On the list of things that disrupt our sleep, unwanted sound undoubtedly deserves a spot on the podium.
Whether it stems from a partner snoring, extra-chipper birds at 5 a.m. or an upstairs neighbor who rearranges furniture all night, noise is a major contributor to junk sleep. Of the 35,000 sleepers in our study with SleepScore Labs, 28% said noise regularly disrupted their shuteye—making it the third-most-common external disruptor behind temperature and visits to the bathroom.
For some people, the noise situation is not external: Rather than outside noise from a partner or neighbor keeping them awake, the disturbance is tinnitus, a ringing in the ears. This can be frustrating enough to deal with throughout the day. But come bedtime, the sound can amplify in a quiet room and make sleep feel impossible.
Luckily, audiologists say tinnitus doesn’t mean mandatory suffering through sleepless nights. Here’s what to do if your tinnitus is keeping you awake.
What is tinnitus?
The general assumed definition is that tinnitus causes a person to hear a constant ringing in his or her ears, but this audiological and neurological condition is a bit more complicated than that. Tinnitus can certainly manifest itself as ringing, but it can also cause you to hear hissing, buzzing, whistling, swooshing in sync with the heartbeat, or even the sound of music. The noise is not necessarily constant, and it can come in waves with varying intensity. More than 25 million Americans experience tinnitus, according to the Centers for Disease Control and Prevention; that’s about 10% of the U.S. population.
According to Dr. Kindra Veith, an audiologist specializing in tinnitus management, a range of medical conditions and medications can cause tinnitus. (The National Institutes of Health has identified more than 200 pharmaceuticals linked to the condition.) Although the most common cause of tinnitus is untreated hearing loss, other issues — temporomandibular joint dysfunction (TMJ), neck injuries, exposure to loud noise, thyroid issues, and tumors, for example—can come into play. Even common issues can trigger tinnitus, from physical issues like wax buildup to the psychological strain of stress and anxiety.
In fact, those who already struggle to get a good night's rest could be at a greater risk of developing tinnitus. “In some instances, a lack of sleep could be the only cause of tinnitus,” Veith says.
Why tinnitus can make it hard to sleep
The relationship between poor sleep and tinnitus lies in the brain’s limbic system, Veith explains. Tinnitus triggers the limbic system, which controls the fight-or-flight response.
“When we [experience] tinnitus, our body is going to respond as if we're in danger. Your heart rate gets elevated; you might feel a little sweaty and a little panicky. If you can imagine trying to sleep when your body is responding as if you're in danger, you can see why that's going to be a tough one,” she says.
One study found that 50% of patients with tinnitus reported poor sleep quality. That number increased to 69% for those with louder, more intense tinnitus.
If someone dealing with poor sleep develops tinnitus and struggles even more with sleeping well, the tinnitus may worsen or get louder as the stress of not sleeping compounds. This cyclical nightmare—which Veith calls the “negative feedback loop” — could be the result of these conditions piling on top of each other.
How to fall asleep with tinnitus
Poor sleep can cause tinnitus, and tinnitus can cause poor sleep. This complex dynamic makes restorative rest paramount — and luckily, there are numerous techniques to help you get the shuteye you need.
Talk to a doctor
It’s critical to see a doctor if you suspect you’re suffering from tinnitus, Veith says. Audiologists are trained to check for all potential causes and can help you manage the condition. According to Veith, some causes have a quick remedy, while others indicate a more serious medical issue. Your first step should be working with your doctor to figure out what could be causing your tinnitus.
Calm the limbic system
Fight or flight kicks off a stress response that can elevate your heart rate and cause your muscles to tense up, making falling asleep seem impossible. Since tinnitus triggers the limbic system — which, in turn, triggers the fight-or-flight response — it’s important to prevent this system from firing up.
“The more you think about tinnitus, the louder it can become,” Veith says. “When a stress response happens, and the volume of the tinnitus increases — and then you become more stressed, and then the volume keeps increasing — that becomes super-difficult to manage.”
Tinnitus can be linked to stress, so finding everyday activities that reduce stress could be helpful. That includes skipping online tinnitus forums and sticking to the solutions you and your doctor have discussed, Veith says. “Some of the tinnitus forums online can be a really negative and fear-inducing place, so I try to encourage my patients to avoid those,” she says.
Add in some white noise
In a perfect world, Veith says, we would all sleep in a quiet room to minimize noise exposure. But since that doesn’t work for everyone, a white noise machine could help distract from the sound of tinnitus.
“If you play a sound that's just below the volume of the tinnitus, that will help train your brain to adjust to it a little bit better,” Veith says. “The brain then knows that the sound is always there, and you don't need to worry about it when it comes and goes. In this sense, the white noise is just a way to try to take the edge off.”
Not ready to try a white-noise machine? Consider a pair of sleep headphones. Another alternative is a pillow speaker. Find one that you can quickly switch on and off if you wake up in the middle of the night and can’t get back to sleep because of tinnitus.
Practice good sleep hygiene
Creating a bedtime routine that works well for calming the mind and body can set the tone for restful sleep. This means minimizing strain on your eyes—minimize blue light! — and on your ears, as well as minimizing stress before bed. Write down your concerns, and track your routines, so that you can identify possible triggers that worsen your tinnitus.
Sleeping with tinnitus can pose a challenge, but it doesn’t have to lead to sleepless nights. Check in with a doctor if you suspect you have tinnitus. Then, once you’ve determined the cause of your tinnitus, find the techniques that help enhance your sleep.
Interested in exploring more topics related to sounds and sleep? Check out how binaural beats could help you sleep, explore how daytime noise impacts shuteye, and find song recommendations to help you fall asleep faster.