Straightforward Information About Tinnitus
Sleep disruption is one of the most common and distressing effects of tinnitus. When the house goes quiet and you lie down, the tinnitus often seems louder and harder to ignore. This can lead to difficulty falling asleep, waking during the night, and poor sleep quality — which in turn makes tinnitus harder to cope with the next day.
During the day, environmental sounds compete with tinnitus for your brain's attention. At night, with less competing sound, the tinnitus becomes more prominent. Additionally, the act of trying to fall asleep often involves lying still with minimal distractions, which naturally shifts attention inward toward body sensations — including tinnitus.
The frustration of not being able to sleep can also create its own anxiety cycle: worrying about not sleeping makes it harder to sleep, which increases frustration, which makes tinnitus seem worse. See Tinnitus and Anxiety.
This is the most important practical step. Do not sleep in silence. Options include:
Bedside sound machines — Devices that produce white noise, pink noise, rain, ocean, or fan sounds. Place it near your bed.
Pillow speakers — Flat speakers that sit under or inside your pillow, allowing you to hear sound without disturbing a partner.
Smartphone apps — Many free and low-cost apps offer customizable sound mixes. Set a sleep timer or let them run all night.
A simple fan — A fan provides both sound and air circulation. Many people find it sufficient.
The sound should be set at a comfortable level that reduces the prominence of your tinnitus without being so loud that it becomes a new disturbance. See Sound Therapy for more on this approach.
Good sleep practices are especially important when tinnitus is a factor. Key principles include maintaining a consistent bedtime and wake time, keeping the bedroom cool and dark, avoiding screens for at least 30 minutes before bed, limiting caffeine and alcohol (especially in the evening), and getting regular exercise (but not too close to bedtime).
If you find yourself lying in bed with racing thoughts about your tinnitus, the cognitive techniques taught in CBT can be helpful. These include thought challenging ("the tinnitus is not dangerous; my body is safe"), attention refocusing (shifting focus to the sound machine or to body relaxation), and getting out of bed if you've been awake for more than 20 minutes (to avoid your brain associating the bed with wakefulness).
Some research suggests that melatonin supplements may help with tinnitus-related sleep difficulty. It is generally considered safe for short-term use. Talk to your doctor about whether it might be appropriate for you. See Medications and Tinnitus.