Sleeping with tinnitus

November 9, 2016 by Mathieu Telefoglou

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Tinnitus can affect many aspects of daily life, such as hearing, emotions, concentration, and, of course, sleep.

Sleep plays a crucial role in health, helping us recover from tiredness and regenerate energy. Some people cannot claim to have good, restorative sleep.

According to a study published in 2011 by Université Laval, 40% of Canadians had one or more symptoms of insomnia at least three times per week in the past month. Symptoms included taking longer than normal to fall asleep, periods of wakefulness exceeding 30 minutes, and waking up at least 30 minutes before the desired time.1 The studies consulted estimate that 25 to 77% of people with tinnitus suffer from trouble sleeping.2

The sleep cycle

A typical night of sleep consists of three to five 90-minute, five-stage cycles. The first four stages are characterized by slow brain activity (slow-wave sleep), while the last—REM (Rapid Eye Movement) sleep—is characterized by brain activity similar to being awake. It is called REM sleep because of the rapid eye movements observed when the body is in a state of muscular paralysis. REM sleep promotes nervous system maturation, brain plasticity, and learning consolidation, and could have a beneficial effect on memory and emotions.   

Normally, as the night progresses, the REM stage becomes longer, while the other stages become shorter.3 In a study published in 2013, researchers looked at the sleep of people with tinnitus using hypnograms and questionnaires on sleep quality and disturbance due to tinnitus. The sleep cycle of the 18 study subjects with tinnitus was statistically different from that of people without tinnitus. On average, those with tinnitus spend significantly less time each night in the third and fourth stages of slow-wave sleep and in the REM stage than the population without tinnitus.

Strategies to sleep better

People whose sleep is disrupted by tinnitus should use strategies to sleep better. One of the most effective is to enrich the sound environment to make tinnitus less prominent. The idea is to use ambient noise at a similar level as the tinnitus but not so loud that it keeps you awake or disturbs your partner. In general, the sound of a radio between two stations, a fan, a dehumidifier or a tinnitus mask could be enough. There are also free smartphone apps that allow users to customize a noise in terms of intensity, duration, and type to fall asleep faster. To download them, simply search for relaxing noise or melody generators on Google Play or the App Store.

The people with tinnitus who complain most about being light sleepers are those for whom tinnitus is the most disturbing.4

Here is a non-exhaustive list of tips to help improve sleep:5-6

WHAT CAN HELP

  • Exercise a few hours before going to sleep, preferably before dinner, or walk after dinner
  • A regular schedule with a set time to go to bed and wake up
  • A relaxing activity around 30 minutes before going to sleep (such as reading, meditation, relaxation, visualization)
  • Positive thoughts
  • A room set up to promote sleep: a comfortable mattress and bedding, light-blocking blinds, drapes, or curtains, soothing wall colours, a cool temperature
  • A comforting and peaceful noise environment: nature sounds (waterfall, wind, rain), soft music, white noise or wideband noise (fan), music played low over earphones or a pillow with speakers that won’t disturb your partner

WHAT TO AVOID

  • Stress
  • Naps, especially in the evening
  • Caffeine, alcohol, and large meals a few hours before going to sleep
  • Negative thoughts (do not bring work, money, or other problems into the bedroom)
  • Stimulating activities (watching TV, playing
    videogames, eating, working)
  • Having a television or computer in the
    bedroom
  • If you haven’t fallen asleep after 30 minutes, get out of bed and leave the room for a diversion. You can do a calm activity such as reading or meditating. Go to sleep when you feel tired, and avoid looking at the clock when trying to fall asleep.

To find out more about tinnitus, consult an audiologist.

References:
Université Laval. “Sleep disorders affect 40 percent of Canadians.” ScienceDaily. September 8, 2011. From www.sciencedaily.com/releases/2011/09/110908104005.htm. Consulted on August 12, 2016.
FIORETTI et al. “Association between sleep disorders, hyperacusis and tinnitus: Evaluation with tinnitus questionnaires.” Noise Health. 2013;15:91-5.
http://lecerveau.mcgill.ca
ATTANASIO et al. “Sleep Architecture Variation in Chronic Tinnitus Patients.” Ear and Hearing. Vol. 34.4, pp. 503–507, July 2013.
http://www.nytimes.com/health/guides/symptoms/sleeping-difficulty/print.html
WITT et al. “Tinnitus activities; sleep strategies.” Annual Tinnitus Conference, University of Iowa. 2015.