Sleeping with Reactive Tinnitus?

Hi, I am 24 years old and I got noise-induced tinnitus in early June. Since the onset I have had a constant ringing or hissing sound in both ears, but recently I have found that my right ear and a bit of my left ear is reactive to sounds. It is difficult to mask, the tinnitus reacts instantly to pink/white/brown noise and for natural sounds like crickets, rain and waterfall it eventually ends up competing with it. Last night I had no sleep because I was trying to figure out which sounds do not aggravate the reactive tinnitus, to no avail. I am in need of some help because sleep is my get-away, I can manage the day if I can be rest assured I can get a good nights sleep! Is it best not to use any sound, exercise beforehand and just let my ears calm down?

Btw, I have no hearing loss.

I would greatly appreciate any positive support/advice/experiences on how to deal with sleep and reactive tinnitus!

 

I've been in the same situation. White noise aggravates my tinnitus too, so I generally fall asleep listening to an audiobook nowadays. Or you could just try soft music to relax and distract you from it, with maybe a warm bath and some deep breathing before bed. I'm on Amitryptiline which helps me sleep through the night. Also making me sleepy through the day but if I can get caught up with sleep then hopefully it will be worth it.

 

I have reactive tinnitus. Any noise from a speakers will spike my tinnitus. So I suggest to not use any noise maskers and over time you will get used to falling asleep that way.

 

You have to learn to live with it... but I don't advise that in the first year honestly. Hopefully it goes away... might not... but if it doesn't you will eventually learn to live with it. In the beginning hot showers and then sitting in the bathroom with the shower on hot hot hot for a while before bed helped. Certain herbs on warm water tea type shit (I can look it up, been a few years) and a fan on even if it's not aimed at you. Also opening your window is amazing if you don't like the fan idea... the wind and cars and just random noise will get you able to sleep. It all comes down to learning to live with it... which seems impossible at first. After about 2 years I decided I was done with the shit and slept in silence for a few months. Just me and my ringing. Some nights where sleepless but now I'm fine with it... and it's still loud af Haha.

 

I agree with Sean. Just try without any maskers, however that might be maybe strange in the beginning if you got used to them. Mine is also reactive, pretty loud and I am also realtively new to tinnitus with having it only for 3 months and from the beginning I haven't used anything to mask it and I am able to sleep pretty well.

 

I like your idea of warm bath and deep breathing, I'll have a go at it. As for amitryptiline, is that an effective long-term med and does it reduce your perception of RT at night?

 

Yeah, I've tried so many things like speaker, sound pillow, ear pyjamas lol not really working so I guess I'll try now without it. Will try to sleep sound free

 

Yes Amitriptyline can be taken long term.

 

Okay thanks!

 

That gives me confidence

 

Okay, and does it reduce your perception of RT when you sleep?

 

HI @Chris809

Many people new to "noise induced tinnitus" will experience what you are going through at the moment. Your reactive tinnitus is actually: Hyperacusis, an oversensitivity to the auditory system and often accompanies Noise induced tinnitus. The term Reactive tinnitus was made up in tinnitus forums and is frequently used to describe this oversensitivity to sound that you are experiencing. However, there is no such condition. Those reading this post and wish to challenge me on it, will get no reply as I have discussed RT many times in this forum. Some in the medical profession have latched on to this word and attempted to make it into a condition that is treatable alongside hyperacusis. Please do not get swept into believing it because it isn't true.

It will take time for your tinnitus and auditory system to recover from the noise trauma. This may require seeing a Hearing Therapist or Audiologist trained in tinnitus and hyperacusis management and treatment. Contrary to what some people believe, hyperacusis is treatable and can be completely cured in many instances, with or without specialist treatment. Please keep in mind, if hyperacusis does not improve naturally over time or specialist treatment is not sought, it will always remain a problem and will manifest itself by one's continuous oversensitivity to sound resulting in tinnitus spiking. Some people address this anomaly by using earplugs and abstaining from certain sounds in normal everyday environment. What often isn't realized, this can make the tinnitus and oversensitivity worse, and thus becoming a vicious circle without beginning or end. It is treatment that is required not earplugs and deliberately keeping away from normal everyday sounds.

If you want to help yourself I advise using sound enrichment whenever possible and particularly at night. Someone with tinnitus and hyperacusis that sleeps in a quiet room risks making the conditions worse. Please click on the links below and read my articles which explain tinnitus, hyperacusis and sound enrichment in more detail.

I advise you not to use headphones even at low volume as you risk making your tinnitus and hyperacusis worse.

All the best
Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/the-habituation-process.20767/

 

So, Tinnitus that increases with noises is Hyperacusis? What I experience is that sometimes, I will get a spike in my T, and with that, all sounds make the T louder, especially things like running water and fans. It actually increases and competes with those sounds. It can last anywhere from seconds to days. That is H?

Also, in my case, exposure to noise does not help. The only thing I can do is find somewhere quiet until it stops. It does not stop until I quiet things down. I have tried exposing myself to noise, but it just makes it worse, and it takes much longer to go away. I once tried white noise could barely hear anything out of the ear because it had gotten so loud. It gradually quiets down for me as long as there is no sound.

 

The issue that he and many others have is that sound enrichment - particularly at night - can exacerbate the tinnitus. It can seem louder and more jarring, making it much harder to fall asleep. I experienced this consistently when I've played a variety of ambient sounds below the level of my tinnitus, as everyone seems to recommend. So while you're point about sound enrichment being helpful at night makes sense to me, and may indeed be advisable for many, it doesn't really address this particular issue - which is that for some, especially early on, it makes sleep more difficult.

 

HI @kiel

Your tinnitus was originally caused by Noise trauma, headphones the same as mine 23 years ago. I had very severe hyperacusis of the type you describe and it has been completely cured using White Noise Generators as part of TRT. As I have said in my post above. If hyperacusis which is oversensitivity to the auditory system, does not improve naturally or specialist treatment is not sought as in using white noise generators as part of TRT, or under the care of a Hearing Therapist/Audiologist this oversensitivity will always be a problem and can get worse by the overuse of earplugs and keeping away from normal everyday sounds. If one isn't careful, additional problems can occur which I explain in my article in the link below.

You have hyperacusis oversensitivity to sound. I explain how to treat this condition using self help in my post: Hyperacusis, As I see it. It doesn't mean to immerse yourself in "noise". You have to take things slowly and I describe it in the article.

All the best
Michael

https://www.tinnitustalk.com/threads/the-complexities-of-tinnitus-and-hyperacusis.25733/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

I suppose it does. When I turn over it still tends to spike my T but I just have got into the habit of practicing my deep breathing and the medication helps me fall asleep again quickly. The main benefit is that it helps me sleep and be less anxious (its main function is as an antidepressant) and my hyperacusis seems reduced too. There are a few threads on here discussing amitriptyline.

 

I understand what you are going though as I encountered the same thing many years ago with my noise trauma. You have to do things very slowly and it takes time to get used to using "sound enrichment at night" at least 8 weeks is required. Remember, you have probably slept most of your life in a quiet room. Therefore, introducing a new sleeping regime will take time for you to adjust. You are trying to help yourself. Please click on the links below and read my articles, which explain the tinnitus, hyperacusis and the use of sound enrichment at night. If you want to help yourself I advise you to start using sound enrichment during the day and night. Keep the volume low. The idea is to use gentle low level sound enrichment not to mask or cover up the tinnitus as this defeats the purpose.

Michael

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/trt-as-i-see-it.19555/
https://www.tinnitustalk.com/threads/should-i-mask-my-tinnitus.17964/
https://www.tinnitustalk.com/threads/sound-machines-and-tinnitus.12072/

 

No, that is not hyperacusis. Hyperacusis is when sound causes physical pain when it should not do so. There are some other variations of hyperacusis but I think “pain hyperacusis” is what most people on Tinnitus Talk mean when they say hyperacusis.

From the Hearing Health Foundation website:

Richard S. Tyler, Ph.D., professor of communication sciences and disorders and of otolaryngology at the University of Iowa, describes four categories of hyperacusis: loudness, annoyance, fear, and pain. While he sees all of these subtypes intersecting in the clinic, epidemiological data on hyperacusis are lacking, “so it's hard to know how much overlap actually occurs,” he said.

• Loudness hyperacusis: moderately intense sounds are perceived as too loud
  
  
• Annoyance hyperacusis: a negative emotional reaction to sounds
  
  
• Pain hyperacusis: a stabbing sensation at much lower sound levels than would typically prompt pain. This is sometimes described as a sharp or dull pain in the ear, jaw, or neck, feeling of fullness in the ear, or a tingling in the ear according to Lindsey Banks, Au.D.
  
  
• Fear hyperacusis: a negative response to sounds that may cause patients to avoid social situations or feel anxiety in anticipation of hearing these sounds

https://hearinghealthfoundation.org/types-of-hyperacusis

 

I can see that there can be a connection between H and T being reactive but it's not always the case, the problem for me is that if I use sound enrichment at night my ears will eventually do sssSSssSSsssSSSSSssssSSSSSSsss and this is near on impossible to sleep with even at low volumes. Don't get me wrong I am not using headphones anymore and I am letting my ears be exposed to the normal random (but safe) sounds of the day and music without hearing protection but the night is my biggest conundrum I want to solve and I feel if I just let my ears rest after a day's exposure to sounds they can have time to heal, just like a plant at night.

 

I have one thing to say about these medical professionals with their Phds and other medical qualifications. The majority of the them have never experienced tinnitus and know nothing about "Noise induced tinnitus". Granted, they know about the anatomy of the ear and auditory system and how to treat medical conditions associated with them but that's where it ends. NIT is an entirely different kettle of fish.

Michael

 

If you want to get taking in by false truths that is entirely your choice I'm not going to argue. I know about "Noise induced tinnitus" having many years experience with it. I also know about the effects of hyperacusis, and know, that in most cases, it can be successfully treated and cured, naturally or with specialist treatment. You are new to tinnitus and it will take: 12 to 18 months perhaps longer to recover.

Michael

 

I do not suggest to use sound enrichment at night. When I used it, it helped to fall asleep, but the T was made worse by a little bit.

Rather, I had more success with sleeping with foam earplugs so I stopped waking up with each little sound disturbance. I also found that daily omega3 helped to reduced the inflammation, about 500 mg worked well for me.

 

Most Hearing Therapists and Audiologists that specialise in the treatment and management of tinnitus and hyperacusis, recommend using "sound enrichment" during the day and especially at night. The reason being the brain and auditory system never switch off. Some people do not like using sound enrichment at night. The main reasons for this is because they are not persistent with it.

If a person has intrusive tinnitus and also hyperacusis, they risk making the conditions worse by sleeping in a quiet room. If the brain hears silence while we sleep, it has the ability to increase its background activity and thus increasing the tinnitus at the same time.

It is well known that hearing loss can cause tinnitus. This is because the brain increases its background activity to hear sounds from the outside environment that it is struggling to hear. When such a person is fitted with a hearing aid/s. The brain and auditory system are now supplied with additional sound from the outside environment - over time the brain turns down its background activity rather like a volume control and in the process the tinnitus reduces too. Using sound enrichment at night works in a similar way to a hearing aid. Over time the brain reduces it's background activity and the tinnitus is pushed further into the background. If hyperacusis is present, sound enrichment helps to desensitise the auditory system.

Michael

 

I've seen you saying this a lot, and it does make sense to me logically. But also, I've noticed that the quieter it is when I'm sleeping, the more my T calms down and stays lower the next day too. I'm not saying complete silence, as I have the window open and can hear crickets and frogs, but when I was using a fan or something louder it was much worse.

Also, I've had T since July 2017 in my right ear and it never bothered me until this year. Why? I'm not really sure, but NOW it's reactive, whereas before it never changed in volume or pitch or was affected by other sounds. What would cause it to do that now? Brain damage? I was exposed to some toxic fumes at my former workplace when this all started going downhill and my ears haven't been the same since. I STILL don't know if I have ETD or not either since apparently crackling ears when yawning is pretty common amongst everyone I've surveyed and none of them have tinnitus or ear issues.

 

@nicole76

Thank you for your question.

Tinnitus can be a complex and will affect each person differently. Whatever is causing the tinnitus can complicate matters too? For this reason the advice that I give in this forum is mostly for people with "Noise induced" tinnitus because this is what I am familiar with. An underlying medical problem within the auditory system or hearing loss causing the tinnitus I tend not to comment on. Occasionally I will give advice on hearing loss as this information is well documented if one chooses to research it.

You have said that you don't sleep in "complete silence". The window is open and you can hear crickets and frogs but when using a fan or something louder the tinnitus increases. This is quite understandable. A fan is the wrong piece of equipment to use for "sound enrichment" because the sound level cannot be adjusted. Sound enrichment must be set at a level where it can be comfortably ignored and not draw attention to itself, otherwise it can become intrusive and a nuisance as you have found.

With your window open at night, the sounds of frogs and crickets is enough to supply low level sound enrichment of the kind I make reference to and which your brain and auditory system have found to be beneficial. There is nothing better than the sound enrichment of "Nature". If there are trees close to where you live, I suspect the rustling sounds of leaves gently blowing in the night breeze creates the ideal ambiance for you. Some people with tinnitus believe "sound enrichment" is to help them sleep but this is incorrect. As I have mentioned above, the purpose of sound enrichment is the supply low level sound to the brain and auditory system while we are asleep because the brain never switches off. Evidence of this is when doctors advise relatives and close friends, to talk to someone they know that might unfortunately be in a coma.

In answer to your question above, I advise that you get a referral to ENT so tests can be carried out on your auditory system and your hearing checked. From what you describe you may need adjustments to your hearing aid or possibly, need one for your other ear. These symptoms need to be investigated by professionals and this is best done at ENT.

I wish you well.
Michael

 

I don't currently have a hearing aid, and was told back in 2017 that they wouldn't help me due to the low level of hearing loss I have. Told the same thing earlier this year by two ENTs who evaluated my hearing and said that it hasn't changed/deteriorated since 2017. Just mild high frequency hearing loss in the right ear.

Seems to be my problem ear since in 2013 I started having balance issues and after testing was told the balance system in that ear was attacked by a virus. Was told the chances of that happening again was slim, yet four years later the tinnitus started and then the hearing loss was discovered. Was it directly related? I have no idea. I've listened to headphones, albeit never loudly, in my youth, went to two handfuls worth of concerts over the years without ear protection (although almost always sat way in the back), worked as a telemarketer and customer service agent for a handful of years (so I had a headset over that right ear all day long), and took my fair share of ototoxic medication too. So it was probably a combination of things, all of which I was completely ignorant about or I would have been far more protective of my ears. Hindsight really is 20/20. You take your hearing, and your ability to hear silence, for granted until something like this happens and then you're consumed by it.

I've tried warning my friends but they don't take it seriously. One of them goes to loud events (bars, festivals, concerts) every single weekend and plays loud music because that's how she likes it. Also takes Ambien to sleep and is much older than me but her hearing is fine. Another one said "yea I should wear earplugs to concerts but whatever". And she actually had tinnitus after a cold for six months! Hers just spontaneously went away. It seems so unfair, really.

That being said, I am still considering hearing aid(s) if just for the masking feature. Not sure how that would work for only one ear, though. One lady tried to sell me on the fact I would need hearing aids for both ears even though I only have the loss/tinnitus in the one. So I'm not sure what to do as I'd be looking at over $5000. Trying to hold out for a device to buy in the U.S. HOPEFULLY in 2020 that can rid me of this noise. I am a highly anxious Type A personality and even though it's not a very loud sound, it can get high pitched and because it is reactive I am having a lot of trouble not letting it rule my life. I was fine the first year and a half with it but now that it's being more intrusive I'm struggling to enjoy my life. My husband, on the other hand, from the way he describes it, has tinnitus in both ears and it's relatively loud but he just ignores it, and doesn't even know how long he's had it. Why I can't be like him, I don't know. I have trouble tuning out irritating noises in general so having one following me around everywhere has made life pretty shitty.

 

It is not a good idea to do exercise just before sleeping, as it activates your body, the same as using smartphones or computers.. screen in general, except for TV maybe.

 

Since your ENT doctors have told you that hearing aids will not be of much help, think carefully about this before purchasing them. I know how annoying tinnitus can be and therefore, it might be better to use dedicated white noise generators, that are made for people with tinnitus. The white noise is set below the tinnitus by the user via a volume control and shouldn't mask or cover it up. This form of sound therapy can be very helpful. They look very similar to hearing aids. I have been using them for many years whenever I feel the need to use them. They can be bought as White noise genertors or if a person has hearing loss, dual purpose units are available. These have hearing aid and white noise generators within the same device. A Hearing Therapist/Audiologist has to examine you and set these up on a computer before fitting. White noise generators alone can be bought without the need to be seen by a Hearing Therapist/Audiologist but I don't advise it. WNG are specialist devices and if used incorrectly can make tinnitus worse.

Many people have experienced tinnitus after night out clubbing or attending a loud music concert. For a lot of them the tinnitus will go completely away by the next morning or within a day or two and they are not too troubled or distressed by it. Some openly laugh about the experience as a friend of mine did some years ago saying: "When my ears are ringing I know I've had a good night out". Indeed I said, until the day the ringing doesn't stop. My solemn expression must have had the desired effect because immediately it wiped the grin off her face. From that day onwards she began using earplugs when going out clubbing and attending concerts.

We are all different. Some people are fortunate and experience tinnitus multiple of times going to the events I've mentioned above, and eventually it goes away or lingers on at a very low level. The brain can happily ignore it and this is called habituation. However, make no mistake, if such a person doesn't change their ways they will eventually develop full blown tinnitus and then come to know, how devastating and cruel this condition can be when it is severe.

Michael