Hearing Problems and Sleep

The ear is a complex organ that is responsible for hearing and balance. When damage occurs to one or more parts of the ear, including the nerves that send signals to the brain, the result can be one of many types of hearing problems.

These problems can include reduced or no hearing function such as with hearing loss and deafness. Another major problem, called tinnitus, doesn’t reduce hearing but causes a person to experience phantom sounds.

In the United States, studies estimate that more than 37.5 million adults -- 15% of people over 18 -- report some level of hearing problems. Within the last year, more than 10 million Americans have had tinnitus, and it is believed that as many as 80% of people may experience tinnitus at some point during their lives. Worldwide, the scale is even greater because these problems tend to be more prevalent in developing countries. The World Health Organization (WHO) has stated that nearly 466 million people worldwide, including 34 million children, have disabling hearing loss with an annual global cost of $750 billion.

While most people know that hearing problems can affect communication and balance, it is less well-known that there can be a connection between hearing and sleep. Studies indicate that people with hearing issues may have a higher risk of sleeping problems. In addition, poor sleep may have detrimental effects on hearing.

In this guide, we’ll explore this multifaceted connection between hearing and sleep. We’ll cover the key details about hearing: how the ear works, how hearing can become disrupted, and how hearing problems are diagnosed and treated. The guide examines the relationship between hearing and sleep, how hearing problems can be prevented, and how people with hearing problems can get better sleep.

How Does Hearing Work?

On first glance, the ear may not seem all that complex, but within its awkwardly shaped structure lies intricate anatomy that makes hearing possible. This anatomy is broken up into three main sections: the outer, middle, and inner ear.

The outer ear involves the part that sticks out from the head (known as the pinna) and the ear canal. The eardrum, formally known as the tympanic membrane (TM), separates the outer ear from the middle ear, which is made up of the ossicles, three small bones that send sound waves to the inner ear. The Eustachian tube, which connects to the back of the nose and is involved in regulating pressure and balance, extends out from the middle ear. The inner ear includes the cochlea, a fluid-filled and snail-shaped organ, that contains nerves that send signals to the brain.

All of these elements play a part in hearing. Sound waves enter the ear canal, causing vibrations in the eardrum, and these vibrations are in effect passed along by the ossicles to the cochlea. As a result, the fluid in the cochlea moves, provoking movement of hair cells and eventually tiny hairs (called stereocilia). The motion of the stereocilia causes tiny pores to open, and those pores are filled with chemicals that generate an electrical signal that is sent to the brain via the auditory nerve. The brain interprets that signal as a specific sound.

This all happens instantaneously, so it’s rare that we stop and think about this elaborate system. But each component contributes to an interconnected process of turning external noise into distinct and recognizable sounds. Harm to one or more of these components can interrupt the whole process, and for this reason, hearing problems can have diverse causes and symptoms.

What are Hearing Problems?

Problems that can affect the ear are numerous and can induce pain, dizziness, discharge, and effects on hearing. In this guide, our focus is specifically on those issues that interfere with hearing itself.

Hearing loss is often the first thing to come to mind when thinking about hearing problems. This problem, which affects the daily communication of more than 10% of Americans, is the most common sensory disorder. But not all hearing problems necessarily involve a reduction in the actual ability to hear. The sensitivity of the anatomy and nerve signaling involved in hearing make it so that in some cases, such as with tinnitus, hearing is disturbed without actually being reduced.

Entire medical textbooks have been written focusing on hearing problems, so we’ll narrow the focus of our guide to two of the most common issues, hearing loss (including deafness) and tinnitus.

What is Hearing Loss?

Hearing loss is a condition in which a person’s ability to hear is partially or completely reduced. It can affect people of any age and can be a temporary or permanent issue.

What are the Symptoms of Hearing Loss?

The primary symptom of hearing loss is a noticeable decrease in a person’s hearing capabilities. This can manifest in several ways such as having difficulty following conversations, struggling to understand speech in places with lots of background noise, inability to discern certain sounds from others, hearing voices as jumbled, or hearing sounds much louder in one ear.

There are different degrees of hearing loss that are broken down into mild, moderate, severe, or profound.  Hearing loss can happen suddenly, but most often it is progressive, meaning that it gets worse gradually and over a longer period of time. It can affect only one ear (unilateral) or both ears (bilateral). Hearing difficulties can be consistent or may fluctuate over time.

In some cases, hearing loss may be accompanied by other symptoms like dizziness and vertigo, pressure in the ear, and/or a ringing in the ears (known as tinnitus and discussed in more detail below). In some cases, pain, discharge, or neurological symptoms, such as headaches or facial weakness, can occur alongside hearing loss.

In babies and children, hearing loss may be evident when a child does not react to loud noises, seems to respond to sounds inconsistently, and/or has delayed development of speech.

What are the Health Consequences of Hearing Loss?

The effects of hearing loss can vary dramatically for any specific person. An individual’s reaction to reduced hearing can play a huge part in the impact that reduced hearing has on their well-being.

For some people, hearing loss can interrupt social and professional relationships. Decreased hearing can make it harder to participate in conversations with family and friends. In some types of work, hearing may be necessary to complete tasks or coordinate with colleagues. For these reasons, difficulty communicating can lead to frustration and feelings of isolation. In people who have acquired hearing loss (as opposed to having it from birth), studies have identified higher rates of psychological distress including depression and anxiety disorders.

On the other hand, some people respond to hearing loss without these same issues. They may see reduced hearing as only a matter of adjustment that requires different means of communication to maintain professional and personal ties. This can even build community and connectedness, such as in people who share the use of sign language.

Beyond communication and social interaction, hearing loss can have other possible consequences. A person with significant hearing loss may have a hard time hearing alarms or noticing impending dangers (such as approaching traffic). If hearing loss is accompanied by problems with balance or vertigo, they can be at an elevated risk of injury from falls or other accidents.

What is Deafness and How is it Different From Hearing Loss?

Deafness is a term used to describe profound hearing loss and refers to having no or virtually no functional hearing. In contrast, people with mild, moderate, and even severe degrees of hearing loss maintain some functional hearing capability.

The terminology around hearing loss can be challenging because not everyone uses the same words in the same way. For example, some people use the term “hearing impaired” to describe any level of hearing loss. However, others find that term to be overly negative and prefer a term like “hard of hearing” or deaf.

What are the Causes and Types of Hearing Loss?

There are numerous potential causes of hearing loss. In general, based on these causes, hearing loss is broken down into three types: conductive hearing loss (CHL), sensorineural hearing loss (SNHL), and mixed hearing loss.

Conductive Hearing Loss

Conductive hearing loss is caused by a problem with the outer or middle ear that prevents sound from effectively passing through. As the name implies, with CHL there is a mechanical problem interfering with sound being conducted through the ear.

Some of the causes of CHL include:

  • Earwax buildup: earwax, also known as cerumen, helps maintain the health of the ear, but if too much accumulates, it can block the middle ear. This is the most common treatable cause of hearing loss and occurs more frequently in older adults.
  • Fluid buildup: if fluid collects in the ear, it can cause CHL. Fluid may collect during or after an ear infection.
  • A foreign object in the ear: more common with children, the insertion of a foreign object can block the ear canal. Removing the object can also risk ear damage.
  • Damage to the eardrum: if the eardrum becomes punctured or covered with scar tissue after infections, it can disrupt the passage of sound.
  • Damage to the ossicles: if these bones are harmed, they will not properly send vibrations to the cochlea.
  • Head trauma: because it can cause damage to different parts of the anatomy of the outer and middle ear, head trauma raises the risk of CHL.

In many cases, CHL can be treated, for example by carefully removing anything that may be blocking the ear canal or by repairing damage to the eardrum or ossicles.

Sensorineural Hearing Loss

Sensorineural hearing loss (SNHL) is caused by a problem in the inner ear or the auditory nerve. Based on where the problem originates, SHNL can be further classified as either sensory or neural.

  • Sensory hearing loss is a problem in the inner ear. This happens when the hair cells in the cochlea that are involved in detecting and transmitting sound do not work properly because of damage or disease.
  • Neural hearing loss occurs when there is a problem with the auditory nerve that transmits electrical signals to the brain.

Examples of things that can cause SNHL include:

A rare type of SNHL is called auditory neuropathy spectrum disorder. In this condition, sound is transmitted along the normal pathways but not in a way that the brain can properly decipher. Its cause is not fully known, but it is believed to be related to abnormalities of the hair cells and/or the way they interact with the auditory nerve.

In most cases, sensorineural hearing loss is not reversible; however, there are some instances in which it can be treated so that hearing improves. Because it normally cannot be treated, experts recommend taking steps to prevent this type of hearing loss, especially through minimizing exposure to loud noise.

Mixed Hearing Loss

Mixed hearing loss involves a combination of conductive and sensorineural hearing loss. It most frequently occurs because of genetics, a head injury, or chronic infections. In some cases, a person who already has SNHL may develop a mechanical problem in the ear, causing mixed hearing loss.

When Does Hearing Loss Start?

Hearing loss, including deafness, can begin at any point in life. Some people have hearing problems that exist for their entire life while others may develop problems over time. When hearing loss happens after infancy, it normally occurs gradually; however, it is also possible to develop sudden hearing loss.

Congenital Hearing Loss

Hearing loss that starts at birth or very soon after is known as congenital hearing loss. According to the Centers for Disease Control and Prevention (CDC), out of every 1,000 children that are born in the United States, between two and three will have some level of hearing loss.

Congenital hearing loss can be conductive or sensorineural. In some cases, hearing loss affecting the outer or middle ear can be effectively treated. Problems affecting the inner ear are normally permanent.

Congenital hearing loss can have a genetic connection and be related to certain known genetic abnormalities. In developed countries, it is believed that most cases of congenital hearing loss are genetic. However, this genetic basis does not mean that a child’s parents necessarily have hearing problems. It is estimated that 90% of children that are born deaf have hearing parents.

This hearing loss can also occur for non-genetic reasons. Some of those reasons include low birth weight, a mother having certain infections during pregnancy, a lack of oxygen at birth, severe maternal jaundice, and the use of certain drugs during pregnancy.

Congenital hearing loss may also be referred to as pre-lingual hearing loss. This means that hearing has been reduced prior to learning how to speak. Delayed development of speech is a common effect of pre-lingual hearing loss.

Acquired Hearing Loss

Acquired hearing loss happens after birth. It can occur during childhood or adulthood. The way that it affects a person can depend significantly on its severity and the age at which it begins. The emotional adjustment to acquired hearing loss can be very different than that for congenital hearing loss.

One type of acquired hearing loss is called sudden hearing loss. Unlike the more common type of slow, progressive hearing loss, sudden hearing loss normally happens within the span of a few hours or is noticed when someone wakes up. Often it affects only one ear and has no known cause. Hearing may be fully come back for about half of patients with sudden hearing loss of an unknown cause, and additional patients have partial recovery.

Sudden hearing loss can also be caused by head trauma, infections, ototoxic drugs, and other coexisting medical conditions. Whether hearing can be restored after sudden hearing loss in these cases depends on the underlying cause and the extent of the damage to the ear.

How is Hearing Loss Diagnosed?

Diagnosing hearing loss is a multistep process involving a number of potential tests that are ordered and reviewed by a medical doctor. These tests attempt to identify both the cause and severity of hearing loss.

Before any of these tests can be conducted, there must be suspicion of a hearing problem. In children, screening for hearing loss -- checking hearing even if there are not any clear symptoms of a problem --  is relatively common. This screening can indicate a need for further testing. Parents may also bring up hearing issues with a doctor if they have noticed development delays related to speech and communication or if their child does not seem to react to sounds.

In adults, screening is less common, and most of the time, a more detailed evaluation only occurs when someone has noticed a problem with their hearing.

A doctor’s evaluation of a patient with hearing problems usually begins with a physical exam and a discussion of the person’s medical history that includes a review of their existing symptoms. This information may provide clues that explain the cause of hearing loss.

Based on this initial review, a number of different tests may be considered. These tests can provide insight into whether a person has significant hearing loss as well as whether it is conductive or sensorineural.

  • Audiometry is often the first hearing-specific test that the doctor will order. It is a check of how well a person can hear different tones and pitches in each ear.
  • Special threshold audiometry tests how loudly certain types of words must be said in order to be understood by the patient.
  • Speech discrimination testing evaluates whether people can discern between two short words that sound similar.
  • In a tuning fork test, the doctor places a tuning fork, which creates vibrations, in different places around the head. Depending on when the patient hears the sound, it can indicate whether hearing loss is conductive or sensorineural. It may also cast light on whether hearing loss is unilateral or bilateral.
  • Unlike many other tests, tympanometry does not require a patient to give feedback about how well they hear words or sounds. Instead, this test measures sound waves and pressure in the ear to determine how well sound is moving through the eardrum and middle ear.
  • Acoustic reflex testing tracks the reaction of the eardrum to certain tones.

After these audiologic tests are completed, further testing may be required to identify the cause. These tests can monitor brain waves and nerve function in different parts of the ear and brain. Computed tomography (CT) and magnetic resonance imaging (MRI) can provide detailed pictures of the interior of the ear and brain. If a genetic cause is suspected, testing of other organs may be ordered to look for corroborating signs of a genetic condition.

How is Hearing Loss Treated?

Treatment for hearing loss depends a great deal on the circumstances of the patient including their age as well as the cause and severity of their hearing impairment.

When possible, addressing the underlying cause is the first step in treatment. This is especially true in situations involving conductive hearing loss such as the removal of earwax, fluid, or other blockages of the ear. Tubes to remove fluid or surgery to repair the eardrum or ossicles can help restore hearing.

In many cases, though, there is no effective therapy to restore hearing. In these situations, the goal of treatment is to reduce the potential complications that can arise from diminished hearing. In children, special strategies in school can promote the development of speech and writing. Strategies to manage a person’s environment can make it easier to understand words and sounds.

Various methods can be used for improving communication including lip reading, sign language, special sound systems in public places, closed captioning, personal amplifiers, telecommunications device for the deaf (TDD), and many others. Alerting systems can help make sure a person is aware if an alarm goes off or someone is at their front door.

Some people wear hearing aids to assist with hearing loss. There are different types of hearing aids; some fit in the ear while others go behind the ear. The goal of a hearing aid is to amplify sound in that ear. It is estimated that only a small percentage of people who could benefit from hearing aids actually wear them. Only 16% of people between 20 and 69 and 30% of people over 70 who could be helped by hearing aids have ever used them.

Another type of device that can improve hearing is called a cochlear implant. These devices work by converting external sounds into vibrations that are transmitted to the auditory nerve, essentially trying to replicate the action of the cochlea. While a cochlear implant does not fully restore hearing, it can improve it and facilitate communication for many people. Cochlear implants may be used for both congenital and acquired hearing loss.

What is Tinnitus?

Tinnitus is a hearing problem that is characterized by hearing sounds that are not coming from the external environment. These may also be called phantom sounds. The most common description of tinnitus is a ringing in the ears, but some people describe a buzzing, clicking, hissing, or roaring sound. The pitch and volume can vary, and it can affect one or both ears.

Tinnitus is a relatively common problem affecting millions of people. Normally it lasts for just a few minutes, but in other cases, it can be persistent.

What are the Types of Tinnitus?

Tinnitus is broken down into one of two types.

  • Subjective tinnitus means only the patient hears the sounds. Though the exact cause is unknown, subjective tinnitus appears to be related to issues in the part of the brain that processes and interprets sounds.
  • Objective tinnitus means that another person, such as a doctor, can hear the sounds as well. This can occur with changes to the flow of blood through blood vessels near the ear.

Subjective tinnitus is much more common than objective tinnitus.

What are the Causes of Tinnitus?

Tinnitus frequently occurs along with other ear problems; it is a symptom of up to 75% of ear disorders. It very commonly occurs along with hearing loss and has many of the same causes. Tinnitus is regularly correlated with acquired hearing loss that is related to aging, noise exposure, or ototoxic drugs.

Like hearing loss, tinnitus can be caused by a blockage in the ear from earwax or a foreign object. Ear infections, sinus infections, or problems with pressure in the Eustachian tube can induce tinnitus.

Though less common, tinnitus can be tied to other health issues like thyroid problems, anemia, cardiovascular issues, brain tumors, head injury, diabetes, and Meniere disease.

Stimulants (including caffeine), alcohol, and smoking are not considered to be causes of tinnitus, but they can make it worse.

How is Tinnitus Diagnosed?

The diagnostic process for tinnitus is similar to that of hearing loss. A physical examination and review of the patient’s symptoms and medical history provide the doctor with a base level of information. A stethoscope may be used to check for objective tinnitus. Audiometry is usually employed to evaluate overall hearing. A CT scan, MRI, and/or angiography (a test looking at blood vessels) can be conducted to check for possible causes.

How is Tinnitus Treated?

As with hearing loss, treatment for tinnitus depends on the cause of the condition. Effectively treating an underlying cause can eliminate tinnitus. Some medications may be prescribed to try to decrease or eliminate tinnitus.

When tinnitus cannot be eliminated, treatments may be used to minimize its impact. These can include methods to amplify other noises such as the use of a tinnitus masker, hearing aids, background music, or a white noise machine.

Another strategy for coping with tinnitus involves counseling and/or techniques for relaxation. These approaches can help a person manage stress and avoid focusing on the sounds.

How Can Hearing Problems be Prevented?

While there are some causes of hearing problems that are beyond individual control, certain steps can reduce the risk of acquired hearing loss.

Reduce Noise Exposure

Noise is a major contributor to progressive hearing loss because of the damage that it can do to the hair cells in the inner ear. This damage is irreversible, so prevention takes on added importance.

Negative impacts from noise are related to both its intensity and its duration. Noises that pose the most risk are those over 85 dBA (A-weighted decibels). The louder the noise, the shorter the duration that you can safely be exposed to it. Normal conversation is 60 dBA, a motorcycle nearby is around 95 dBA, and a rock concert is around 110.

It is good practice to try to minimize exposure in daily activities and in the workplace. When using headphones, keep the volume low and take breaks without music. For sounds that you can’t avoid entirely, attempt to move away from the source. Ear protection, such as earplugs or earmuffs, can help as well.

Use Caution With Ototoxic Medications

There are circumstances in which using these medications may be necessary to treat other health conditions, but you can talk with your doctor about any possible steps -- such as minimizing the dosage or duration of treatment -- to decrease the risk of hearing loss.

Avoid Smoking

Smoking can cause damage to the nerve endings in the inner ear and may amplify harm that can be caused by aging and noise. It can also exacerbate tinnitus.

Keep Foreign Objects Out of Your Ears

Though it may be tempting to use a cotton swab or other narrow object to try to remove earwax or scratch an itch in the ear, experts strongly recommend against this practice. These objects can cause earwax to become impacted inside the ear and have the potential to injure the ear canal or eardrum.

Get Your Ears Checked

If you are frequently exposed to loud noises, such as in your work, consider having regular hearing checks with your doctor to screen for ear problems.

If you notice any reductions or disruptions in your hearing, don’t wait too long to go to the doctor. If hearing loss is detected early, a plan can be developed to try to slow the rate of its progression.

What is the Relationship Between Hearing Problems and Sleep?

People who have hearing problems often suffer from sleep disturbances as well. Understanding the exact nature of this relationship can be challenging because of the complexity of sleep and the fact that other issues can contribute to sleeping problems.

Despite the challenges to definitive studies, researchers have been able to identify aspects of a bidirectional relationship between hearing and sleep. Problems with hearing may have negative effects on sleep, and at the same time, poor sleep may contribute to hearing problems.

How Can Hearing Problems Affect Sleep?

While the extent of hearing problems on sleep can be highly variable, there are indications that both hearing loss and tinnitus can negatively influence sleep quality.

Hearing Loss

Because hearing loss typically occurs as a result of another underlying cause, it can be hard to separate the unique effect on sleep from the hearing loss itself. For example, hearing loss often occurs with aging, which itself poses numerous challenges for good sleep. Moreover, the diversity of types and severities of hearing loss can complicate the effort to generalize about this condition’s impact on sleep. For these reasons, it is no surprise that many studies of this relationship have had mixed findings.

Though the research is far from conclusive, there are strong signs point to the fact that high levels of noise exposure can, in addition to contributing to hearing loss, disturb nightly sleep. Stress from occupational noise during the day has been found to harm sleep quality at night. One study found overall sleep efficiency was reduced by 80% and that time in deep and REM sleep was decreased in workers exposed to significant noise. Repeated exposure to loud noise, then, may fundamentally affect a person’s sleep while also doing damage to the inner ear.

Hearing loss may also create or exacerbate sleeping problems through effects on mood and anxiety. A study of prelingually deaf older adults found elevated rates of depression that was correlated with insomnia. The way an individual responds to their situation of reduced hearing can impact their mood and social engagement. People who respond poorly can become depressed and anxious, and this can lead to sleep disturbances.

Tinnitus

The impact of tinnitus on sleep is more clearly established. Tinnitus is often most noticeable when other background noise is at a minimum, including at bedtime. For this reason, studies have found that 60% or more of people with tinnitus report sleep disruptions. Common complaints include difficulty falling asleep, waking up earlier than desired, waking up during the night, and feeling fatigued.

On top of the fact that the sounds from tinnitus can disrupt sleep, tinnitus can lead to or exacerbate mental health problems, such as anxiety and depression, that can affect sleep.

How Can Sleep Affect Hearing Problems?

Sleep has far-reaching consequences for both physical and emotional health. As a result, it comes as no surprise that sleep deprivation can play a role in hearing loss and tinnitus.

Hearing Loss

Several studies have found a connection between poor sleep and hearing impairment. Higher degrees of hearing impairment have been associated with insomnia in people who work in high-noise environments. Other studies have found a similar association with a correlation between insomnia and reduced hearing at low frequencies.

The mechanisms by which sleep has an impact on hearing is still unclear. One possibility is that lack of sleep causes oxidative stress. Oxidative stress, caused by the elevated presence of unstable molecules called free radicals, can cause different types of cell damage. A consequence of oxidative stress can be damage to the hair cells in the inner ear.

Another possibility is that insomnia and poor sleep negatively affects circulation in ways that reduce blood flow to the cochlea. Lack of sleep also reduces cognitive function, such as attention, which is often required for careful listening and comprehension among people with hearing impairment.

Snoring and obstructive sleep apnea (OSA) have also been tied to hearing loss. OSA is a health problem that involves blockage of the airway during sleep that causes numerous pauses in breathing. OSA affects oxygen levels and blood flow, and researchers have speculated that this may have an effect on the inner ear. In addition, loud snoring, which is common with OSA but also occurs in patients without this condition, may provoke hearing loss through continuous noise exposure.

Tinnitus

Tinnitus is strongly associated with sleep disturbances, and this relationship appears to be bidirectional. When tinnitus patients suffer from insomnia -- because of either tinnitus or a separate, coexisting health condition -- they report the phantom sounds being louder and more severe. People who have tinnitus along with frequent sleep disturbances have reduced quality of life and less ability to tolerate the symptoms of tinnitus.

How Can People With Hearing Loss and Deafness Get Better Sleep?

Given the potentially reinforcing relationship between problems with sleep and hearing, many people with hearing impairment can benefit from better sleep. Although there is no sure-fire solution, patients with hearing issues can take several steps to try to enhance their sleep.

Work Closely With a Health Professional

Both sleeping and hearing problems are medical issues that demand the attention of a medical professional. Identifying and addressing underlying problems is one of the most effective ways to improve sleep and hearing.

It is not uncommon for a family doctor to make a referral to a specialist for further care. This specialist could be an audiologist, a sleep specialist, or a psychiatrist. Health professionals with these backgrounds can work with you to develop a plan for treatment and symptom reduction.

Cognitive behavioral therapy (CBT) is a type of talk therapy that can be conducted by a trained psychiatrist. CBT is used for an array of mental health conditions and has been specifically applied to sleeping problems through a specific form called cognitive behavioral therapy for insomnia (CBT-I). CBT-I involves various strategies to eliminate negative thoughts about sleep and to cultivate sleep-promoting habits.

One study evaluated CBT-I in 32 people with both insomnia and hearing impairment. Patients who underwent CBT-I reported decreased levels of insomnia, including reduced time awake and higher sleep quality. These benefits were found both immediately after treatment and at a follow-up three months later.

Research is still ongoing, but methods like CBT-I may hold potential for treating tinnitus as well. Because most patients have subjective tinnitus related to abnormal brain functioning, one multi-pronged treatment approach combines sound therapy, relaxation, and CBT. In a study of 68 patients, this treatment improved patients’ ability to cope with tinnitus, including reducing rates of anxiety and depression, over a long-term period of five years.

Review and Step Up Sleep Hygiene

Many factors influence how easily we can fall asleep and stay asleep. Sleep hygiene encompasses the sleep setting and sleep-oriented habits, and anyone looking to get better sleep can benefit from reviewing and improving their sleep hygiene.

Creating an Environment Conducive for Sleep

Making your bedroom conducive for sleep is critical to sleep hygiene and can incorporate a number of elements.

  • Set up alerting devices for safety: people with hearing impairments may need to take steps to ensure they are warned in case of an emergency. Special alarm systems using light or vibration can provide an alert if smoke, carbon monoxide, or another risk is detected. Having this system provides both personal safety and peace of mind that can make it easier to get to bed.
  • Eliminate possible disruptions: people with hearing impairment may be less susceptible to disruptions from noises, but they can still be helped by reducing light in their bedroom. Blackout curtains or an eye mask can keep bedroom light pollution from bothering you. In addition, a white noise machine can be helpful for people with tinnitus at bedtime.
  • Put down blue-light emitting devices: when trying to make your bedroom dark, you might prioritize blocking light coming from outside. But the light emitted by electronic devices like mobile phones and tablets can alter your body’s normal process for preparing for sleep. As much as possible, avoid using for a half-hour or more before bedtime.
  • Control the temperature: there is no one best temperature because what feels right to one person may not work for someone else. However, err toward a cooler bedroom and then adjust to fit your preferences.
  • Don’t overlook your mattress and pillow: sleeping well is difficult if you aren’t comfortable and well-supported in bed. Make sure you have a high-performing mattress and a pillow that keeps your head and neck properly cushioned.
  • Choose your bedding wisely: not all bedding is created equal, and just like your mattress and pillow, it can affect how comfortable you are in bed. Look for a sheet set and a comforter that fit your preferences and your local climate.

Developing Healthy Sleep Habits

Sleep habits, a common area of focus of CBT-I, can influence how we approach sleep and whether our mind and body are primed for rest.

  • Have a sleep schedule: a near consensus among sleep experts is that it helps to have and stick to a schedule for going to bed and waking up. Follow that schedule and don’t change it during vacations or weekends.
  • Prepare for bed the same way every night: the process of getting ready for bed can send a powerful message to your body that sleep is impending. This message comes through more clearly if you follow the same steps -- like brushing your teeth, doing relaxation exercises, having a cup of tea -- every night in the same order.
  • Don’t eat or watch TV in bed: it’s easier to get in the right mindset for sleep if you build an association between your bed and sleeping. Doing other activities in bed can disrupt this mental link, and for that reason, experts recommend that you use your bed for sex and sleep only.
  • Make time for exercise: exercise has so many potential health benefits that they are hard to list in one place; however, to highlight just one, research indicates that exercise can help with sleep.
  • Go easy on caffeine and alcohol: caffeine consumption can make it harder to fall asleep, and alcohol can disrupt sleep quality. Both can also worsen symptoms of tinnitus.

Find Ways to Relax

Many sleeping problems have to do with anxiety or other negative thoughts about getting to bed. Relaxation techniques can help counteract these thoughts and may be especially useful for people with tinnitus.

You can collaborate with a doctor or counselor to identify and practice techniques and to find which approach might work best for you. Examples of some relaxation methods include:

  • Meditation: meditation is a mind-body practice that dates back thousands of years. It has been proven to help reduce the stress response that can interfere with sleep. You don’t have to be an expert at meditation to enjoy its benefits.
  • Journaling: though it doesn’t work for everyone, getting your thoughts out on paper can be a way of reducing how much you ruminate on them when trying to fall asleep.
  • Progressive muscle relaxation: this is a technique that involves tightening and releasing muscles in a specific sequence while taking deep breaths.

Learn More About Hearing Problems and Sleep

For further information about hearing problems, sleep, and related issues, you can explore the links below.

Information, Coping, and Support

Prevention

Genetics

Research

Cochlear Implants

Anxiety and Depression

CBT-I

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