist, can provide personalized advice and treatment to help you find relief from hearing issues like tinnitus that can interfere with quality of life and quality of sleep. The most common treatment options include the following:

• Tinnitus Retraining Therapy (TRT). TRT can help with tinnitus severity by essentially teaching the brain how to respond more appropriately and easily to the spike in tinnitus symptoms. By combining counseling and sound therapy, TRT helps mask tinnitus, while counseling to improve mental and emotional responses to chronic tinnitus.
• Cognitive Behavioral Therapy (CBT). Cognitive behavioral therapy is most frequently used in treating mental health conditions, but can also help improve quality of life for individuals with tinnitus, by improving emotional and mental responses to symptoms, and lessening the effects of anxiety and depression.
• Hearing aids. Hearing aids are typically associated with age related hearing loss, but they have also been used to treat tinnitus. This is achieved in a twofold manner: by using hearing aids to target the loss of normal hearing, as is the case when using them for age related hearing loss and other forms of hearing loss, people with tinnitus can more easily perceive the sounds around them, over the sound of ringing in the ears. They can also be used to deliver sound therapy and ambient music or sounds.
• Sound therapy. Sound therapy can be enormously helpful, as it can both mask the sounds of tinnitus and create a sense of calm or ease in the body. Whether it is used to improve the negative interactions between tinnitus and sleep, or used throughout the day to mask symptoms, sound therapy is a frequent and useful therapy for tinnitus.

Learning how to fall asleep (and stay asleep) with tinnitus can be difficult. Nevertheless, there are many ways to make sure that people with tinnitus achieve better sleep, from using hearing aids to deliver sound therapy, to addressing stressors overall, hearing loss and tinnitus do not have to mean the loss of sleep, and it is possible to find relief from sleep disturbances while treating tinnitus.