Many of you reading this will be doing so because you are struggling with sleep because of your tinnitus. It is common for those with the condition to report difficulty getting to sleep, tinnitus waking them up or not being able to get back to sleep due to tinnitus. It is generally considered to be true that it is not tinnitus that directly wakes you, however it is usually the first thing you will notice on waking up.
We all know sleep is important, but the effects of a lack of sleep can be further reaching then just weariness, bad temper or struggling to concentrate. Our health, cognitive function, muscular repair, our overall wellness and of course our reaction to tinnitus can all be affected by our night time experiences.
It should be noted at this point, that many people with tinnitus sleep very well, so it is possible and there is good likelihood that you can and will improve with your own.
When you are sleep deprived and tinnitus is to blame, then you begin to build a negative association between the two.
Lack of sleep due to tinnitus = increased tinnitus due to a lack of sleep.
It is common that people with tinnitus experience heightened stress and anxiety close to night time as they prepare to be kept awake by the unpleasant noise. Stress and anxiety in turn make it more difficult to get to sleep.
Although it is not always obvious how, it is important to break this cycle!
We have highlighted some simple tips below, which if managed together, can go a long towards supporting good sleep habits. Remember, it can take from three weeks up to three months to form a new habit, so perseverance and self belief are important.
Tinnitus often appears heightened close to bedtime or in the night, simply because you are in a quiet room. The usual sounds that surround us in the day time, disappear and are replaced by quiet, a space that tinnitus likes to fill.
So where possible use gentle relaxing sound or the T-Minus sound therapy at a volume below your own tinnitus, not to mask but to add additional sounds into the room, tinnitus sound therapy will be more valuable here then normal music, as feeding your own frequencies back to yourself during the night has been shown to reduce tinnitus intensity over time.
If you have a partner who is not prepared to allow the sounds on a speaker in the room then why not consider a sound pillow or headband with built in speakers, even headphones if you can sleep comfortably in them.
Also try not to wake up in silence, many people ask us for a sleep timer in the app but if you wake up in silence, whether in the middle of the night or first thing in the morning, then you are back to square one. Perception of tinnitus will be higher, subsequently increasing our stress and anxiety and in turn making it harder to get back to sleep or starting the day with a negative. Try and mediate the quiet times with gentle sound therapy.
You may struggle to find anyone who doesn’t enjoy the very occasional nap, it can be a bit of a treat! However, if they become part of your routine, they can potentially cause sleep problems. Throughout the day, we build up our internal need or appetite for sleep, by taking a nap you are reducing that appetite, in turn this can make it harder to fall asleep and stay asleep. So avoid naps where possible. If you are really struggling with sleep at night and naps provide your only opportunity for sleep, then consider reducing the length and frequency of naps over time, eventually trying to commit to achieving longer night time sleep and more activity instead during the day.
Many of us rely on coffee to stay awake or alcohol to calm down or get to sleep, often we utilise these to try and manipulate our natural rhythms.
Many studies suggest that those with a moderate to high caffeine intake, equating to around 4 cups of home brewed coffee or more, experience more disturbed or interrupted sleep then those who do not consume any. This doesn’t mean you have to cut out a nice cup of coffee completely, in fact there are also reported benefits to consuming caffeine, including protecting from liver cancer, type 2 diabetes and cardiovascular disease, amongst others.
So moderation is key, enjoy you morning coffee, avoid too many cups and avoid caffeine in general after the early afternoon.
Alcohol has the opposite effect to caffeine and depresses the central nervous system, making us feel tired or fall asleep faster. It also causes disruptions to the different stages of sleep which are believed to have multiple functions supporting our wellbeing. Alcohol has been show to affect the early sleep cycles and also our Rapid Eye Movement (REM) sleep. REM is a stage of sleep linked to creativity and emotional regulation. There is even evidence showing that alcohol before bedtime can impair critical sleep-dependent processes, such as memory consolidation.
It can be hard to switch off or put down our devices, they are such a big part of our lives and often keep us connected to others. However, it seems as though the light given off by smartphones, computers, tablets and even TV’s can suppress melatonin release. The natural process that takes place as we transition from light to dark through from day to night, stimulates our bodies to release melatonin, a natural chemical that helps us fall asleep. So stopping it’s natural production is bad. In addition to this, we are exposed to so many interesting, arousing or stressful stimuli through our devices and these feelings are not helpful when it’s time to sleep. That message to a friend or colleague can almost always wait until the morning!
It is advisable to try and reduce exposure to these artificial light sources where possible, from around 1 hour or 30 mins before bedtime.
Try to reduce the light in your home as you approach bedtime too, mimicking a natural sunset.
Minimising stress and anxiety is important for a restful nights sleep. In an ideal world we would all leave our stresses, trouble and worries at the bedroom door, but unfortunately, this is difficult for most. In fact, many people find that when their head finally hits the pillow at night, it is the first time in the day they have the chance to think and process what’s going on.
There are many effective methods to help us all manage day-to-day stress. If you find yourself worrying or mulling over the day at bedtime, consider taking time in the afternoon or evening to dedicate to “processing” or journaling the events of the day and planning for the following day.
You may wish to consider taking time to meditate before bed, there are several guided meditations on the T-Minus app, or reading a good book you can get lost in is a great way to relax.
Also, there is an opportunity for us to reassociate our head hitting the pillow with the activation of positive emotions, a nice habit could be to generate three things that you are thankful for, for example what made you feel happy today? Try to picture the situation and relive the feelings, even if they are just small things.
Don’t try to change all of your sleep habits in one go, it is unlikely to work and you will probably be sat awake in bed getting frustrated. Gently ease yourself into new routines over time.
For most people sleep doesn’t come immediately, it takes the average person between 10 and 30 minutes to fall asleep, so be patient and don’t worry if it isn’t immediate. If after 30 minutes you are still wide awake, try getting up, leaving the bedroom and performing some relaxing activities, whether reading, meditating, listening to relaxing music etc.
Avoid exercise close to sleep, it can take a couple of hours before the body returns back to our normal resting conditions after exercise, so it is good to get this done earlier in the day.
If sleep is an ongoing problem it is ok to speak to your doctor about possible medications to support your sleep.
If you have had considerable difficulty in falling and/or staying asleep on an ongoing basis, it is possible you may have insomnia. Insomnia can be define as sleep difficulties occurring at least three or four times a week and persisting for six months or more. If this is you then it could be worth reaching out to your doctor, as advice may differ.