Waking Up, Especially from Naps, Is Tinnitus Hell

There are some discussions floating about this phenomenon, but not many concrete conclusions. Theories are:

1. Reticular formation looking for "vitals".
2. "Awakening response", probably same as (1).
3. Cortisol levels highest at the time.

For me, my tinnitus is at its worst after short naps, which I try to avoid. It is bad in the morning (or whenever) after longer sleep, fairly consistently, but not always. The time for the spike to lessen can vary from anywhere from 20 minutes to 2 hours. On rare occasions I will wake up to my normally bothersome tinnitus.

It is hell. I don't know what could be done to mitigate it. Dragging myself in the shower is usually the best bet. But it still takes time to shake that off.

And if the tinnitus is catastrophically bad, my head feels "full" in a strange way. Not a headache quite. It is a new sensation I don't quite remember ever having.

Anyone else? Ideas? Tips? Comments? Thank you.

 

I have the same response to naps. Uber level tinnitus compared to my normal horrific level. It takes about an hour to settle back to horrific.

Currently trying a new med to lower my resistive BP, which is giving my post nap level a run for the money, except it is 24/7.

Again, acceptance and hope are my two approaches to dealing with the increasing tinnitus. Just another brick in the wall that is never finished. It is, but I still am here, just losing my ability to hear evermore.

 

If you haven't already, try Sertraline 25 mg, which is an antidepressant but also has a powerful action over tinnitus.

You could also potentially consider that fact that your tinnitus is somatic (unconscious clenching of the jaw) — it is reported that during sleep, jaw clenching may reach pressure up to 900 PSI (normal chewing food is around 68 PSI). In such a case, you may ask your GP about Cyclobenzaprine (aka Flexeril), as you may have neck tension in addition to jaw clenching. The inflammatory response may take weeks to subside.

 

Your story scares me. I am not you, but yours was caused by acoustic trauma like mine.

I don't have luckily (yet) any blood pressure problems. I have always had perfect blood pressure along with a low heart rate.

Have you tried Sertraline? Did it help? AFAIK, it's a Russian roulette. I recall reading some study where Sertaline (Zoloft) helped tinnitus, but there are many people who got worsened by it, or got tinnitus from it in the first place.

Well, mouth guard is probably a safer choice. I had one made as my dentist claims I grind (I don't think so), but I wasn't too diligent about using it. Perhaps I should try again to see if I can lessen the morning symptoms by using it.

 

If this was true, there wouldn't be anyone bothered with tinnitus.

 

I'm going on almost 2 years since my tinnitus suddenly worsened significantly. My tinnitus is sometimes more mild at bed time, like a distant field of crickets instead of a constant hiss or piercing high-frequency tone, but it seems to always get back to a louder baseline by morning, sometimes a hiss, sometimes a piercing tone. I have never been able to nap over the last 2 years with this worsened tinnitus. Fortunately, I can usually fall asleep at bedtime without sleep meds and can save them for when I wake up overnight.

On my 6th day on Sertraline (Zoloft) 25 mg, I noticed a chirping tone in my left ear that I had never heard before. It also caused stomach aches from the first dose (taken with food). I switched to Lexapro after 8th day on Sertraline, and both the chirping tone and stomach discomfort continued, and the stomach discomfort got even worse and painful at times through weeks 6 and 7. So I weaned off Lexapro over two weeks.

It has been 2 months since I've been off both those SSRI antidepressants, and I still have stomach aches and pains of varying degrees. I don't experience that chirping sound much, though. Due to the stomach issues and additional anxiety from that, I'm worse off now than I was before taking those meds.

 

If you fall into a subgroup type described in this paper, the problem may be that short naps rarely evoke REM sleep. There is an idea that the connection between sleep and tinnitus is often backwards. It's not (just) that tinnitus gives us bad sleep, it's that a problem with sleep phases can cause or exacerbate tinnitus. I suspect that to be the case for me.

For what it's worth, I've noticed that I've had fewer "bad awakenings" from naps after taking Lamotrigine for tinnitus (previously I'd get them 100% of the time). There's a little bit of research that Lamotrigine increases REM sleep cycles. Although, as the paper notes, there tends to be a weird circadian thing going on too. That is, the likelihood of getting out of a nap without a tinnitus spike also seems to depend on the time of day you nap.

There needs to be a lot more research into the connection between sleep and tinnitus - and I don't just mean another low grade study into whether tinnitus patients get less sleep overall.

 

Interesting, thanks for the link. But the study seems to be asking more questions than giving answers.

I really need to track my good/bad days and amount/time/quality of sleep I get. Common sense suggests that regular and good sleep should be good overall and for tinnitus as well. I do have better days sometimes and it seems like there is a connection to sleep. It may be the key to improving my shitty quality of life.

 

Don't be so hasty to assume that tinnitus is compatible with common sense! A different paper suggests that the trick might be to accumulate sleep pressure (i.e. get very, very tired) so that by the time you nod off your brain has to jump straight into heaps of slow wave activity. They do that to treat insomnia (ask me how I know). For tinnitus it's thought to be beneficial because <insert actual hard science here instead of yet another hypothesis about disrupting tinnitus>.

For what it's worth, I've found getting up a scooch too early so that I am tired generally means I'll have a better day in terms of loudness. I used to think "more sleep" must be good but I ended up sleeping for like 12 hours and still had 10/10 days. Then I noticed the weird correlation with less sleep and quieter tinnitus. Who knows. What I do know is that if I go back to bed when I'm fully 'up' I'm basically setting myself on fire.

 

Interesting. I guess "good or regular sleep" does not need to mean long. There is something to it, it happens to me on weekends when I sleep longer and usually suffer.

Thanks for pointing that out. I remember this advice about tiring oneself in late afternoon (but not too late in the evening), so one crashes tired to bed.

 

My tinnitus has taken on an interesting new pattern these past few months. I’ve been experiencing this nap spiking phenomenon more than usual as well. I think that’s because my sleep has been broken these past few months. I’m always waking up every other hour and as result my tinnitus feels more intense than normal when I wake up from these short sleeps. It eventually subsides and returns to its baseline loudness level. I hardly get those ‘calm’ mornings anymore. I think I need to fix my sleep...

 

Do you take any sleeping aids such as Magnesium Bisglycinate, Apigenin or Melatonin?

 

I take Melatonin from time to time. It can help me fall asleep, but unfortunately it can’t help me stay asleep. Going to add some Magnesium to my supplements again. See if it helps with sleep. Thanks for the suggestion.

 

I take one capsule each of below two supplements:

Natrol Melatonin Time Release Sleep Aid Tablets, with Vitamin B-6, Fall Asleep Faster, Stay Asleep Longer, Dietary Supplement, Drug Free, 1mg, 90 Count

Eleva Nutrition Apigenin Theanine Magnesium Bisglycinate 3-in-1 Complex Supplement Support Relaxation - Made in The USA - Zero Fillers - Gluten Free & Non-GMO - 120 Veggie Capsules

 

Thanks for labeling your brands of choice. I have never tried time release Melatonin, so will give this a try. Eleva Nutrition Apigenin looks intriguing too.

 

Please be aware that the second supplement consists of Apigenin, Magnesium Bisglycinate and L-Theanine. If you get nightmares or start sleep walking, then L-Theanine is the culprit. I do get nightmares from time to time which are generally me showing up for my high school Chemistry exam without preparation.

I am thinking of replacing the second supplement with separate supplements for Apigenin and Magnesium Bisglycinate.

 

I have probably spent over $300 on many supplements, vitamins, CBD, THC, and Melatonin, including time release and different doses, over the last couple of years.

No help.

I don't feel that anything worked to improve my sleep or ease anxiety. OTC sleep meds, Hydroxyzine, and Trazodone didn't help much for sleep, sometimes not seeming to help at all.

The prescription medication Zolpidem often gets me back to sleep if I take a small dose sublingual when I wake up overnight but will often wake up in an hour to hour and a half.

I would like to try one of those new DORA sleep meds.

 

Do you have trouble sleeping because of anxiety or is your sleep still bad regardless of anxiety? I’m the latter for the most part. If you can improve anxiety, hopefully that’ll help you.

Waking up after one hour of sleep is such a terrible feeling. Then trying to fall back to sleep again and having trouble doing so feels even more worse.

 

This seems to be a hallmark of tinnitus. I have no idea of why it happens, it just does. For me, it almost always happens when I'm having a bad bout of it, as mine can be almost gone for a while and come roaring back for months.

If I can remember to do it, a good DIY earwax removal usually helps a lot. It's scary getting myself to do anything around my ears, but it does generally help. Which shows (at least in my case) that tinnitus is not solely a brain thing, it also has a lot to do w/ the ears themselves.

My hypothesis is that tinnitus causes the brain to produce extra earwax in an attempt to stave off what it perceives as an outside threat. This happens on the subconscious level, and is merely as I said, a guess. But I've done a ton of research on how the brain and mind are two separate things. A great deal of my mind's time seems to be devoted to winning a power struggle w/ my brain's wiring, LOL.

 

I think anxiety is a factor because I definitely have had ongoing anxiety issues for two full years now. But I think there's more to it than that because my anxiety is normally at its lowest level by late evening, and some days it's better than others throughout the day, especially on evenings after biking for an hour in the late afternoon or early evening, yet my sleep is consistently poor, even if I'm usually falling asleep initially without much a problem.

 

If one has been anxious all day, then even if your anxiety goes down in the evening, it will still not let you sleep in the night. That's what I was told by someone who battled anxiety, but not a doctor/medical professional.

 

You have two types of tinnitus: somatic and sensorineural (hearing loss). While science is still trying to figure out the sensorineural type, most common cases of sudden tinnitus are due to anxiety, stress, acid reflux or involuntary excessive tension of the neck, trapezoid or back muscles, as well as bruxism (jaw clenching). It can also be caused by co-morbidity between some or all of these factors.

- You should see an audiologist to perform a hearing test first. If your hearing's fine, then it's somatic tinnitus.

- One way to find out is to push your mastoid bone against your skull. If you see that tinnitus recedes, changes in sound or intensity or just stops altogether, it's 100% due to tension (turn your head left or right and palpate that large muscle coming down from your ear and down your neck — that's the sternocleiodmastoid muscle, and one of the culprits. Look into smoothing out the temporalia and masseter as well, if you have bruxism.

- If you train your back too much, your back and neck muscles can become extremely tense for an indefinite period of time, causing tinnitus because of slight vertebral changes. You need muscle relaxants, stretching exercises and physiotherapy.

One way to find out if your back is too tense, is to lean against a wall, placing your elbows at 90 degrees on each side of your head as a starting point. Now stretch your arms completely over your head without having your arms or back lose contact with the wall. If you can't do that easily, back tension.

- Acid reflux (GERD): Acidic vapors from silent acid reflux while you sleep on your back can reach up your airways, into your sinuses and even into your ear canal, causing inflammation of the auditory canal (otitis externa) and potential Eustachian tube dysfunction on the longer term.

It's said it's not a common symptom; that's incorrect. It's also reported that it does not lead to vasculitis, but hypothetically it can. It most certainly is a common symptom if your acid reflux is not controlled, and will definitely produce somatic tinnitus. Ask your GP about Dexilant to control potential GERD.

*About Sertraline: Sertraline might cause changes in your somatic tinnitus initially because the initial adaptation response feels like you're on very high doses of caffeine. This explains the change in sound pitch or intensity, as your muscles involuntarily tense up during sleep and you might wake up at night with severe tinnitus.

To alleviate the stress response, you need to combine it with a low-dose non-benzodiazepine for insomnia treatment (Z-drugs) like Zolpidem - no more than 5 mg. You have to hang in there for an estimated two full weeks until your brain adapts. At some point you might notice that your tinnitus has noticeably receded and that it might even have completely gone away. I've taken it for 3 months total and then stopped, and eventually habituated to somatic tinnitus (which can come back due to anxiety or muscle tension, but you have the strong emotional response associated with it, that you might experience now — I've been through this, I'm telling you You will invariably habituate.

Of course, do not auto-medicate by all means, always seek your GP before attempting any new medication or treatment.

*About tinnitus after short naps: Some studies have presented that serotonin might not only have pro-relaxant effects, but also pro-contractile. Generally, during a nap, the body may progress through the stages of sleep more quickly compared to a full night's sleep. This may have an effect on muscle tension, also according to your sleeping position. Always take naps in your bed, and not on your couch (lying on the side).

 

Use your mouthguard! I have one, I know — the cleaning is annoying. But it really helps with snoring and tinnitus, and also it takes a few days for somatic tinnitus to recede, as it is a stronger inflammatory response than most GPs think.

 

My anxiety is always significantly lower in the evening where it doesn't affect my ability to fall asleep, but it can vary significantly day to day as well. But there hasn't been any correlation to sleep. I normally fall asleep fine but wake up too often and don't always get back to sleep unless I take Zolpidem. The tinnitus noise itself is probably a big issue. And I've tried with and without partial masking sounds of different types as well as silence and music Nothing really helps to any significant degree except Zolpidem, and even that isn't good enough.

 

Oof. First off, sorry to hear you're going through this. I developed nocturnal panic attacks last year that thankfully have relented. I would wake up heart pounding, sweating and anxious, and until I learned to calm it, unable to fall back asleep. First it was 6 hours, then it was 5 hours for a few days, then 4 hours... Before I knew it I would wake up in such a state 3 hours after, regardless when I fell asleep. It scared the shit out of me.

I still wake up 5-6 hours after I fall asleep, but I no longer wake up in a panic.

Anyway, I would avoid Sertraline if possible.

 

I have been taking L-Theanine for a couple of weeks now. No nightmares, thankfully. I feel like I’ve had some good stretches of decent sleep lately, especially last week. The sleep could still be better, though, but at least it’s enough to prevent me from feeling extremely groggy and sluggish during the day. My tinnitus still amplifies in loudness from short sleep/naps, though.

Thanks.