What can help me get a good night's sleep?

Many people with tinnitus report difficulty sleeping. What practical steps can we take that might help improve the situation?

When your surroundings are quiet at the end of the day, your tinnitus becomes more noticeable. This can make it harder to sleep.

As you become anxious at being unable to sleep, some experts believe that this increases the attention being paid to your tinnitus, which worsens the problem.

Simply taking sleeping pills will affect the body, but they may not help if your mind is racing. So working to relax your mind may well be the best strategy to help you get to sleep.

What are the different strategies I can pursue that might help me get a good night's sleep?

The best thing to do is to see a specialist. One of the following routes might help:

  • Obtain a referral to a tinnitus clinic to receive counselling.
  • Learn relaxation techniques.
  • Undertake a specific therapy, such as cognitive behavioural therapy (CBT). This aims to reduce anxiety by looking at improving throughts and behaviours

What practical steps can I take tonight to help get a better night's sleep?

  • It may be helpful to prepare for sleep by doing activities that help you relax. Things like having a bath, stretching your muscles or having a warm milk drink.
     
  • It helps to identify a suitable time to go to sleep, and then stick to it as routine. But if you do go to bed, feeling tired, but cannot fall asleep, it may be a good idea to get up until you feel sleepy again. This is recommended by Dr Grant ingrams, one of our GP advisors.
     
  • Once in bed, try listening to the radio, to music, or to nature sounds. Our GP advisor Dr Gordon Hickish, who has tinnitus, listens to BBC Radio 4 of the World Service. He uses an ear piece to prevent it from disturbing anyone else.
     
  • When lying in bed, focusing on the other senses may help to distract the mind. Perhaps focus on some smells from relaxing essential oils, or visualise a favourite place.
     
  • If your mind is overactive and preventing you from sleeping, another visualisation tactic can help. Betty Harthorne of the Sheffield Tinnitus Association recommends visualising putting any thoughts or concerns into a lidded box, so that they can be thought about at another time. If you aren't comfortable letting go of these thoughts, keep a pen and paper by your bed so that you can keep a record of them. This way you will be able to relax and go to sleep, safe in the knowledge that you can forget about these concerns until the morning


Whilst overcoming sleep problems may not happen overnight, Dr Hickish says that "If you can come to realise that that tinnitus needn’t have a big impact on your life, it does become easier not to worry about it."

Breathing exercises can also help. Our advisor Dr Danuta Orlowska explains the breathing exercise she recommends to her patients:

"How easy is it to fall asleep when we are faced with danger or threat? Not very: as the priority in such circumstances is getting the body ready for “fight or flight” and not for sleep. When people are worried about their tinnitus and how it will affect their sleep, this can be seen as a situation of threat to their well-being. Their body is likely to enter a “fight or flight” state, which will only make the situation worse.

One of the things we can do to help our body unwind a bit from the “fight or flight” response is to try abdominal breathing. This involves taking slow steady breaths (not gulping or taking deep breaths quickly as that is hyperventilation and is linked with various unpleasant sensations including tingling and light-headedness).

The way I teach people about abdominal breathing is given below:
•Place your hands on your abdomen at around waist level with your middle fingers just touching.
•When you breathe IN, you should get slightly bigger as the air enters your lungs.
•You will notice your middle fingers moving apart a small amount (or feel your abdominal area move).
•When you breathe OUT, your fingers will touch again.
•One cycle of IN and OUT is one breath.

Once you know how it feels to breathe like this, try the following breathing and counting exercise. You do not need to hold the IN breath, just breathe steadily in and out.

You might find that your speed of breathing slows down a little after a few such breaths to a more relaxed rate
1.Breathe IN and OUT: count ONE
2.Breathe IN and OUT: count TWO
3.Breathe IN and OUT: count THREE
4.Breathe IN and OUT: count FOUR
5.Breathe IN and OUT: count FIVE
6.Breathe IN and OUT: count SIX
7.Breathe IN and OUT: count SEVEN
8.Breathe IN and OUT: count EIGHT
9.Breathe IN and OUT: count NINE
10.Breathe IN and OUT: count TEN

Then when you have got to TEN, go back to ONE again
1.Breathe IN and OUT: count NINE
2.Breathe IN and OUT: count EIGHT
3.Breathe IN and OUT: count SEVEN
4.Breathe IN and OUT: count SIX
5.Breathe IN and OUT: count FIVE
6.Breathe IN and OUT: count FOUR
7.Breathe IN and OUT: count THREE
8.Breathe IN and OUT: count TWO
9.Breathe IN and OUT: count ONE

If you like counting sheep – make sure you only have ten sheep! With ten sheep you can count them out and back again and more easily lose track of time. If you have a thousand sheep, you know how long you have been counting if you get to 974 and you are still not asleep! The exercise above takes about 2 minutes and you can repeat it more than once.

Try this during the day as well as in the evening and even in bed (you’ll find it easier to lie on your back if you are doing the breathing exercise in bed). It’s free, portable and you never run out of batteries. Some of my patients have gained considerable benefit from this exercise."

 

For more advice and guidance on tinnitus, please download one of our tinnitus factsheets or order one of our leaflets on tinnitus.

Last updated on 10th July 2012

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