Tinnitus Lowers When I Wake Up

[Kriszti]

Dear Dr. Nagler!

I've just read your answer to Tom Cnyc regarding tinnitus being louder in the morning and after waking up from a nap due to reticular formation.

I have the exact opposite experience. I'm 1,5 month in this horrendous tinnitus journey, started with a low hum in the left ear, that is barely audible now, but 2 weeks after the onset, I developed a high pitched, fluctuating, always changing sound, which sometimes resembles crickets, or hiss, or metallic/electronic sizzle, scream, whistle, you name it. I also can't decide whether I hear it from my ears, brain.

I have been sleeping awfully poorly. For 2 weeks, I slept 1-1,5 half hours per night with sleeping pills. I never nap, because I'm afraid that it messes up my night "sleep" even more. Now I sleep 3-4 hours in pieces a night with melatonin, valerian, occasionally Frontin, but when I wake up during the night and stare at the ceiling for hours in utter despair, my tinnitus is lower, that's the time when it's mainly hissing. In the mornings, it's quieter too.

Up until yesterday, I took Piracetam 2400mg daily (mornings, and midday) and Betahistine (morning, night) . I stopped them, because they may be the cause of not being able to sleep. I don't know yet that the stopping of the meds have any effect on my tinnitus.

What do you think can cause my tinnitus lowering during the night?

Thank you very much in advance.

 

[Dr. Nagler]

Dear Dr. Nagler!

I've just read your answer to Tom Cnyc regarding tinnitus being louder in the morning and after waking up from a nap due to reticular formation.

I have the exact opposite experience. I'm 1,5 month in this horrendous tinnitus journey, started with a low hum in the left ear, that is barely audible now, but 2 weeks after the onset, I developed a high pitched, fluctuating, always changing sound, which sometimes resembles crickets, or hiss, or metallic/electronic sizzle, scream, whistle, you name it. I also can't decide whether I hear it from my ears, brain.

I have been sleeping awfully poorly. For 2 weeks, I slept 1-1,5 half hours per night with sleeping pills. I never nap, because I'm afraid that it messes up my night "sleep" even more. Now I sleep 3-4 hours in pieces a night with melatonin, valerian, occasionally Frontin, but when I wake up during the night and stare at the ceiling for hours in utter despair, my tinnitus is lower, that's the time when it's mainly hissing. In the mornings, it's quieter too.

Up until yesterday, I took Piracetam 2400mg daily (mornings, and midday) and Betahistine (morning, night) . I stopped them, because they may be the cause of not being able to sleep. I don't know yet that the stopping of the meds have any effect on my tinnitus.

What do you think can cause my tinnitus lowering during the night?

Thank you very much in advance.

Hello @Kriszti -

I am sorry to hear of your struggles. It seems to me that your tinnitus is exerting a lot of power over your life right now. Here are some thoughts about that ...

• Your tinnitus is real, and its effects on your life are real. Just because your tinnitus is in your head, that does not mean it is in your imagination.
• Even though your tinnitus is real, your tinnitus is not associated with a sound wave. Your tinnitus in-and-of-itself has no physical correlates at all. So unlike cancer, infectious diseases, arthritis, heart disease, a gunshot wound, etc., your tinnitus cannot cause any physical damage to you - not to your ears, not to your brain, not to any part of your body whatsoever. And that is true no matter how loud or pitchy your tinnitus might be. Your tinnitus can make you feel absolutely horrible, but it cannot posdibly cause you any physical harm. (The physical damage to the ears that results from prolonged exposure to a loud external noise is actually caused by the sound wave that produces the loud noise. Tinnitus has no sound wave, and therefore your tinnitus cannot damage your ears.)
• Since your tinnitus has no physical correlates, 100% of the power that your tinnitus has over you must be coming from you. It is not your fault, of course, but you are the only possible source of the power your tinnitus has to make you depressed, angry, frustrated, anxious, distracted, frightened, exhausted, sleepless, etc.
• There is a lot of research going on, and ideally someday science will discover a way to eliminate your tinnitus or lastingly mitigate its intensity, which will be terrific! But until that day occurs, perhaps your personal goal should be to gradually over time regain the power that you have unwittingly given away.
• There are any number of strategies for taking the power back, but they all require time, patience, and determination.
• You do not have to take 100% of the power back to have a wonderful life. You can have a joyful, fulfilling, rewarding, productive life without having a perfect life.

Now, as far as your question about why for most folks tinnitus is louder when they wake, but in your case it is softer, I suspect it may have to do with GABA, which is the dominant inhibitory neurotransmitter in the auditory system. It is possible that you have elevated circulating GABA levels upon waking, which override the reticular formation effect that I have previously described. It's just a guess, but that is my thinking.

Hope this helps.

Stephen M. Nagler, M.D.