Severe Sleep Disruption: Tinnitus Masking Makes It Worse — Any Ideas?

[mikeh]

I struggle with severe anxiety caused by the tinnitus sound at bedtime, which prevents me from sleeping and feels disastrous. I've tried numerous options—headphones, earbuds, sound generators, and ambient sounds near the ear—but none have worked for me. The issue is that I've always relied on sensory deprivation to sleep, and my nervous system becomes overstimulated even by sound masking. In many cases, it feels no better than the tinnitus itself.

Is anyone else with a hyperactive nervous system dealing with a similar challenge? Are there any medications or non-drug methods (preferably quiet ones) that can help improve sleep?

Interestingly, when my tinnitus is lower at bedtime (which seems to happen randomly), I sleep much better. If anyone has tips or advice, I'd love to hear them.

 

[MrRing]

Honestly, you might need something to help you sleep, like Melatonin or something stronger. Getting back into a good sleep rhythm is important for managing it.

 

[Mark F.]

Have you tried a simple, old-fashioned box fan? You can adjust the settings to low, medium, or high. It provides a soothing, hypnotic drone to fall asleep to.

 

[mikeh]

I got a prescription for Trazodone and time-release Melatonin and used sleep buds with a fireplace sound. So far, it has worked, though I feel super groggy in the morning.

When I remove the sleep buds in the morning, my tinnitus temporarily increases. I read online that the goal is to avoid relying on sound therapy for sleep, so you do not become dependent on it. The idea is to eventually sleep normally, as you did before, once the tinnitus is habituated. However, I am not sure if this is more theoretical than practical.

It is also unpredictable whether I will be able to sleep without any sound on a given night, which makes planning ahead difficult. If I need to adjust in the middle of the night, it can add extra anxiety.

 

[object16]

I got a prescription for Trazodone and time-release Melatonin and used sleep buds with a fireplace sound. So far, it has worked, though I feel super groggy in the morning.

When I remove the sleep buds in the morning, my tinnitus temporarily increases. I read online that the goal is to avoid relying on sound therapy for sleep, so you do not become dependent on it. The idea is to eventually sleep normally, as you did before, once the tinnitus is habituated. However, I am not sure if this is more theoretical than practical.

It is also unpredictable whether I will be able to sleep without any sound on a given night, which makes planning ahead difficult. If I need to adjust in the middle of the night, it can add extra anxiety.

@mikeh, I used to be like you, needing complete silence to sleep. Unfortunately, I ended up wearing earplugs all the time since there was always some noise coming from somewhere. A very knowledgeable audiologist told me that was the worst possible thing to do, and I can attest to that. I gave myself a really bad case of hyperacusis.

When I ended up in rehab, they had no sympathy for my condition. After a couple of weeks of complete sleep deprivation, I went psychotic and spent some time in full lockdown. Of course, those clowns made a so called diagnosis of sound phobia, and their so called treatment was to expose me to as much loud noise as possible.

When it comes to sound at night, remember that our ancestors slept outside. They heard wind rustling through the leaves, birds, maybe a brook. Because of that, I keep my ambient sound at around 60 dB, very quiet music and restful rain. Rainfall is a natural sound, something our ancestors would have slept through. It just takes some getting used to.

Right now, I play both rainfall and music simultaneously, like quiet Enya. My daughter processed the audio through Audacity, a free online tool, to make the quiet parts slightly louder and the louder parts slightly quieter. I am pretty much addicted to it, and I am confident it is safe.

I used to have severe anxiety too, but over time, it faded because nothing bad ever actually happened.

Trazodone can make you groggy due to its hangover effect. I have to be careful with my medications since I take quite a few. If I feel hungover, I try to figure out which one is causing it. For me, it is Mirtazapine, which has a half life of 20 to 40 hours. If I feel off, I cut my dose back.

Right now, I am dealing with a spike from dental work noise, so I am relying on Clonazepam and have basically been in bed all weekend. My workplace is aware of my condition, so no one gives me a hard time. Fortunately, my hours are pretty flexible, which helps.

Trazodone's half life depends on your metabolism, and it can range from 5 to 13 hours. It sounds like you may have the longer half life due to your metabolism. I take Carbamazepine, which induces liver enzymes and reduces the half life of some medications for me.

If your doctor agrees, you might try taking 100 mg of Carbamazepine to see if it reduces Trazodone's half life and lessens the hangover effect. A 100 mg dose is actually quite small. In some people, Carbamazepine also helps with tinnitus, so it might be worth trying.

 

[mikeh]

@mikeh, I used to be like you, needing complete silence to sleep. Unfortunately, I ended up wearing earplugs all the time since there was always some noise coming from somewhere. A very knowledgeable audiologist told me that was the worst possible thing to do, and I can attest to that. I gave myself a really bad case of hyperacusis.

When I ended up in rehab, they had no sympathy for my condition. After a couple of weeks of complete sleep deprivation, I went psychotic and spent some time in full lockdown. Of course, those clowns made a so called diagnosis of sound phobia, and their so called treatment was to expose me to as much loud noise as possible.

When it comes to sound at night, remember that our ancestors slept outside. They heard wind rustling through the leaves, birds, maybe a brook. Because of that, I keep my ambient sound at around 60 dB, very quiet music and restful rain. Rainfall is a natural sound, something our ancestors would have slept through. It just takes some getting used to.

Right now, I play both rainfall and music simultaneously, like quiet Enya. My daughter processed the audio through Audacity, a free online tool, to make the quiet parts slightly louder and the louder parts slightly quieter. I am pretty much addicted to it, and I am confident it is safe.

I used to have severe anxiety too, but over time, it faded because nothing bad ever actually happened.

Trazodone can make you groggy due to its hangover effect. I have to be careful with my medications since I take quite a few. If I feel hungover, I try to figure out which one is causing it. For me, it is Mirtazapine, which has a half life of 20 to 40 hours. If I feel off, I cut my dose back.

Right now, I am dealing with a spike from dental work noise, so I am relying on Clonazepam and have basically been in bed all weekend. My workplace is aware of my condition, so no one gives me a hard time. Fortunately, my hours are pretty flexible, which helps.

Trazodone's half life depends on your metabolism, and it can range from 5 to 13 hours. It sounds like you may have the longer half life due to your metabolism. I take Carbamazepine, which induces liver enzymes and reduces the half life of some medications for me.

If your doctor agrees, you might try taking 100 mg of Carbamazepine to see if it reduces Trazodone's half life and lessens the hangover effect. A 100 mg dose is actually quite small. In some people, Carbamazepine also helps with tinnitus, so it might be worth trying.

I find that Trazodone does not work for sleep if the anxiety is too severe. However, this could be dose dependent. I have never tried more than 37 mg. At one point, I even felt anxious about the excessive sedation, but that was a one time experience. I suppose it needs to be timed correctly to take effect at the right moment.

Lately, I have been using the sound of footsteps on autumn leaves. There is a good one on YouTube. I also like a blend of fire, rain, and water dripping in a cave. I figure our ancestors lived in caves, where they had both soothing sounds and natural soundproofing. Some sounds feel too harsh for me. I prefer gentle crackles—very mild, like synapses trying to make a connection but failing. Maybe something like sparks from a live wire, if I can find that sound.

I use earbuds at a very low volume, but for some reason, I still wake up with what feels like "gain" tinnitus. I am not sure if this is caused by the low volume sound, which is barely audible, or if it would happen regardless. I could try ambient sound, but it feels too distant, and I am not sure if that would be comforting enough to help mask part of the tinnitus.

 

[object16]

@mikeh, I'm pretty sure I also have "gain" tinnitus, where it seems to get louder with more ambient sound. Right now, I'm keeping the volume very low.

I also use natural sound—specifically, the Restful Rain CD, which I ripped to FLAC format. My daughter removed the very quiet parts, so I ended up with a more continuous rainfall sound.

I don't think I could sleep with earbuds on, but footsteps on leaves sounds promising.