Tinnitus and Sleep

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Tinnitus and Sleep

Tinnitus is a condition that causes a ringing in the ears. While ringing in the ear is one of the most common symptoms of tinnitus, other sounds people might hear are buzzing, humming, hissing, clicking, or roaring. Although not considered a serious health problem, anyone with tinnitus can tell you that the condition can cause discomfort that ranges from mild annoyance to unbearable. Beyond the discomfort, tinnitus can also lead to sleep disturbances. In fact, current research on tinnitus and sleep shows that somewhere between 50 to 77% of all tinnitus patients also develop sleeping problems, ultimately making sleep the most common complaint among those with tinnitus. 

Some common causes of tinnitus include: 

  • Age-related hearing loss 
  • Noise-induced hearing loss
  • Ear and sinus infections
  • Head, neck, or ear injury 
  • Diseases associated with the heart or blood vessels
  • Hormonal changes (women)
  • Brain tumors
  • Certain medications (antibiotics, diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs))
  • Thyroid disorders 
  • TMJ disorders

Tinnitus And Sleep

People with tinnitus often have difficulty falling asleep and staying asleep. Ultimately (and understandably), that can lead to frequent issues with daytime fatigue. “Tinnitus can make it difficult to fall asleep, as the noise can distract from being able to relax enough to fall asleep,” says Amy Sarow, doctor of audiology. “For some people, it can even wake them up in the middle of the night.” 

Sleep disorders are the most common symptoms associated with tinnitus. One study even showed that 54% of tinnitus patients were diagnosed with sleep disorders

Sleep problems commonly associated with tinnitus include:

  • Trouble falling asleep
  • Poor sleep quality
  • Not getting enough sleep
  • Unrestorative sleep 
  • Chronic fatigue 
  • Daytime sleepiness

Does A Lack Of Sleep Trigger Tinnitus? 

It would seem that sleep and tinnitus have a cyclical relationship. While the symptoms of tinnitus often interfere with sleep, research shows that sleep deprivation may be a cause of chronic tinnitus. 

Does Tinnitus Cause Sleep Disorders? 

Tinnitus can lead to sleep disturbances, the most common of which is insomnia. Insomnia is a common sleep disorder, the hallmarks of which are difficulty falling asleep and staying asleep. When viewed side-by-side with tinnitus symptoms (trouble falling asleep, difficulty staying asleep, and frequent nighttime wakings), it’s quite easy to see the connection. According to The Hearing Journal, “The greater the tinnitus severity, the more likely the patient will have insomnia or a sleep problem.” 

Tinnitus And Sleep Apnea 

Anyone doing some digging on the internet may find that tinnitus and sleep apnea are often linked. And while those resources may lead you to believe that there’s a cause-and-effect relationship between the two, Sarow explains that’s not quite the case. 

“Tinnitus does not cause sleep apnea; however, sleep apnea can make it more likely to perceive tinnitus,” says Sarow. “The reason for this is that stress aggravates tinnitus and can make it louder and more intense. [Moreover], a lack of quality sleep is stressful for the body and can [also] be a trigger.” 

Sarow explains that when you pair poor quality sleep as a result of obstructive sleep apnea (OSA) and the fact that CPAP machines cause negative pressure in the middle ear space or Eustachian tubes, tinnitus symptoms can be more pronounced. 

Tips For Getting Better Sleep With Tinnitus 

While there is no cure for tinnitus, there are things you can do to mitigate the symptoms and reduce its impact on your daily life and get some sleep. 

Practice Good Sleep Hygiene

First and foremost, Sarow notes that “sleep hygiene is key. If you’re fighting the good fight every night only to find that sleep still doesn’t come easy, a few tweaks to your sleep hygiene may be in order.” In addition to ensuring that your bedroom is cool and dark, Sarow also suggests “getting regular physical activity during the day and following a set night-time routine.” 

Try sound masking

Background noise (i.e., nature sounds, a fan, ambient music, or colored noise) is a common go-to for those with tinnitus. “If tinnitus is louder in quiet [times or settings], using a masking sound can help to take the edge off,” says Sarow. “For example, some patients find listening to ocean sounds or other nature sounds to be soothing and enough to mask the sound of their tinnitus.”

And while noise may help mask the perception of tinnitus at night when things are quiet, you may have to do a little trial and error to find the one that works for you. 

White noise can work very well for some people, while other types of noise may be more beneficial for others,” says Dr. Sarow. “For example, brown noise can have a rounder, more gentle sound that masks tinnitus better for some people.” 

Digging a little deeper into research on noise colors and tinnitus, one study found that ⅔ of participants preferred white noise for masking tinnitus symptoms, while red noise came in second. 

Keep Your Stress In Check

While there seems to be a causal relationship between stress and tinnitus, researchers have yet to untangle exactly how or why. (Interestingly, one working theory is that tinnitus acts as an alarm of sorts when stressful situations arise.) 

Although we don’t know exactly how stress affects tinnitus or how tinnitus affects stress, we do know that there are plenty of people who find that their tinnitus symptoms are exacerbated in stressful situations. If you’re one of them, you might want to think about making some lifestyle changes to keep your stress in check. Daily exercise and meditation can both be helpful here. 

Steer Clear Of Things That Cause Tinnitus Spikes 

When dealing with tinnitus, avoidance is a pretty good approach — in terms of triggers, that is. You may have to do some homework to figure out your specific triggers, but once you do, avoiding them or doing what you can to minimize their impact is key. 

Common tinnitus spikes include:

  • Smoking 
  • Caffeine
  • Alcohol
  • Stress
  • Anxiety/Depression
  • Being around loud noises

Watch Your Medications 

Certain drugs can trigger tinnitus or worsen your symptoms. This includes some antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs, like Advil), diuretics, and tricyclic antidepressants. If you take any of these for pain or ongoing issues, you might consider talking to your doctor and exploring possible alternatives.

Try Some Cognitive-Behavioral Therapy 

Tinnitus is a recognized medical condition, and research shows that cognitive-behavioral therapies can help you manage the symptoms of tinnitus and improve your quality of life with the condition. It’s worth noting here that CBT does not (and cannot) eliminate your auditory perception of tinnitus; instead, it aims to reduce your negative response to the sound.

Additional Treatments For Tinnitus 

Like most medical conditions, the treatments for tinnitus will ultimately depend on the underlying cause of the condition and therefore vary from person to person. 

Some other common treatments for tinnitus include:

  • Earwax removal
  • Tinnitus retraining therapy (TRT – a combination of counseling and noise therapy)
  • Hearing aids 
  • Treating blood vessel conditions

The Last Word From Sleepopolis 

Tinnitus is a relatively common condition, and for many people, the ringing and noise in their ears can make it difficult to get some quality shut-eye. While there is no cure for tinnitus, the symptoms can be managed, and there are treatments that work. Minding your sleep hygiene and masking the noise is a great start, but for more long-term care and management, you may want to speak with your doctor about cognitive behavioral therapy, tinnitus retraining therapy, or even something as simple as changing your medications. Living with tinnitus can be challenging, but it doesn’t have to keep you up at night. 

Sharon Brandwein

Sharon Brandwein

Sharon Brandwein is a Certified Sleep Science Coach and a freelance writer. She specializes in health and beauty, parenting, and of course, all things sleep. Sharon’s work has also appeared on ABC News, USAToday, and Forbes. When she’s not busy writing, you might find her somewhere curating a wardrobe for her puppy.