and what we can do about it
Hands up, dear tinnitus tribe, if you have noticed that your tinnitus seems to get way louder at night than it has been during the day.
Yep, me too!
This can be one of the most challenging aspects of tinnitus. Just when we’ve climbed into our jim-jams and snuggled under the duvet, BAM! tinnitus cranks up the volume like an after-party DJ. But why does this happen? And what can we do to make bedtime easier?
Let’s take a look.
Why tinnitus is more noticeable at night
Here are four reasons why our tinnitus can seem louder and more intrusive at night:
1. There’s less ambient noise
During the day, normal environmental sounds provide a nice amount of background noise. Whether it’s conversation, music, traffic, sounds from the office or the TV burbling away in the background, they all contribute towards masking our tinnitus. But at night, when our environment gets quiet, the contrast makes the tinnitus stand out more. This is even more noticeable if you take your hearing aids out at bedtime and experience that sudden drop in hearing levels.
2. There’s less to distract you
During the day we often have plenty of things to distract our attention away from our tinnitus. It could be work, looking after the kids (or grandkids), hobbies, TV or studying. Distraction can work well as a coping strategy for tinnitus. Until it stops. And then we can be left with tinnitus that seems completely overwhelming.
3. Mental focus amplifies it
Whether or not we use distraction as a coping technique for our tinnitus, there’s one thing guaranteed to make our tinnitus more intrusive, is listening to it. Which of course we do, because we’re human. Problem is, by listening to our tinnitus we tell our brain that it’s important; that it’s something it needs to monitor. And that teaches our brain to become hypervigilant about our tinnitus. It’s the same as if we share a room with someone who snores. If we focus in on the sound of a wildebeest sharing our bed, it becomes all we can hear. And then the emotions kick in, and the thoughts. And before we know it, it’s 2am and we are still stuck in a vicious cycle of thoughts and feelings about our tinnitus, or our snoring companion, or both.
4. Anxiety and stress play a role
If we’re anxious or stressed when we climb into bed (and, let’s face it, there’s plenty going on right now to be anxious about) our tinnitus can react to those emotions. So, if we start replaying something we’ve seen on the news, or beating ourselves up about an email we sent that perhaps could have been worded better, then our tinnitus is probably going to sound louder. And, of course, even if our day has gone perfectly well, we can still be anxious about the tinnitus itself.
Strategies for coping at night
So now we know the whys, let’s look at some solutions:
1. Use low masking noise
The shock to the brain of moving into a quieter room can be reduced by playing sound that masks our tinnitus. Masking is very much an individual experience. I love to use the sound of water, preferably rain or waterfalls. Other members of the tinnitus tribe hate that with a passion!
The key to masking is not to drown out our tinnitus, but to occupy the brain with another sound so tinnitus is less noticeable. Plus, sometimes tinnitus can “compete” with loud masking sounds. That’s two solid reasons why I recommend playing any masking sound just below the volume of the tinnitus we can hear. They are also why I recommend using a phone or a masking/white noise machine, because it’s much easier to adjust the volume on those rather than, say, a fan.
2. Do a relaxing exercise in bed
Deliberately taking ourselves through a relaxation exercise in bed has four benefits:
a. it trains the brain that bed is a space for relaxation and sleep;
b. it helps to reduce anxiety or stress;
c. it gives us something else to focus on mentally, and
d. it distracts us from tinnitus
Here’s a relaxing sleep meditation for you to try:
3. Practice mindfulness
Mindfulness helps us shift our relationship to the sound of our tinnitus. Instead of fighting it or judging it, which is often our default reaction, we learn to notice our tinnitus – and any thoughts, feelings or body sensations it creates – gently disengage from it and refocus where we want to pay attention, rather than where tinnitus drags our attention. With practise, this trains us to respond with calmness to our tinnitus rather than reacting in fear to it.
Here’s a simple mindfulness practice for you to try to help you slide into sleep:
I offer a course based on mindfulness for tinnitus relief. If you are interested in finding out more, please drop me an email.
4. Try Cognitive Behavioural Therapy techniques
Cognitive Behavioural Therapy (CBT) doesn’t “cure” tinnitus, but it helps change how we think and feel about it. One CBT practise is to challenge habitual thoughts we might have. For example, if we lie awake listening to our tinnitus and telling ourselves “I won’t be able to function tomorrow if I don’t get to sleep now”, CBT practices would invite us to reframe that thought by:
- Recognising the thought we are having
- Asking ourselves “is this really true?”
- Reminding ourselves that we have experienced nights of disturbed sleep for many reasons (late nights having fun, sick children, being ill ourselves etc) and have been able to function the next day on 100% of those occasions. We might not have been as perky as we would have liked, but we got through the day.
I use CBT practices as part of my coaching sessions. If you are interested, please drop me an email.
5. Build a Soothing Bedtime Routine
Sleep hygiene is a science, and often it requires experimenting to find the right combination for each of us. Here are some suggestions that can make a big difference to being able to sleep (even with tinnitus joining us in bed):
- Turn of screens before heading into the bedroom. If possible switch them off an hour before bed.
- Turn off the big light! Dim the lights in your living room/bedroom in the last couple of hours before bed.
- Avoid caffeine, alcohol and exercise for 3 hours before bed.
- Develop a calming bedtime routine that signals to your brain that it’s time to sleep.
- Keep the bedroom cool.
- I personally find it useful to eat toast before I sleep (or if I wake in the night). There’s some talk of the tryptophan in carbohydrates helping the body release serotonin and melatonin to help sleep. It could of course be codswallop, and I’m experiencing the placebo effect. But it works for me, so I don’t care!
Remember you’re not alone
Awake in bed at 12am, 1am, 2am it can feel like we’re the only ones in the world not sleeping, which simply enhances the feeling of isolation that can come with tinnitus. But we’re far from alone in struggling to sleep. The advertising for sleep aids of all sorts shows us that.
If you’d like to work with me to find practical tactics and strategies to manage your tinnitus effectively, I’d love to hear from you. Feel free to drop me an email and we’ll go from there.