British Tinnitus Association

It is quite natural to feel anxious and afraid when you first experience tinnitus, but once you acknowledge it is part of you and that it cannot harm you, you are on the way to putting it aside and living a full and normal life. There are plenty of simple ways to help you improve your quality of life and make a real difference to living with tinnitus. If you take up any strenuous activities, remember to be gentle with yourself, and not to exaggerate your efforts.

Some of the things to try are:

• Relaxation                                                                                                                
• Exercise                                                                                                                    
• Activity                                                                                                                         
• Good posture                                                                                                               
• Diet                                                                                                                        
• Personal contact

Relaxation
Learning to relax properly is one of the best ways to help yourself. Many people who practice regular relaxation say it reduces the loudness of their tinnitus and helps them become indifferent to their noises - the tinnitus is still there but it is much easier to ignore. Relaxation helps to break down the vicious circle of stress and anxiety many people find accompanies their tinnitus. There are a number of different types of relaxation such as yoga, tai-chi or meditation. It is possible to find classes in most parts of the country and it is always a good idea to shop around to find one that suits you. Of course you may not want to attend classes, so we have included a simple relaxation/meditation exercise for you to try at home, or you could use one of the variety of relaxation CDs available. Some feature a voice gently talking you through a series of relaxation exercises, others offer pleasant, natural sounds or soothing music designed to complement relaxation.

Simple relaxation/meditation exercise                                                                            
Firstly find a quiet place where you feel comfortable and at ease, and where you are unlikely to be disturbed. You can do this exercise sitting in a comfortable chair or lying on your back on a supportive surface. Whichever you choose, don't cross your arms, legs or ankles. 
                                                                                                              
Once you are settled take several deep breaths, breathing in through your nose and out through your mouth. As you do this repeat silently to yourself a word or phrase such as "calming", "relaxing" or "letting go", while settling into your body and releasing the thoughts of the day, your worries and anxieties. You are now ready to begin: Let yourself breathe naturally and on each out-breath relax one part of the body, beginning with your feet, gently say to yourself "letting go of the feet" and feel the tension in your feet dissolving. Then work your way up your body in the same way, in the following order:

Lower legs
Thighs
hips and pelvis
back
chest
arms and hands
neck
head and face allowing the eyes to relax and soften (letting go of the jaw)                                     

Now you are ready to focus your attention on your breathing. The object is to concentrate on the simple motion or sensation of your breath moving in and out of your body. For people with tinnitus, it is useful to place the attention in the diaphragm (because it is further away from the ears/head).

The diaphragm is the large muscle deep in the top of the abdomen. As you breathe in, it pulls down towards the pelvis, as you breathe out, it moves upwards towards the throat. Watch your diaphragm move on the in-breath and count one. As you breathe out, count one again. On the second breathe count two and so on, until you have counted to ten.

Then go back to number one and repeat. While you breath and count, just concentrate on the movement of your diaphragm. You will start thinking about other things, but let your thoughts pass and gently return your attention to your breathing, some people like to imagine these thought as clouds moving across a blue sky. Don't worry if you lose count, this is quite natural, just start from one again and feel your body becoming more and more relaxed.

Finally you may stop counting and quietly observe your breath on its own. This is the deepest part of meditation. Your body is very relaxed, thoughts come and go - let them. Gently return your focus to the motion of your breathing, this is the only important thing - the feeling of being relaxed and awake, not involved in your thoughts, simply watching your breathing. And now begin to return. Gently stretch your muscles and open your eyes slowly. After meditation it is a good idea to take things easy for a while. Don't just get up and start rushing about.

This exercise takes between 12 and 25 minutes, although it can be performed for longer if you wish. To feel the real benefit, it is important to practise regularly, so try and fit four 20 minute sessions in each week.

People with tinnitus can find it difficult to meditate in a quiet room, but with practice it is possible to focus past the noise to the muscles you are relaxing and to your breathing. However, if it helps, you can play a tape of soothing music or natural sounds. (The BTA has a list of some tapes and CDs that are available). Although it sounds easy, learning to relax properly is a skill, it takes practice and effort, but once you have mastered it , you will find it not only helps you cope with tinnitus, but with all the other stresses and strains of everyday life.

Exercise
Most modern occupations and lifestyles contain little in the way of exercise, although we evolved over thousands of years in circumstances which required far higher levels of fitness. Regular exercise helps the body achieve a higher level of well-being and in most cases this helps people to ignore and cope with their tinnitus better. If you are not used to exercise, begin gently with a swim or brisk walk (choose somewhere quiet to walk if you find the traffic stressful, although some people with tinnitus seek out noisy places to reduce its intrusiveness). Try to do a range of exercises to improve strength, cardiovascular training, suppleness and flexibility.

Activity
If your mind is occupied with something absorbing, it is easier to forget about the tinnitus. Work, leisure pursuits and other interests can all help to provide a worthwhile focus. If you don't have a hobby, now might be the time to start something, many people say that painting or writing helps. Bear in mind however, that excessive activity may produce stress, so take time for relaxing activities and social interaction where possible.

Posture
Good posture in sitting and standing makes it easier to breathe fully and naturally, helping both relaxation and concentration, many Eastern practices such as yoga and tai-chi work on posture. Another approach is the Alexander Technique which concentrates solely on posture, through breathing and exercises. Teachers of these methods can be found in most parts of the country, but look for someone who is fully accredited by the appropriate national body and with whom you feel comfortable. Details can usually be obtained from your local library or in Yellow Pages.

Diet
Some people say that particular foods or drinks can aggravate their tinnitus. The most commonly mentioned are red wine, caffeine and tonic water(which contains quinine). If you suspect something is affecting your noises, try keeping a brief, but detailed diary of things you eat and drink for a couple of weeks and see if there are any variations in your tinnitus ( when you keep this diary, make sure it doesn't encourage you to think about your tinnitus too much).

If you think something is making it worse, try cutting it out for a couple of weeks to see if there is any improvement. If there is, repeat the trial again and if you get the same result, you may want to avoid that substance in future. But don't give up on things unless you are sure they are having some effect, especially if it's something you enjoy, you could end up feeling miserable and deprived for no reason. In general, try to eat as good a balanced diet as you can. The healthier your diet, the better you will feel and the easier your tinnitus will be to cope with.

Personal contact
It can often be very helpful to talk to someone who understands how you are feeling, who can reassure you about any anxieties you may have, and answer your questions. The BTA office in Sheffield can provide details of self-help groups and contacts in the UK. Most of the people who run groups or are contacts, have tinnitus themselves and have been helping people with the condition for a long time. Even if you don't want to take part in group activities, it can be a comfort to know there is someone you can contact. Also, it can be helpful to tell your family and friends about your tinnitus. Let them know what it is like to experience it (e.g. by tuning a radio ‘off-station’ to produce a suitable sound or by playing the BTA's simulated noises of tinnitus CD) people are almost always sympathetic and understanding.

April 2008 – © British Tinnitus Association

This information is not a substitute for medical advice. You should always see your GP / medical professional