How the Restorative Power of Sleep Supports Long-Term Tinnitus Recovery
When night falls and the world goes silent, most people look forward to sinking into the comfort of sleep. It’s a time to rest, reset, and heal.
Sadly, the nightly ritual can feel more like a battle than a blessing for those living with tinnitus. To provide more context, that’s nearly 25 million adults across the US. The constant ringing that dampens during the day amplifies in the silence of the night.
This makes managing tinnitus distress especially difficult when the body most craves rest. The truth is that the sleep that feels so elusive holds the key to long-term tinnitus relief.
In this article, we will understand how deep, restorative sleep plays a central role in tinnitus recovery. Also, you will discover strategies that help harness the restorative power of sleep. Just as a clarification, the restorative sleep encompasses the deep, active stages of sleep essential for physical and mental repair, while tinnitus is the perception of ringing or other sounds in the ears when no external noise is present.
The Bidirectional Relationship Between Tinnitus and Sleep Disturbances
The foremost thing to know is that tinnitus and sleep are deeply interconnected. A 2023 study found that sleep issues among those with tinnitus range between 25% and 77%. The percentage difference had to do with the population examined.
This is an alarming stat, which only underscores the importance of sleep management. Now, let’s understand why the bidirectional relationship even exists. The most common complaint among those with tinnitus is a persistent ringing sensation in the ears.
This symptom tends to get worse in quiet environments, especially at night. As a result, falling or staying asleep becomes a challenge. This, in turn, heightens stress, emotional reactivity, and overall tinnitus sensitivity the following day.
Moreover, the individual may begin fearing bedtime due to worsening tinnitus symptoms. Chronic sleep deprivation is a double-edged sword as it equally impacts cognitive function and emotional regulation. From a long-term perspective, a self-perpetuating cycle develops where poor sleep worsens tinnitus distress, which further impairs sleep.
The Neuroscience of Restorative Sleep
Did you wake up this morning feeling rested and refreshed? Then, you enjoyed what is known as restorative sleep. The truth is not all sleep is restorative.
Regular non-restorative sleep can have serious consequences. Healthline shares both the short and long-term repercussions, ranging from concentration issues to chronic conditions like heart disease.
As you sleep, peacefully oblivious to your surroundings, your body does not. Sleep is not passive, but is supposed to be an active biological process that contributes to physical and mental restoration.
Now, different stages of sleep have specific functions. Your body will cycle through one Rapid Eye Movement or REM stage and three Non-Rapid Eye Movement or NREM stages as you sleep.
The NREM 1 stage is when you just fall asleep. It lasts a few minutes to allow the heartbeat/breathing to slow down and the muscles to relax. The NREM 2 stage lasts about 25 minutes, during which body temperature drops and the brain begins to produce ‘sleep spindles.’
The latter two stages, NREM 3 and REM, are said to be the most important. Let’s look at these stages closely to understand their implications on tinnitus:
NREM 3 or Slow Wave Sleep
This is the deepest stage of sleep, and also the most restorative. Your body uses the previous two stages to prepare for this stage. When an individual does not enter or stay in NREM 3 while sleeping, they wake up feeling tired or drained.
The Cleveland Clinic shares that ideally, the deepest sleep stage accounts for over 25% of total sleep time in adults. In this stage, the brain waves are slow but strong. The body takes advantage of this to repair tissues, strengthen bones, and reinforce the immune system.
It is also the stage in which the nervous system regulates itself, facilitating stress recovery. From a tinnitus viewpoint, this stage is crucial for emotional balance. It prevents hyperarousal and calms the body’s fight-or-flight response. Without sufficient NREM 3 sleep, those with tinnitus will experience daytime distress.
In other words, the ringing sensation will be a lot worse and more difficult to ignore. Since emotional equilibrium will also be disturbed, the individual will display signs of greater anxiety and irritability.
In turn, this hypervigilant state may extend to bedtime, thereby delaying sleep onset. It forms a vicious cycle where reaching the NREM 3 stage becomes difficult.
REM or Dream Sleep
This is the stage in which vivid dreams generally appear. It’s when the eyes can be seen moving behind one’s eyelids (due to the dream). In this stage, brain activity tends to look similar to that of being awake.
REM is crucial from the perspective of cognitive functions like memory and learning. The brain gets busy consolidating memories from the day and processing negative emotions as well.
If an individual with tinnitus gets proper REM sleep, their brain can detach from negative experiences associated with the condition. If not, anxiety tends to build, and one’s coping ability is compromised.
To provide clarity, this stage gives the brain the rest it needs to benefit from tinnitus coping strategies (which we discuss later). Inadequate REM sleep is why individuals with tinnitus undergo regular therapy but do not respond well to it.
Strategies to Harness Sleep’s Power in Tinnitus Recovery
Getting restorative sleep each night is crucial for one and all, particularly for those with tinnitus. It will help determine how well the body responds to tinnitus treatment.
Here are some effective strategies to harness sleep’s power. Subsequently, they will help ease tinnitus symptoms. It’s important to give time; tinnitus does not happen overnight, and generally does not get reversed overnight either.
The Sound Relief Tinnitus & Hearing Center advises planning on at least a year, possibly even two, of treatment. This makes sense in light of two facts: we’re looking at long-term tinnitus recovery, and sleep restoration takes time.
Cognitive Behavioral Therapy (CBT)
This is a structured, short-term treatment that targets thoughts and behaviors responsible for sleep disruption. It will address sleep restriction, stimulus control, mindfulness, and cognitive restructuring of negative thought patterns.
When done under professional guidance, CBT can reduce pre-sleep anxiety, break the negative sleep-tinnitus cycle, and enhance healthy coping skills.
As a result, the individual can experience nighttime relief. Even if the ringing sensation remains, it becomes less disruptive and distressing.
Sound Therapy
The purpose of this therapy is to make eerily quiet surroundings less scary. In other words, the individual can use white noise or soft music to mask the ringing sensation at night.
Digital apps are available to generate customized masking sounds that match one’s tinnitus frequency. They can inhibit the ringing sensation, thereby facilitating sleep onset.
The main benefits of sound therapy include reinforcement of healthy sleep associations and promotion of deep sleep. It can be a great tool in achieving the much-needed NREM 3 stage of sleep.
Medication and Supplements
Though not the first resort, medication and supplements may be needed if the other methods fail to provide nighttime relief. Usually, they act as temporary, short-term solutions in cases of severe sleep disruption.
Some individuals are prescribed medicines/supplements to restore healthy sleep patterns in acute phases. Others are prescribed medications for co-occurring conditions like depression or anxiety.
This strategy must be used judiciously and only in the short term. They are meant to be a part of a comprehensive treatment plan, and not a standalone fix.
In conclusion, as we just discussed, poor sleep can slow down tinnitus recovery, even worsen the symptoms. Not only that, but the National Institutes of Health states that poor sleep patterns increase the risk of developing tinnitus.
Take a close, hard look at how rested you feel each morning. What does it say about your sleep routine? If you’re someone with tinnitus, how can you modify your sleep schedule?
This article has shared the link between sleep and tinnitus, along with strategies to improve both. The sooner you address the problem, the better. Just remember to rebuild your nights as you seek to reclaim your days.