Sleep Strategies for Tinnitus Related Sleep Problems

Jim

Member
Author
Benefactor
Mar 6, 2011
204
San Francisco
Tinnitus Since
04/2007
Let me start by saying that getting good quality sleep was the single most important factor for me in getting the tinnitus under control. Without good sleep the tinnitus just wears you down more and more. I have two elements that have really worked well for me. I know everyone is different so this may not apply to all.

I have always been hesitant to use any medication unless absolutely necessary and in the case of tinnitus it became a necessity quickly. I started using ambient but it would not get me all the way through the night and would leave me with a hangover. Same thing with Benadryl. Had some success with Xanax and Temazepam. I'm back to about 2mg of ambien now.

The other half of the equation is music and masking. I have the Neuromonics device and tried it at night but the headphones supplied would not stay on and the music volume is not consistent enough. The folks at Neuromonics suggest that you use their device to fall asleep and then turn it off and continue to sleep through the night unassisted. No way will this work for me! So that did not help me at night.

I did some internet research and found a blog by a guy who does a lot of business travel. He had developed some techniques for maximizing his sleep while traveling on commercial airlines. As it turns out I travel fairly frequently as well. By the way I found it necessary to protect my ears from the high noise levels on commercial jets anyway. (more on this later as it turns out I have hyperacusis as well) So this is what I took away from his blog.

First, get earphones that will stay in your ears and that are not too bulky. Second, get earphones that provide good noise isolation. You don't want to be awakened by outside noise once you do finally get to sleep. Third, play music that is very familiar to you. This is not the time to try to find some new music to add to your library. You don't really want to be challenging your brain with anything new. I took these basic principles and added an important element. I have an iPhone/iPod so I don't know if this can be done on other devices but maybe you can come up with a similar effect. I have an iPhone app called "Ambiance" There is a free version and I think the full version costs $1. It allows you to down load the masking sounds that cover your tinnitus the most effectively for you. I personally like the sound of "rain". These are actual real recordings of natural sounds that are looped. The loops are well done so you don't notice the "start over". They have beach waves, thunder, fan, jungle sounds, cat purring, you name it they have it. All free of cost. They do have white noise but I find it is monotone, harsh and annoying to me. I have about 10 different rain sounds. You can play 1 or more sounds that cycle through all night long with a nice fade in and out between sounds or just pick the one that you like best. The coolest thing about the app is you can play your music simultaneously over the masking sound for a predetermined length of time and then the music fades out and leaves you with your masking sound for the rest of the night. Brilliant! There are other similar apps but this is the best one for me. Some other apps like "White Noise" offer balance control, but no music over the sound feature.

Headphones: I did quit a bit of research on headphones/ earphones. I found a company called Etymotics Research. They make professional musician quality stuff including earplugs, onstage monitors, etc. They also have some interesting products for the hearing impaired. I highly recommend their earplugs for hearing protection. They also specialize in "on stage performance" in-ear monitor earphones. I ended up getting the HF2's because they go well with the iPhone. They are expensive at $179 but worth every penny in my opinion. They have a less expensive pair without the microphone. They stay in the ear and I can sleep all night with them. The added benefit is they produce incredible hi fidelity sound that will deliver music like you have never heard before. They quite simply make the standard apple phones sound pretty bad by comparison. This is starting to sound like a commercial but I am not working for anyone. I am retired and have no interest in ever being employed again.

It's not ideal to have to get wired up every night before bed but it beats lying awake. I'm still trying to figure out how I'm ever going to be able to go camping again with all the electronics that I depend on now. One step at a time I guess.

I think Yogi Berra's famous quote about baseball is directly applicable to tinnitus,
"Ninety percent of the game is half mental"

Cheers,
Jim.
 
As for sleeping with in-ear monitors, I'd suggest the Mee Electronics M9. They are available for well under $20 on Amazon and sound surprisingly good, especially after you break them in. I think of them almost as disposables but they sound comparable to some much more expensive sets and better than one $100 set I have.
 
I bought a number of 'pillow speakers' early on and they were all rubbish.

New one was delivered this morning, a Relaxso Stereo Asleep Pillow Speaker, and it's excellent!

Thought I would post the details in case others are having trouble finding one that actually does what it's supposed to without being uncomfortable. I've also purchased an extension lead so that the MP3 player can be a distance away.

http://www.amazon.co.uk/dp/B005H0CSIU/
 
I too had a problem finding a good pillow speaker so I am glad you found one Click! What I did after I gave up trying to find one was to just put the relax melodies App on my iPad on and put that right under my pillow. Worked great and because the iPad has a 10 hour battery, never had to worry about it dying on me.
 
When this happened to me few times before (hope it won't again!) I think it was just best to surrender. I just get up, make a warm tea, get on my couch and start watching some talk shows or a movie on dvd. I would usually wake up in the morning not knowing when did I fall asleep in the first place!
 
A couple of suggestions:

1) White (brown, pink, or purple) noise. Basically something like radio static. You can try a white noise machine, or white noise CDs. You can also download some white noise to an MP3 player, but I personally don't find it helpful when played through head phones. iTunes has some free or cheap white noise. You can search web for other sources.
2) Soft/soothing music, or even the TV on in the background.
3) Pillow speakers to play this stuff through. Someone in this forum recommended these: Relaxso Stereo ASLEEP Pillow Speaker

Just leave the noise/sound it on all night at alow volume. I have the same problem - after sleeping a few hours the tinnitus wakes me up. I just listen to an audio book on my iPod at the lowest volume possible. It seems to reduce the frequency of waking up to screaming ears, but doesn't stop it completely.
 
Try sleeping with two pillows so your head is elevated. I haven't slept with one pillow for some time.

Play some rain/thunder cd sounds so when you do wake up you can focus one the rain sounds.

Oh and WELCOME!!!!!
 
I agree with Calin's suggestion about sleeping on two pillows to elevate the head. It seems to help. And, I've tried sleeping on both sides as well as face up. Face up seems to work best --- if you can get to sleep like that!

Also, I've found that taking a Pharma-GABA tablet when I wake up sometimes helps. The Pharma-GABA is a natural supplement that works quickly, but very subtly, to calm down your brain.
 
Is your tinnitus only in one ear or both? If you sleep on your side, make sure you are not sleeping on the side where your tinnitus is worse. If it is worse in your left ear, sleep on your right.
 
Melatonin before bed works amazing, some people say it reduces tinnitus, and that's why they sleep better. It is super relaxing.
The regular dose is 3 mg before bed, but 1 and a half is good for me. Take half hour before bed.
 
I use over the counter sleep aid gelcaps to help sleep through the night a few times a week. Unisom, Equate Nightime, etc. They're all the same, just antihistamines; diphenylhydraminehcl, in a larger dose gel form. Exactly the same as Benadryl. Tylenol PM contains the same stuff. I dont' know why, but the gelcaps seem to work better than the tablets. In any case, none seem to affect my T one way or another.
 
So I have a boot camp ahead of me for 10 weeks. Whilst there I won't be able to bring anything to mask the sound of my tinnitus. It only bothers me in a silent room when trying to sleep. For the past 15 years I just used a fan. But at boot camp I obviously can't use that. Portable music devices are not allowed as with phones 99% of the time. I have never run into this problem before and haven't had to sleep without something to mask it.

So what do other people do to help themselves sleep? Are there any other strategies.
Originally I wanted to ACR reset. But since I started my research I found I have dual tone tinnitus. Which makes me think it would be impossible to make any kind of dent in the volume before I go.
 
I don't think it's going to be as quiet in a barracks as you would think. There will be the other sound from all the other guys in there sleeping I would imagine. Look at it this way, you'll get used to sleeping without the fan. In fact, you'll probably get to the point where you won't need it anymore. Forge ahead, my friend.

Wear those damn ear plugs while you shoot as well. Don't forget to take plenty of Zinc, Magnesium and vitamin B supplements before your shooting exercises either, as those supplements have shown to help protect against noise induced hearing loss .
 
Please use ear plugs and muffs when shooting.

Hudson's suggestion of taking those supplements is a good one. Also maybe take N-acetyl-cysteine before shooting. I remember it being protective.

The below study is a longitudinal one, and doesn't directly apply to you, but still interesting and scary:
http://www.ncbi.nlm.nih.gov/pubmed/19925337
In conclusion, deterioration to hearing may occur after long term exposure to gunshots, even when double hearing protection is used. Further study is in progress regarding how to preserve both cochlear and saccular function during long term gunshot exposure.

And I either wouldn't worry about sleeping too much. I'm sure you'll be fine.

Good luck!

Markku


PS. This is just I thinking, but I want to disclose that I myself wouldn't shoot guns after acquiring tinnitus. Double hearing protection is maybe just enough, but one needs to take into consideration the bone conduction. I just wouldn't want to risk tinnitus getting worse. Guns are so insanely loud, and their explosive sound is the worst kind.

.2$
 
I was in the US Air Force back in the sixties. When I went to basic training at Lackland AFB, TX I was not allowed to bring ANYTHING with me. Everything was supplied to me by the military. Certain things I was allowed to have for hygiene, eg, toothbrush, razor, etc.

Did you discuss your tinnitus with the recruiter?
 
I use a sound machine when I sleep - it's a small and light travel one has a time display. It doesn't play music or anything - just a variety of sounds so may be allowed as it doesn't include a phone. I definitely find it helps with sleep which of course can be difficult.

Not surprised that so many military suffer from tinnitus as exposure to loud noise does come with the territory - I suppose apart from earplugs there's not much you can do about it -but as tinnitus can worsen with further loud noise exposure I'd definitely consider your options in the long run.
 
You and your doctor have to keep 'experimenting' until you find a combination that works for you - gives you about 6 hours of good sleep and no 'hangover'. I use 1mg of lorazepam (Ativan) + 5mg of melatonin + 25mg of diphenhydramine (Benadryl) and that works most nights. Without decent sleep, your tinnitus will not come under control.
 
Hi, I have been playing Enya on low levels constantly through the night - I have been doing that now for 2 weeks, along with Restful Rain compact disc set on constant repeat. I am gradually training my brain to habituate - believe it or not - I am gradually getting better. Ear plugs will not do anything for me, because it will make my tinnitus too loud, and valerian root I tried that years ago - there are no herbs that you can take for this, just constant levels of back ground pink white noise and quiet music - that is the only thing that has been reliable in getting relief, and it can take 6 months of 2 years to get better - at that point you will still hear the tinnitus, but it will not cause distress and you should be able to sleep with no meds.
 
Imovane is great for falling into sleep. L-Tryptofan helps with me. It converts to HTP-5 -> melatonin in your body. Melatonin makes me wake up around 3am but this one seems to prolong the effect.
 
It is true that without adequate sleep, it is unlikely that you will get control over the tinnitus. If you can get at least 6 hours of sleep using earphones and sound to initiate sleep - great. For most people however, that won't work. The best combination for sleep medication is whatever works and none of the typical sleep medications is 0totoxic, irrespective of what you read on the Internet. A good combination to try (discuss all of this with your doctor) is melatonin 5-10mg to initiate sleep and hyphenhydramine (Benadryl) 25-50mg to maintain sleep. If you are very anxious when you go to bed, try lorazepam 1mg to reduce this anxiety. I used to use sound through my hearing aids during the day, but now I have habituated so mainly I just ignore it. This will happen to everyone if they just establish and regime they are comfortable with.
 
I have had the tinnitus since late May (it is now late June) and I believe it stemmed from insomnia and stress as well as stopping high blood pressure meds, Amlodipine and Hydrochlorothiazide cold turkey plus taking too much Benadryl to try to sleep. My doctor prescribed Trazodone for insomnia in early May before the tinnitus started, but after having taken it once or twice and reading the side effects it proved to be quite disagreeable and unpleasant.

The doctor then prescribed Mirtazapine (Remeron) on May 30th after the tinnitus began May 24th and initially I was impressed with the results after reluctantly taking it as it had the effect of reducing the noise. It had backfired a couple times leading me to search for other sleep aids such as Rozerem which did nothing, and the doc also prescribed Seroquel, which turned out to have a good night/bad night pattern which led me to stop it and Gabapentin which was little better than Rozerem. I finally asked for Klonopin, which the doc prescribed, but have taken it only once so far with results of a constant hiss the next morning which thankfully subsided.

So, I'm back with Remeron again and am afraid of it becoming less effective but with a dependence and I have been reading about it being challenging to say the least in trying to taper off it. It is 15mg and as I mentioned it has usually done the job of at least getting me to sleep but is a roll of the dice as to whether I will stay asleep. Last night I woke at 3am after getting to sleep at 10pm--5 hours is not too good, but it has been less. Watching the "dawn's early light" has become an unwelcome but familiar feature of this condition. Anyway, I'm sure many of you have been where I am now and am wondering what advice/comments you might have. I am scheduled to see an ENT doc and am keeping a sleep diary for a nurse practitioner in a sleep clinic. I am also scheduled to see her later in July. At age 65 I realize this has been one of the most challenging and frustrating things I have ever faced. I would not be human if I did not wonder if death were preferable, but taking that step is abhorrent to me. The tinnitus has made me realize a lot about the human condition and made me wonder, considering the recent prayers I have done, if there is a God and if he/she/it is listening.
 
I've had tinnitus for ~18 months now. It came about from a combination of viral inner ear infection and blood pressure medication (Telmisartan). The early few months were barely survived because my system is already hard-wired to be pretty reactive, and I had a really rough time. Most physical symptoms eventually calmed down, and my tinnitus is generally lower and bothers me less these days, although I wouldn't say that I'm completely habituated.

My remaining issue is that my sleep is still completely messed up. I fall asleep fine almost every night, but wake after 4-5 hours. On a really good night, I'm awake for only 30-60 min then drift back into a choppy sleep until morning, but on a bad night, I'm awake for the rest of the night after waking at 2am. Some nights recently, I've woken and there is literally no tinnitus at all (boy it's been a long time since I've heard silence!), but other nights I wake and it is blaring away. I've covered all the bases for good sleep hygiene (dark room, not too hot, etc).

I frequently use a noise app, with crickets/night noise as a masker for the first two hours of sleep. If I leave it on all night, I find it aggravates the tinnitus. I've tried every supplement under the sun (melatonin, valarian, magnesium, and others) which don't work or don't agree with me, plus a few meds like ambien and ativan - neither of which I want to take more than once a week. I have also tried mirtazapine at a really low dose (2-4mg) both PRN and recently a 5 week course, and it completely conks me out for 6-8 hours, but the next day fatigue and binge eating it triggers really aren't good at all. Plus, it seemed to aggravate my tinnitus, and I had more loud days while taking it.

I'm a former competitive athlete, and find that at the same time the tinnitus started, I became hypersensitive to intense exercise as well. Even if I do a good run or bike workout early in the morning, it exacerbates my sleep issues even worse, and I've worked out a few days in a row or one really hard session I get stuck with sleep onset insomnia. Essentially it looks like my sympathetic system is in overdrive all the time.

Any ideas for new things to try?
 
The worst problem of my tinnitus is falling to sleep. Sometimes I lie there and think about the tinnitus so it only makes it worse.

I have a white noise generator for my phone but it does not seem to help much. One issue is my tinnitus is at a high frequency. I would put it around 15 kHz. I used to work in an old TV shop so I know what that sounds like. How I wish to be able to hear that high now. ;) But who knows, maybe one of the many things that has caused my hearing lose.

But I digress. Lately I have had a lot of trouble sleeping. I am been om Ambien for the past few days which is bad. Normally I might take it once a week or so. It is the weekend so no Ambien for the next couple of days. Try to get myself off of it.

So any tips for masking? I read an old thread about a pillow speaker or ear buds? Do people use those just not to disturb their partner? Or does it really help with the masking?

Any other tips for sleeping? I was going to give melatonin a try again. Any tips on dosage?
 
Dear all,

I have been dealing with tinnitus for almost 10 years but, unfortunately, have recently joined an "elite" group of sufferers... having had it increase to a very intrusive level.

Whilst I was always able to use sound machines/iPad to distract and mask in the past to fall asleep. I find it impossible at this level today. I have tried Melatonin but to no avail... and have had to resort to sleeping pills...which is something I would like to stop ASAP.

I would greatly appreciate if someone from this "elite" group could offer advice and suggestions for this matter.

Thanking you in advance,
Rogi
 
I thought I would share something that has helped me get a little bit better night's sleep. It is "Nature Made 3 mg Melatonin with 200 mg L-theanine" (One bottle has both of those things). I bought mine at Target.
 

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