How to sleep better with Tinnitus

Hi guys. Rachael Cook, doctor of audiology at Applied Hearing Solutions in Phoenix, Arizona, and in today's video, I'll be telling you my very own three-step bedtime routine to sleep better with tinnitus. Coming up. As an audiologist, I meet with tinnitus patients nearly every day who all want to know the secret to reducing their tinnitus. But because tinnitus has so many different causes and because it sounds different from person to person, it's really hard to give one size fits all advice. But nearly all tinnitus sufferers can agree that their tinnitus is most noticeable in quiet situations like when lying in bed and trying to go to sleep. During the day, most people see their tinnitus easily fades into the background with surrounding noise and while your attention is focused on different tasks. But by the end of the day, stress levels tend to be higher and without the distractions of the daytime, the tinnitus can seem so much louder. This can not only make it tough to fall asleep and stay asleep, but the poor sleep from the night before can increase stress levels and thereby increase tinnitus levels the following day. As you can probably expect, this cycle of increased stress to increased tinnitus to increased sleep issues can be relentless without the right tinnitus management strategies in place. That's why today I'll be telling you all about my three step bedtime routine that's guaranteed to help you sleep better with tinnitus. But before we dive in, if you could please take a quick second to give this video a thumbs up. It really helps bring these videos to a wider audience, and if you haven't yet already, go ahead and hit that subscribe button with notification bell so that you never miss any one of our newly released videos. Now, it's important to begin by saying that anyone with tinnitus, but especially those with sudden or rapidly developing symptoms, tinnitus that is different between ears or has a pulsing rhythm, tinnitus that develops after loud noise exposure or tinnitus that is accompanied by hearing loss, fullness or pressure of the ears, or vertigo, should be urgently evaluated by an audiologist to rule out any potential contributing factors and refer you to the appropriate specialist. Tinnitus is very highly associated with hearing loss and loud noise exposure, but can also be the result of head and neck injuries, certain medications, jaw disorders, and health conditions affecting blood flow. A comprehensive hearing evaluation by an audiologist is really the first step in determining the cause of your tinnitus and the next steps in managing it. But no matter the cause, every person with tinnitus can benefit from implementing this tinnitus bedtime routine that actually starts hours before you even crawl into bed. Which brings us to step one, which is ideally four hours before, but certainly no less than two hours before bed. You need to reduce or completely remove your intake of caffeine, nicotine, alcohol, high salt foods, and marijuana. All of these have been shown to either reduce or increase blood flow and neurotransmitter production or change the concentration of elements within the cochlea, your hearing organ, which has major impacts on tinnitus perception. I know for certain that caffeine boosts my tinnitus perception and it makes it that much harder for me to fall asleep. And for that reason, I actually have a hard stop for all coffees, sodas, or energy drinks of 2:00 PM. I also know that a single glass of red wine is very likely to take my tinnitus up a notch or two. Monitor how your tinnitus reacts to each of these items and reduce or halt your intake of them accordingly. This will help you avoid a preventable tinnitus spike right before bed. After limiting these substances, step two is to ideally carve out an hour or so before bed to reduce stress. Tinnitus is very reactive to stress levels, which can often spike after a long or busy day right before bedtime. Therefore, it is critical that you take some time to calm your body, your mind, and your nerves at the end of each day. This will look different for each person and may include a combination of activities. It might be a physical way to reduce stress in the body, like completing a 15 minute stretching or yoga routine on YouTube. It might be a mental way to de-stress, like journaling some thoughts, filling out your planner for the next day, or completing a guided meditation to turn your brain off. It may even be with something that brings you joy, like reading that new book or my personal favorite, finishing a few more rows of a crocheting project. Whatever the activity, remember the name of the game is to calm your mind and your body, so avoid watching the evening news, playing video games, or completing a CrossFit workout right before bed. Now, before you jump under the covers, it is time for us to complete step three, which is getting your room ready for a good night of sleep. Something they probably didn't teach you in school are the evidence backed elements to get a good night of sleep. These are things like reduced light, a cooler temperature, and for those with tinnitus, sound therapy strategies. Light impacts your brain's sleep-wake cycles, and even small amounts can keep you awake. Blackout curtains can help to block out moonlight and morning light that can mess with your sleep cycles. Light can even come from LEDs on our alarm clocks, TVs, remote controls, and even charging hearing aids. Be sure to cover or put tape over all of the light sources in your room as even the unassuming ones could be contributing to your inability to fall or stay asleep. And yes, light disturbance can even come from blue light, the kind that is emitted from our cell phones, our tablets, and our laptops. Research suggests that blue light specifically can suppress your production of melatonin, the sleepy time hormone, for up to two hours after you put your device down. That can certainly make it more difficult to fall asleep. To avoid this, be sure to power your device down before you get into bed, ideally by one to two hours. Now, I know that this advice is probably one of the most ignored good sleep habits with probably the biggest payoff if it was actually followed. Social media apps in particular are great at triggering quick hits of dopamine that your brain is designed to keep chasing, making it hard to stop scrolling and turn your brain off. If you wanna see major improvements in the quality of your sleep and major reductions in your tinnitus perception, I'm sorry, but you have to follow this step. Don't worry. I'm still working on this too. Now, research also suggests that temperature plays a really big role in the quality of our sleep with most people getting their best sleep somewhere between 60 and 68 degrees Fahrenheit. Now, if you live anywhere like Phoenix, then you know that this may not be feasible to do year round, but you may wanna test out how you sleep with your thermostat set just a few degrees cooler. Our bodies naturally drop in temperature as a part of the sleep cycle, and cooler temperatures also help to increase melatonin production, supporting falling and staying asleep. And finally, ready your room for some high quality rest by using sound therapy strategies. Now you can learn everything that you need to know about sound therapy by checking out my video that will be linked in the description below. But the basis of sound therapy is to reduce your tinnitus perception by adding calming or soothing background noise into your environment. One main hypothesis for tinnitus perception is auditory deprivation, which really just means that the brain is not receiving as much sound as it's expecting. Without detecting the anticipated external sounds, it's thought that the brain can try to make up the difference by creating its own internal signals. This could explain why nearly 90% of those with tinnitus have some level of hearing loss as the reduction in hearing results in less sound being sent to the brain and therefore increased tinnitus. But even if your tinnitus has nothing to do with hearing, quiet environments will still make your tinnitus more noticeable as there is less surrounding sound to take the focus off of your tinnitus. For this reason, it's actually best to avoid sleeping in total silence and instead give your ears and your brain some extra sound stimulation. Now, this can take some getting used to as many people have some very particular sleep habits, which makes sense as we spend about a third of our life asleep. But if you sleep alone or if your partner isn't a particularly light sleeper, you may want to use an air purifier or fan to provide some low level background sound. The air purifier in my bedroom is set at just the right level to take that piercing edge off of my tinnitus, allowing me to fall asleep pretty fast. If these are not strong enough or the right type of sound to reduce your tinnitus, you may wanna use a tabletop speaker that can play your choice of sounds like ocean waves, a crackling fire, or even soothing music. It's important to find a blending volume for whichever sound that you choose to use that is not much higher or lower in volume than your actual tinnitus. This level is particularly important in retraining your brain to seek out sounds coming from around you rather than increasing the internal tinnitus signals. Try to avoid using the television as your sound source if possible, because this of course increases the levels of light in the room. Now, depending on your sleeping arrangement, this extra sound may bother others that are in the room. But don't worry, I've got solutions for that too. One example is a sleep mask with headphones that can wirelessly connect to your phone to deliver whatever sound therapy you'd like right into your own ears. Following the same idea, companies like Sound Oasis provide pillow speaker inserts that can provide sound through your pillow and into your ears only. And don't worry, both of those products will be linked in the description below. Now, it's gonna take some time and some patience to land on the perfect sound therapy strategy for you to give you the results that you've been looking for. But believe me, once you land on it, it's gonna be difficult to fall asleep without it since it works so well. That being said, don't lose hope and stay persistent as it takes time to retrain the brain's response to tinnitus. In summary, a good night of rest with tinnitus is possible and is very likely to happen if you follow my three step routine. Your best tinnitus bedtime routine will of course depend on your own lifestyle preferences and symptoms. But following this framework gives you the best chance at determining which factors can give you more control of and relief from your tinnitus. Step one, limit caffeine, nicotine, marijuana, alcohol, and salt at least two hours, but ideally four hours before bedtime. Step two, complete at least one calming activity before bed to reduce stress, settle the mind and increase relaxation. And step three, prepare your room for deep sleep by blocking all light sources, including your cell phone, turning down the temperature, and finding the most effective sound therapy for you. If you are experiencing new or worsening difficulty falling asleep or staying asleep and you think that your tinnitus is to blame, please schedule a comprehensive hearing evaluation with an audiologist that specializes in tinnitus management. They cannot only help determine what's causing or contributing to your tinnitus perception, but also review treatment options and discuss management techniques. And don't forget to download our free tinnitus checklist that I will have linked in the description below. Did I miss anything? If you have something that you swear by as a part of your tinnitus bedtime routine, make sure you drop a comment.

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