Still Having Sleep Issues Due to Tinnitus 2.5 Months Later

Dear Dr. Nagler!

Some background: I developed tinnitus on 14th October this year, which started with a unilateral, left 125Hz low, vibrating buzz. This completely went away after like 3 weeks. 2 weeks in I got bilateral, very high frequency 10-12000Hz ever-changing sounds. Currently it's down to a 3/10 volume, but the pitch is so shrill, that it makes me very anxious and it changes a lot in volume. I haven't slept more than 3-4 hours in pieces for 2,5 months, the first weeks I had 1-1,5 hours a night. I'm a mess. I'm on the verge of dropping out of law school because I can't concentrate at all. My stress and anxiety level is high because of the uni and not sleeping.

I take vitB, magnesium, curcumin, omega3 on a daily basis.
I tried valerian, lemongrass, St. John's Wort, Melatonin. I very ocassionaly take 0,25 Frontin (that's basically Xanax in my country), but it doesn't do anything, neither does 0,5mg. I'm using YouTube nature sounds as sound enrichment at night. I used to be an okay sleeper, always had trouble falling asleep. Now, falling asleep is the smaller problem, I can't stay asleep during the night.

I would like to ask, what do you consider a safe amount of Melatonin? I never went over 12 mg.
Can it have adverse affect besides vivid dreams if I take more than that? Can I mix the herbs and melatonin? Can I mix the natural stuff with the benzo? I'm very afraid of benzodiazepins, tolerance and withdrawal issues, but desperate times. Right now life doesn't seem to be worth living in this condition. I'm so exhausted all the time in spite of tinnitus not being overly loud at the moment.

Thank you very much in advance.

 

The most common dose of melatonin that folks use for insonmia is 5 mg. My understanding is that the 12 mg dose you mention above should not be used for more than a few weeks. That said, I myself do not consider any amount of melatonin to be "safe," and I personally would not take it under any circumstances. The reason really does not have to do with 5-Methoxy-N-Acetyltryptamine (the chemical formulation for melatonin) per se, but rather it has to do with the fact that melatonin is considered to be a supplement, and as such the product in the bottle is not subject to strict FDA guidelines insuring strength, quality, and purity. In other words, with supplements what you see is not necessarily what you get! Now if you are going to take melatonin, please be sure that the bottle says "USP-verified," which means that is has satisfied the requirements of the U.S. Pharmacopeial Convention. While not exactly at FDA standards, it gives you at least some level of assurance in that regard.

I am going to attach a piece I wrote a while back on "Hints for Sleep." It is not an overnight fix, but perhaps it will help with your sleep challenges.

Tinnitus can be exhausting regardless of its intensity. This phenomenon has less to do with sleep than it does with your autonomic nervous system. As long as your autonomic nervous system sees your tinnitus as "The Guest from Hell," it will work overtime to protect you from your amorphous intruder.

Hope this helps. And thank you for your patience while I was unavailable for a few days.

Stephen M. Nagler, M.D.