For many people living with tinnitus, lying down can become a challenging experience. The sounds often associated with this condition can become more prominent.
Dr Edmund Farrar

Dr Edmund Farrar

Medically Reviewed by
Dr George Leidig
Co-Founder & CEO of Oto

Why Is My Tinnitus Worse When I Lay Down? A Comprehensive Guide

For many people living with tinnitus, lying down to rest can become a challenging experience. The variety of sounds, which extend far beyond buzzing, ringing or hissing, often associated with this condition can become more prominent. But why is tinnitus worse when lying down? This phenomenon involves a combination of physiological, neurological and psychological factors. Understanding these elements can provide crucial insights into managing tinnitus more effectively​.

This article will explore potential causes that might worsen tinnitus when lying down. We will also discuss effective strategies to reduce awareness of tinnitus and the importance of support in habituating to this condition. So, if you've ever wondered about the nocturnal behaviour of tinnitus, stay with us as we delve deeper into this intriguing topic.

What Causes Tinnitus? 

In many cases, the exact cause of tinnitus remains a mystery. Every individual's experience with tinnitus is unique, with different underlying causes and perceived sounds. One of the most common factors is exposure to loud noise. This could be a single, deafening sound, such as an explosion, or prolonged exposure to high-decibel environments, like a noisy workplace or loud music at concerts​. 

These intense sound exposures can harm the small sensory hairs in our inner ear's cochlea, leading to disruptions in normal hearing processes and leading to the perception of sound where there is none.

Age-related hearing loss, known as presbycusis, can also be a culprit. As we age, our auditory system naturally begins to wear down. The gradual loss of hearing makes the brain more prone to pick up and amplify internal noises, like the ones associated with tinnitus.

Earwax blockage is another factor. Our bodies produce earwax to protect the ear canal from dust, foreign particles, and microorganisms. However, when too much earwax accumulates, it can cause hearing loss or irritation, leading to tinnitus.

Similarly, changes in the bones of the ear can impact how sounds are perceived. This condition, called otosclerosis, involves an abnormal growth in the bones of the middle ear, impeding their movement and causing hearing loss or ringing in the ears.

Certain ototoxic medications (ones that cause damage to the sensory cells responsible for hearing and balance) are known to have tinnitus as a side effect. High doses of salicylates, commonly found in aspirin and certain antibiotics, cancer drugs, diuretics and quinine medications, have been linked with the condition.

Certain health issues often play a role too. Meniere's disease, a disorder of the inner ear characterised by episodes of feeling like the world is spinning (vertigo), tinnitus, hearing loss and fullness in the ear, is one such condition. Moreover, temporomandibular joint (TMJ) disorders affect the hinge joint connecting the jaw bone to the skull. One symptom of TMJ disorder may be tinnitus. In addition, a head or neck injury can have similar effects, as can certain types of tumours.

Why Is Tinnitus Worse at Night?

Tinnitus can become particularly pronounced as the day turns into night. The amplified experience during the night-time hours can be attributed to several factors.

One of the main factors is the relative quiet of the night. During the day, our auditory system is immersed in an array of sounds – the hum of traffic, the murmur of conversations, the chirping of birds, the ticking of a clock and more. This ambient noise can be a natural distraction, helping us notice our tinnitus less. But when the sun sets and the world around us quiets down, the contrast can increase the perception of tinnitus and make the sounds appear louder and more intrusive.

Secondly, the human brain is wired to be more alert during periods of silence, an evolutionary trait that served our ancestors well when predators roamed the night. This heightened alertness can increase awareness of internal sounds, such as those associated with tinnitus.

Moreover, our daily routines and activities also have a role to play. The tasks that fill our day, whether it's work, hobbies or social interactions, occupy our minds, leaving less room for the perception of tinnitus. However, when we settle down for the night, this mental distraction subsides, allowing the ringing sounds to take centre stage.

Physical fatigue and stress levels can also impact our experience of tinnitus. After a long day, our bodies are tired, and our stress levels might be high. This combination can make us more susceptible to the disruption caused by the condition.

Lastly, the position of our body can influence the perception of tinnitus. Lying down can alter the blood flow in the body and lead to changes in the auditory system, making the ringing more noticeable to some individuals.

Managing amplified tinnitus at night requires a multi-faceted approach that involves learning to habituate to the condition, accepting its presence and employing strategies to soothe its impact. This process can be greatly aided by the right support, which can provide the necessary tools to reduce the awareness of tinnitus, ultimately leading to a less disrupted night-time routine.

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How Do You Reduce Ears Ringing at Night?

Achieving a peaceful night's slumber in the presence of tinnitus involves engaging in a variety of strategies aimed at helping one become less aware of the ringing in the ears. Here are some ways to navigate through this journey:


Habituation is the process by which our brains learn to relegate constant, non-threatening stimuli to the background and is important in reducing the impact of the condition, particularly when trying to sleep. It's akin to living near a railway line; at first, the sound of every passing train is intrusive, but over time the noise becomes part of the ambient soundscape, barely registering in our consciousness.

This process doesn't happen overnight, but gradually, over time, the brain can learn to perceive the sound of tinnitus as a neutral signal rather than one that causes distress or commands attention.

Relaxation Techniques

Relaxation techniques, such as conscious breathing, progressive muscle relaxation and guided imagery, can be beneficial in reducing the impact of tinnitus. These techniques can soothe the nervous system, reduce stress and help divert focus away from the tinnitus.

Consistent Bedtime Routine

Creating a consistent bedtime routine can be a powerful tool to reduce the awareness of tinnitus. This regimen might involve activities such as reading a book, meditating or taking a warm bath. Such activities can distract from tinnitus and signal your brain that it's time for sleep.

Sleep-Conducive Environment

Creating an environment conducive to sleep can also help reduce tinnitus intrusion. This includes keeping the room dark, maintaining a cool temperature and having comfortable bedding. In addition, using a white noise machine or a fan can provide a constant ambient sound that may help distract from the ringing in your ears.

Sleep Positions

Experimenting with different sleeping positions can be a non-intrusive, easy adjustment that could help reduce your tinnitus awareness at night. For example, if you often sleep on your back, try switching to your side. Always ensure your sleeping position is comfortable and supports good neck and spine alignment.


Navigating through the challenges of tinnitus can be less daunting when you have the right support. This can be through support groups, online communities or professional counselling. Sharing experiences, learning from others and understanding that you're not alone in this journey can be immensely comforting and empowering.

Oto: Your Companion in the Tinnitus Journey

Navigating the tinnitus landscape can feel like an isolating experience, a continuous symphony of ringing in the ears that constantly disrupts daily life. Here, Oto steps in as a supportive guide, offering a digital program that uses Cognitive Behavioural Therapy (CBT) techniques to help you notice your tinnitus less and guide you toward habituation.

Developed by a team that personally understands the impact of tinnitus, Oto's program offers tailored tools to soothe the frequent noise intrusions into your life. Whether it's the constant ringing affecting your focus or the struggle to achieve a good night's sleep, Oto's expertly-crafted content offers a personalised support system that is accessible anytime, anywhere via a mobile app.

But Oto goes beyond being just an app. It's a community. With regular webinars and Q&A sessions featuring world-leading tinnitus experts, you become part of a journey shared with others.

With Oto, you're not just getting a service but a trustworthy companion that understands your struggle. The simplicity of its design ensures ease of use, even for those who might be less tech-savvy.

Ready to embark on this journey towards reduced awareness of tinnitus and a reclaimed life? Download the Oto app on your iOS or Android device and begin your journey of habituation today. 


Living with tinnitus can feel like a constant intrusion, which may seem to get worse as you lay your head to rest at night. But each step you take towards understanding and accepting this condition can significantly reduce the disruption it causes in your life. And remember, you're not alone in this journey. Oto is here to provide the support you need. Why not take that first step towards habituation today? Download the Oto app and let us journey together towards a life where tinnitus takes a back seat.

Unlock the Secret to Tinnitus Relief With Our Free Webinar

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Discover how to tune out tinnitus with our free webinar

Register for our 20 minute webinar and learn why you don't just have to live with tinnitus.
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Oops! Something went wrong while submitting the form.