If you’re like a lot of people, it can be tough to get a good night’s sleep. Kids, pets, a snoring or restless partner, an uncomfortable mattress, light, noise or racing thoughts can all interrupt your rest. And if that’s not bad enough, tinnitus can make it even harder to get the restorative sleep you need.
Tinnitus isn’t a disease. It’s a symptom of another condition. The most common type of tinnitus is called subjective tinnitus. With it, you hear ringing, buzzing, hissing or whistling in your ears even when nothing is causing the sound.
“It’s a perception of sound that doesn’t come from an external source, so others can’t hear it,” said Jason Smith, an audiologist with Banner - University Medicine.
The sounds of subjective tinnitus may come and go, get louder and softer and change in pitch. The constant noise can make it hard to fall asleep or stay asleep. It can be tough to deal with when your sleeping area is quiet since that can make it harder to ignore the tinnitus.
Another type of tinnitus, called objective tinnitus, is rare. It’s often caused by middle ear disorders, and other people may also hear it.
It’s important to manage tinnitus so you can get the sleep you need. When you don’t sleep well, you’re at risk for health issues like a weaker immune system, stress and trouble concentrating.
What causes tinnitus?
It’s not clear exactly what causes the condition. Experts think that when you have hearing loss, your auditory nerve activity increases — it’s responding to the lack of input. “This increased neural activity is perceived as sound, even though it isn’t sound,” Dr. Smith said.
You could have tinnitus because of:
- Age-related hearing loss or damage to the inner ear from loud noises.
- Earwax buildup, ear infections or other blockages.
- Some medications, particularly in high doses, including certain antibiotics, diuretics and anti-inflammatory drugs.
- Conditions such as high blood pressure, diabetes, thyroid disorders and head or neck injuries.
- Emotional stress and anxiety.
How tinnitus can impact your sleep
“The effects of tinnitus on sleep are different for everyone,” Dr. Smith said. It doesn’t always disrupt sleep. But it can cause:
- Difficulty falling asleep. The constant noise can make it hard to relax and fall asleep, particularly in quiet spaces where you notice it more.
- Waking up throughout the night, so you have fragmented and restless sleep.
- Waking up for other reasons, then not being able to fall back asleep because of tinnitus.
- Discomfort and distraction that keep you from reaching the deeper stages of sleep you need for restorative rest.
- Increased stress and anxiety, which in turn can make tinnitus seem more prominent and further disrupt sleep.
How to sleep better with tinnitus
These tips can help you get the rest you need:
- Create a relaxing sleep environment: If you can, invest in a good mattress and pillows — you’ll sleep better if you’re comfortable.
- Keep your bedroom cool (60 to 67 degrees F) and dark.
- Use blackout curtains or an eye mask to block out light and signal to your body that it’s time to sleep.
- Use a TV, white noise apps or sound machines at a low volume to mask the tinnitus. You might want to experiment with ocean waves, falling rain, nature sounds or other gentle noises to see what works best. Many smartphone apps and other devices provide customizable soundscapes.
- Stick with a regular sleep schedule. Going to bed and waking up at the same time every day helps regulate your internal clock and reinforce your sleep-wake cycle.
- Limit caffeine and alcohol in the evening since they can disrupt your sleep.
- Avoid heavy meals and exercise close to bedtime. Try to finish eating two to three hours before bedtime and exercise earlier in the day.
- Try relaxation techniques such as deep breathing, progressive muscle relaxation, mindfulness meditation or guided imagery.
- Limit screen time before bed, since the blue light that screens emit can interfere with melatonin, the hormone that regulates sleep. An hour before bedtime, try reading, listening to calming music, working on a craft or hobby or taking a bath.
When to get medical care
If these steps aren’t helping you sleep well, you may want to talk to your primary care provider, an ear, nose and throat (ENT) provider or an audiologist. A professional can help figure out what’s causing tinnitus and suggest treatment options.
“Anyone with tinnitus should have their hearing evaluated to rule out medical causes, especially if the symptoms are worse in one ear or seem to coincide with your heart rate,” Dr. Smith said.
Treatments for tinnitus include:
- Hearing aids. “People who have diagnosed hearing loss and use hearing aids regularly can get accustomed to the tinnitus, so symptoms aren’t as bad at night,” Dr. Smith said.
- Cognitive-behavioral therapy (CBT) for managing tinnitus-related anxiety. “Most people aren’t aware that stress and anxiety can make symptoms worse,” Dr. Smith said.
- Tinnitus retraining therapy, which is a combination of counseling and sounds that mask tinnitus. However, it’s not clear if this therapy is better than other treatments, and it’s usually not covered by insurance.
Don’t try to treat tinnitus on your own without consulting a health care professional. “Some nonmedical treatments may cause harm,” Dr. Smith said.
The bottom line
Tinnitus, a ringing, buzzing or humming sound in your ears, can make it hard for you to fall asleep or stay asleep. It can help to take steps to improve your sleep and to mask the tinnitus symptoms with white noise.
You should also have your hearing checked to make sure there’s not a treatable cause for tinnitus. If you would like to connect with a health care professional who can evaluate tinnitus and help you develop a treatment plan, reach out to an expert at Banner Health.
