Hello from Bruce — Struggling with Sleep & Amitriptyline Makes My Tinnitus Worse

Hello friends,

I am a 59-year-old man who played in loud rock bands in my teens in early 20s, which was the genesis of my tinnitus.

About 10 years ago, I had an ear infection, and lost some hearing in my left ear. However, the tinnitus did not become worse, and it was very low level, so I really did not notice it. It did not make an impact on my life.

In early November of this year, my primary care physician suggested I try Paroxetine as a means of being able to manage my fear of flying. My son is being married in California in a few months, and that is a very long drive from where I live, 3,000 miles.

I was prescribed 20 mg pills, which I split in half to make 10 mg doses. I just didn't feel comfortable taking the full 20 mg dose. They were film-coated pills, but every doctor and psychiatrist I have talked to (and there have been at least half a dozen of them) have said that should not have made a difference. In any case, I only took the medication three nights in a row, 30 mg total over three nights.

This was a horrible drug for me. It made me incredibly edgy, anxious, and borderline suicidal. So I abruptly stopped taking it, which my doctor later said was okay, and thought that would be the end of it.

2 days after I stopped taking the drug, I developed a terrible ringing in my ears, which was dramatically louder than anything I had ever experienced, except after going to a very loud rock concert. In those instances, the tinnitus would resolve by the next day.

This time, however, the ringing did not stop, and I feel like I've had some loss of hearing in my left ear, as well. Not a huge amount, but I feel like it's a little more difficult to hear out of my left ear, now.

I would describe the sound as a very high pitched ringing, and when I am especially stressed out, it gets worse. When I am more calm, it is less so, but still very noticeable, and I think about it all the time.

My biggest issue is that I have not slept well in 6 weeks. I will go to bed, and wake up after an hour to an hour and a half, use the bathroom, and then generally sleep for an hour to an hour and a half, on and off, for the rest of the night. Sometimes I am up every hour. I probably string together six or so hours of sleep, but they are not even remotely restful, and I am exhausted, the next day.

I used to take Amitriptyline for about 25 years for chronic fatigue syndrome, which I developed when I was 27. My chronic fatigue came back at the beginning of COVID-19 in April of 2020, so I went back on the Amitriptyline to sleep. I sleep like a rock on 20 mg of Amitriptyline, every night. So my physician recommended I go back on the Amitriptyline.

The problem is that when I take Amitriptyline, now, it makes the tinnitus worse. So now I take Lorazepam, 0.5 mg, every couple nights so is to not get addicted to the stuff. I also take Magnesium glycinate, which does seem to calm me a bit, and I drink several cups of chamomile tea, each day. I tried 2 mg of Melatonin, and it didn't do much for me.

Other than that, I just suffer. My days are spent obsessing about my tinnitus, and my nights are spent obsessing about why I don't sleep, while I listen to my tinnitus.

I have a hearing test scheduled for 3 weeks from now, and I am hoping that the Signia notch technology hearing aids can help me.

Beyond that, I'm holding out hope that Lenire/Neuromod gets approved in the USA soon.

Any help anyone can lend for sleep or habituation would be greatly appreciated.

Thanks all,
Bruce

 

Hi Bruce,

Sorry but there is no silver bullet here. Sound enrichment can help with sleep if the tinnitus is keeping you up. I’ve found that multiple sound sources are better than one. So I have the TV on, white noise playing on a phone, and rain sounds coming from my sound machine. All are on as low a volume as possible.

If it’s not the tinnitus keeping you awake, you may have to consult your doctor about other potential meds, although there is always a degree of risk with medications.

Apart from that, the best advice I’ve got is to try not obsess about the sound or have any negative reaction to it. Impossible I know but please do try, the more you try the easier it becomes. In the vast majority of cases things will improve over time, and you will eventually stop obsessing about tinnitus. I’m 6 months in and only now starting to see some genuine improvement in my quality of life, although I think the volume is just the same.

Wishing you a good sleep.

 

I think Lenire is garbage. Be careful with the benzodiazepines, they can worsen tinnitus when you stop them. I’m a victim of that.

 

Thanks makeyourownluck---I appreciate your perspective. I know that I have some significant hearing loss, so as long as the frequency of loss isn't too high, I'm holding out hope that hearing aids could help. I don't need to be totally rid of tinnitus, I just want the loudness to fall back to where it was, previously, which was manageable.

Brian P, thanks for your thoughts. I'm really careful about Lorazepam. I keep a log of how often I take it and how much. I never use more than .5 mg per night, and never two nights in a row. Usually it is about once every three nights and I just don't sleep well, the other nights.

I have a psychiatrist who I see online, and he is thinking of prescribe be generic Seroquel (begins with a q). He says they give it in the psych hospital where he works, and it puts people to sleep nicely. Very low-dose, so not addicting like Benzos. I may give that a try.

As for Lenire there has been some great information on this website, and from what I can determine, it seems like a complete hoax, which is unfortunate. I guess we all will have to wait to see what Susan Shore's device looks like, if it gets approved in the States.

 

Hi Bruce,

Since your tinnitus was originally caused by exposure to loud noise it is important that you try not to make it worse. If you are a user of any type of headphones including earbuds, AirPods or headsets, my advice is not to use them even at low volume, as they could increase the tinnitus.

A person with hearing loss can develop tinnitus. The brain tries to compensate by increasing its background activity to hear sounds from the outside environment. However, in the process the onset of tinnitus can occur. Once the person is fitted with hearing aid(s) and the hearing improves, over time the brain reduces its background activity and thus the tinnitus decreases. Someone that already has tinnitus and develops hearing loss the same can happen. Therefore, it's good you are having a hearing test. If you are prescribed hearing aid(s) then hopefully there will be an improvement in the tinnitus with time.

Try to avoid quiet rooms and surroundings during the day and especially at night by using a sound machine. This device will provide low level sound enrichment, that will help your brain not to focus on the tinnitus. Please click on the links below and read my articles: New to Tinnitus What to Do? Tinnitus, A Personal View.

All the best,
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

Michael,

Thanks so much for your kind words and advice!

I take very good care of my ears---very few concerts (and I wear earplugs, if I do attend), and I don't wear earphones or earbuds of any kind. I used to work out with over the ear headphones, and sometimes would crank the volume, and my tinnitus would go off but rails. So I just stopped.

What makes this currently episode so maddening is that I'm just not exactly sure how it happened. Was it Paxil? I only took it three nights in a row at a split dose of 10 mg---is the stuff that ototoxic?

Was it the Moderna vaccine booster? I had the booster on a Thursday and my tinnitus exploded on Sunday.

Is it genetics? My dad has had horrible hearing since the US Navy, and when he was about my age (59) my mom was developing nodes in her throat from raising her voice so he could hear her. He then got hearing aids at about age 60.

I guess I just blame myself, somewhat---is there more I could have done to prevent this? I also haven't slept well in six weeks, and I know that can damage one's hearing, as well.

The whole thing is exhausting, but I do hope hearing aids can help. I have definite hearing damage in my left ear (and maybe a bit in my right), so hopefully I'm a candidate. We shall see.

I look forward to checking out your articles----thanks for the links!

Thanks again, Michael!

 

Thank you for your kind comments @Bruce.

Ruling out hearing loss, noise-induced tinnitus which is what you have, will usually remain stable for many years. Certain things can increase it. Typically, it is further exposure to loud noise or using any type of headphones even at low volume. The wearing of earplugs even the best is no guarantee you are safe - if external sound is loud enough, it will pass through your head and transfer to your inner ear by bone conduction. This can spike the tinnitus which may be temporary, or increase it to a new permanent level.

Hearing loss can increase the tinnitus as previously explained. Once fitted with hearing aid(s) the tinnitus will usually calm down after a while. Some medications have been known to increase tinnitus but this is usually temporary. Stress is known increase tinnitus but once this is brought under control, either by self help or with medication the tinnitus will usually return to baseline level.

Please click on the link below and read my post: Will My Tinnitus Get Worse?

Take care,
Michael

Will My Tinnitus Get Worse? | Tinnitus Talk Support Forum

 

Michael,

I read in your link the following:

"In 2011, by chance I was surfing the Internet and wasn’t looking for anything in particular and happened to visit a website where Tiex, tinnitus therapy device was sold. I was so desperate I ordered it and the rest is history because it helped me."​

Is this device still helpful and one that you continue to use to this day? I'm just wondering if others may benefit...

Thanks.

 

I still use Tiex twice a day @Bruce, 10 years on as I find it helps. I have attempted to reduce or stop using it many times, but the tinnitus gradually increases. I have a severe form of noise induced tinnitus that fluctuates. It changed to this in 2008 after a second noise trauma.

I believe it can no longer be purchased as the company was bought out. A Tiex Mk2 known under a different name, Sono medical device, is now available at a much higher price: Homepage - Cleanhearing

Michael

Can I Habituate to Variable Tinnitus? | Tinnitus Talk Support Forum

 

Michael,

Thanks so much. I followed the discussion thread and see that the company is now Cleanhearing, to your point.

I hear what others are saying, thinking some of the company's statements are preposterous or misguided. However, the company has some pretty impressive people on board, and if it works for some, why not? Try before you judge, no?

I live in the States, so I cannot obtain the device, myself. I will be curious to see if they seek FDA approval, and when they roll it out here, if approved.

Thanks again.

 

My advice @Bruce NH USA, is to wait and see if you are advised to wear hearing aids. If your hearing is impaired then the hearing aids should restore it to optimum, and with time the tinnitus should reduce. In addition to this I recommend you see an audiologist that is experienced with tinnitus management, before starting a treatment like the Sono device.

Just my suggestion. All the best,
Michael

 

Michael,

Absolutely. I'm scheduled for a hearing test and a review with a doctor of audiology in just under three weeks.

Then I will see an Ear-Nose-Throat specialist the next day.

We will see what they all say.

As for Clean Hearing, it sounds interesting.

Thanks,
Bruce

 

Hi Bruce,

Remember to use low level sound enrichment especially at night using a sound machine. The idea is not to mask the tinnitus. Keep the sound slightly below the tinnitus and give yourself at least 6 to 8 weeks to get used to sound enrichment. If you buy an Oasis sound machine they can be connected to a pillow speaker for privacy.

Best of luck,
Michael

 

Thanks, Michael!

 

Hello @Bruce NH USA, how are you?

 

Hi Eleanor!

I'm hanging in there, thank. Very tired, still not sleeping well and it's been 8 weeks since my tinnitus got a lot worse.

My psychiatrist prescribed 7.5 mg Remeron/Mirtazapine for sleep. I guess the stuff really knocks you out, and you gain a lot of weight, so I'm a little ambivalent about it. But I need to sleep, so I think I'll try it.

How are you doing? Do you have any sleep issues, yourself? If so, have any medications/treatments worked for you?

 

Hello @Bruce NH USA, I’ve always managed to sleep into the noise of my tinnitus...

Although I have started using sound at night just to help with the hyperacusis. I like the crackling fire sound.

I never bothered with any sound therapy 26 years ago as it irritated me.

I was on Prozac 26 years ago for some time, and eventually I habituated.

But this time I haven’t taken anything.

You must take the medication as sleep is so important. And you will feel better for it. And try and stay positive as we will get better. Just give it time.

 

Hi Eleanor,

Thanks for your response! I use an app called Relief that I play at night as I sleep. I mix in rain with some ocean sounds (very mellow) and it helps to keep the tinnitus in check as I sleep.

I have read so much conflicting info on Remeron/Mirtazapine... some say it helps tinnitus, others say it can make tinnitus worse... who do we believe???

So I am going to wait until I see the ENT at Massachusetts Eye & Ear, which is a really great institution in Boston, here in the United States. He specializes in tinnitus as well as sleep medicine. I see him on the 18th, so fingers crossed!

Thanks again, and be well!

 

Hi Bruce.

 

Hello @Bruce NH USA, you will always get conflicting comments on forums. That’s why it’s best to just read the positive stories.

Listen to what your ENT says and see how it goes, it might be ok for you.

I was on Prozac 26 years ago. Some people on here have conflicting views on it but it really helped me get better.

So try not to listen too much to the negativity. Stay positive.

 

Hello friends,

I have had extreme tinnitus for 8 weeks (after Paxil ototoxicity) and haven't slept well, since. My lack of sleep has actually made my hearing deteriorate even more, and I am getting very depressed.

My psychiatrist prescribed Mirtazapine to help me sleep (7.5 mg at night). The first night it was OK, though I didn't sleep more than 2 hours at a time. But I did sleep in for a total of 11 hours in bed. So, not terrible.

Last night, however, I was up after an hour and a half, then up every hour after that. I am a 59 year-old man, so yes, I do get up to use the lavatory, a time or two, but my psychiatrist and GP said I should be getting 4-6 hours from my first sleep, each night.

What do you folks use for sleep meds to knock you out? I can't sleep with my tinnitus, as it is. I know it's early (only 8 weeks) but I am really struggling.

Any help is greatly appreciated!

Thanks,
Bruce

 

Hi!

 

My doctor prescribed me 3.5mg Zopiclone.

It has worked some nights.

 

Thanks! I was prescribed that at 3 mg, but thought that might be too much, per the FDA, which recommends 1 mg.

Does it give you at least 4-6 straight hours of sleep before waking up? That's my biggest issue...

 

Hey Bruce. I see an otologist at Mass. Eye and Ear.

As far as medications go, the MD’s advice was more related to meds that are truly known to be ototoxic. NSAIDs in high doses taken for long periods of time, cancer drugs, certain antibiotics. As for antidepressants he did not advise me one way or the other. What he did say is that there are over 200 things that cause tinnitus and you never really know what caused yours save for detectable hearing loss. I think with other medication it’s a crapshoot.

I was on Zoloft for a number of years. I felt great on it. Didn’t impact my tinnitus at all. However, I’m sure that there are people on the site who believe that they got their tinnitus from Zoloft. I gained like 60 pounds on it. They had me on a really high dose which probably is part of the problem. So I decided to go off of it.

It was a real pain in the butt to get off of with lots of symptoms so I have chosen not to go back on it. Plus, quite frankly, being on the site and reading the stories of people taking a medication and seemingly getting tinnitus from it scares you away from everything.

I’m wondering if your perceived hearing loss is a causative factor.

Did the low-dose Seroquel work for you? I find it helps me but only at like 12.5%. At 25% I’ll sleep all the next day.

Good luck at Mass. Eye and Ear.

 

Thanks for your reply, Forever Hopeful! I am seeing Dr. Noah Siegel on Tuesday at ME&E. I found a YouTube video of a seminar that he was a part of back in 2016. Really smart guy, and he also specializes in sleep medicine. So I am hopeful.

I was prescribed Quetiapine (Seroquel) at 12.5mg, but have not taken it. I would have to break the 25mg tablets in half, and I think that's what got me into trouble with the Paxil. I'm also not sure that I want to be on that drug, as it's very powerful.

I just tried the Mirtazapine for two nights at 7.5mg and it absolutely obliterated me. I was a total zombie the next two days. And yet, I didn't get the kind of sleep that I wanted. Same deal of up every hour and a half. If I can't get the benefits from a med, then I'm not going to suffer from the side effects. Remeron/Mirtazapine also has a very long half-life, so it's a commitment...

I know I have some hearing loss, and have for years, so in a strange sort of way I hope that makes me a good candidate for hearing aids. I never thought that I'd be wearing hearing aids at the ripe old age of 59, but it is what it is. Have you tried hearing aids, yourself?

Thanks again, and my best to you!

Bruce

 

It gives me 2 or 3 hours sometimes.

At the moment I would take anything.

 

Thanks, that's kind of what I figured. To quote the Ramones, I want to be sedated...

 

Same problem with sleep. My psychiatrist prescribed 100 mg of Trazodone for sleep. Any experience with that?

 

My fiancee also has sleep issues, so her PCP prescribed Trazodone 50 mg. All it did was give her a headache with no help for sleep.