In the silence and calm of night, sleeping with tinnitus can be very difficult. The ringing or buzzing in your ear while you lay in bed can be very distracting and it's normal to fixate on the sound, getting trapped in a negative thought cycle. While trying to block it out might be all you want to do, your mind will often focus on it more.
Difficulty sleeping does not only affect your night but also the following day. We all know sleep is vital, and we have all experienced the irritability, short-temper, and fatigue that comes with a bad night’s sleep.
Sleep does not just re-energise us for next day's activities, it also is important in boosting our immunity, improving our mental-wellbeing and can ward off diseases such as diabetes and heart diseases.
If you've been struggling with insomnia for some time, visit a medical professional for help learn a structured way to help your mind and body wind down for sleep.
Read on for our tips on how to sleep with tinnitus.
How to sleep with tinnitus - our tips
Sleep hygiene does not refer to brushing your teeth or washing your face before bed.
Sleep hygiene means curating a sleep plan to get your body into a routine around bedtime. This will help relax your body and mind and move it into a more peaceful state, ready to go to sleep. By sticking to a routine, you create triggers and cues to inform your body when it is time to drift off.
The following tips have been shown to be helpful if you can't sleep with tinnitus:
1. Dim the lights an hour before bed
Light encourages your body to experience 'wakefulness' whereas the absence of light helps tell your body it's time to rest.
Melatonin is a hormone which sends a signal to the brain that it is time to wind down and levels of Melatonin naturally rise as it gets dark. Melatonin levels continue to rise through the night, and then fall as it starts to gets light.
Suddenly switching off the lights won't help you sleep with tinnitus but gradually lowering the light will start to send the right signals to the brain, to prepare to rest, and trigger the pineal gland to release Melatonin.
If your bedroom gets a lot of light from outside during the night, try investing in blackout blinds or curtain to block out any outside light.
You might want to buy a lamp or night light to help lower the lights before bed.
You could also explore the option of a self-timed light that comes on in the morning, if during the winter months the mornings are still very dark.
Consider trying a tinnitus pillow that provides relaxing masking noise directly to the ear as well as a comfortable and supportive place to rest your head for your best sleep.
2. Avoid caffeine before bed
Drinking a caffeinated drink before bed has been shown to interrupt the body's natural circadian rhythm.
The circadian rhythm is the way in which your body naturally wakes up and goes to sleep over a 24 hour period. It's affected by the external factors of day and night as well as internal processes of the body.
Caffeine blocks the adenosine receptors involved in this process. Adenosine is a chemical which promotes sleep and it's produced when you're awake. So normally, the chemical builds up the longer you're awake. But caffeine blocks this process and you remain alert.
Therefore, drinking too much caffeine throughout the day, or having a caffeinated tea close to bed time will make it harder for you to drift off naturally.
3. Try to wake up and go to sleep at the same time
Unless you are following a medical 'sleep programme', keep regular hours in which you go to sleep and wake up. This will help programme your body to get sleepy at the same time each day, as well as be able to get out of bed in the morning.
Once you've decided on the hour that you'll go to bed and get up, keep to it.
Avoid hitting snooze, as tempting as it might be.
You could put your alarm across the room from you to force yourself to get out of bed. Or ask someone to help you wake up, if you're trying to get up earlier and go to sleep earlier.
Once you're awake, get up, so that your bed can remain your body's cue to go to sleep.
Remember, everyone needs slightly different amounts of sleep so don't worry if you're different from those you know.
It can be tempting to moralise the hours that you sleep, deciding the earlier you get up the 'better'. Whilst it's good to get out of bed as soon as you wake up, and to respond to the natural light of day and night, there is no 'perfect' time to go to sleep or wake up.
4. Avoid blue light in your sleep routine
There are many objects around us that emit blue light, like your phone or tablet. Blue light has been found to suppress the hormone Melatonin, the 'sleepy hormone'.
As we discussed this chemical is crucial in regulating our sleep pattern and circadian rhythm. Most of the blue light we get is from the sun, and it helps us to wake up in the morning. It makes you feel alert and gets your body ready for the day.
When you're trying to sleep, the last thing you want is to suppress your Melatonin. Therefore, avoid blue light before going to sleep.
For those with tinnitus, this is easier said than done because digital devices are needed to play distracting sounds at night. Try to use your device's dark mode where possible, or your device might have a 'dark mode filter' in its Settings.
A simple way to reduce blue light exposure is by putting your phone or tablet down once the distracting sound is playing, perhaps with a self timer so it switches off at a certain time.
5. Practice breathing techniques and meditation
Never underestimate how useful breathing techniques can be. It has shown to have many positive effects on the body.
Tinnitus mindfulness incorporates breathing exercises to help you relax and find a peaceful state of mind as you notice the thoughts you have pass.
By practising breathing exercises or meditation before bedtime, it will not only help your mind to calm down but also help you release any negative thoughts you have accumulated during the day.
You might find that different breathing techniques are beneficial to you. A variety of audio conscious breathing techniques can be found in the Oto app.
A popular breathing technique is the '4-7-8 conscious breathing exercise'.
To practice this technique:
- Place the tip of your tongue on the roof of your mouth, just behind your front teeth
- Inhale through your nose for 4 seconds
- Hold your breath to the count of 7 seconds
- Exhale gently through your mouth for 8 seconds, as if blowing on food to cool it down
If you're just starting out, practice this for a few minutes and then take a break.
Conscious breathing exercises like this one slow down the body's processes, reducing stress and anxiety and helping you to frame your thoughts in a more controlled way.
6. Explore safe supplements and medications
Whilst relying on medication is not a long term solution, there are many natural supplements and medications available which are widely used as sleep aids for people struggling to sleep with tinnitus.
Take care because some sleeping tables can be very addictive and often natural sleep aids have not been rigorously tested in humans.
They can be useful to help you regulate your sleep initially but are not the answer to helping you get to sleep every night.
Natural supplements generally work to calm the mind and body and include:
- Valerian Root
- Passion Flower
Prescribed medications are also available though are not always advisable since they could do more damage than good long term:
- Benzodiazepines: these drugs, such as diazepam, help you relax by slowing down the body and acting as a sedative to help you sleep. These medications can be very effective but doctors do not like prescribing them on a long term basis as they are very addictive and are less effective after long term use.
- Melatonin: in the UK, man-made melatonin supplement is prescribed and is generally only used for adults over 55 with short term sleep problems.
7. The sleep environment
Making your room 'sleep-friendly' is a key way to induce sleep.
- If possible, try to only use your room for sleep. The mind makes associations between spaces and what's required of it, so you want your bedroom to trigger cues to get ready to go to sleep.
- Working or watching TV in your room can break this association and can make it harder to unwind and relax before bed. It might be you start to associate it with negative thoughts, stress, or a to-do list or even just with the task of staying awake!
- Get a comfortable mattress and pillow, if you're struggling to sleep with tinnitus at night. There are a variety of firmness options available for both.
- Regularly change your sheets and vacuum your bedroom to help exterminate any dust mites and avoid any allergic reactions.
- Finally, the temperature of the bedroom can encourage sleep. It's normal for your temperature to drop as you sleep and this is good because it helps you to remain sleepy. Generally a room that's between 15 and 22 degrees Celsius is appropriate for sleeping.
8. Distracting sounds
Often you'll hear people recommend quieter environments to help with sleep. For those with tinnitus, that is impossible to achieve.
Complete absence of noise can be detrimental for managing tinnitus.
Whilst ear plugs might help you block out external noises, you might find that they amplify the perception of the tinnitus sound.
Sound therapy can therefore be an excellent way to help drift off.
Tinnitus maskers, soothing music, and soundscapes are all very useful for sleeping with tinnitus as they provide external ambient noises to mask the ringing/buzzing sound interfering with your sleep.
When using one of these machines, it is recommended to set the volume of the white noise to just above the volume of your tinnitus to sufficiently mask it.
Nowadays, there are a lot of tinnitus apps which provide white noise or distracting sounds. If you do not like simple white noise, you can also play wind, rain, forest or household sounds, for example.
What is the best way to sleep with tinnitus?
Finding good sleep hygiene will take time and patience. Work through this guide to explore areas where you could make changes.
There is no best way to sleep with tinnitus - finding what works for you might take a bit of experimentation to find the combination.
Most people will find that the best way is to find a good combinations of many of the techniques we describe above.
The Oto app offers a comprehensive tinnitus solution in the palm of your hand, including several resources to improve sleep:
- Sleep support including sleep stories, mindfulness for sleep, and sleep preparation
- CBT techniques to reduce tinnitus intrusion
- A library of various masking sounds such as birds, ocean, ambiance, and waterfall
- Meditation and breathing exercises
- Physical therapy stretches for the neck, shoulders, back, jaw, and arms
Check out Oto's Tinnitus Support Group, a supportive community for individuals with tinnitus or related conditions to receive regular tips and tricks from the expert team at Oto!