Do you feel sometimes that your tinnitus is taking over? Some people do. At times like this, it can be difficult to imagine that there are ways of turning the tables and managing your response to tinnitus.

Whilst there is currently no known ‘cure’ for tinnitus, there are a range of strategies that can help to minimise the intrusiveness of the noises. People can and do manage the impact that tinnitus has on their lives. Here are some ideas.

‘Forgetting’ the tinnitus

Research shows that, whilst many people have tinnitus, only some are aware of it all the time or distressed by it. This is because people often get used to the noises just as we get used to other noises around us (eg air conditioning, a clock ticking, or aeroplane noises). This is known as habituation. The noises we are most able to ‘forget’ are predictable, repetitive sounds that we perceive as benign, non-threatening, and thus unimportant. If our attention is focussed on something else it may be possible to ‘forget’ the tinnitus at times and it will therefore have less impact. Here are some ideas for starving tinnitus of attention:

Do:

  • notice the environments and activities where the tinnitus is less intrusive. Try to do more of the activities that help to shift your attention away from the tinnitus - these will probably be activities you enjoy or are interested in.
  • expect that tinnitus will be more noticeable in some environments, for example where there is less background noise. If possible, try to find ways of making these environments more ‘tinnitus friendly’, eg by occasionally introducing some low-level sound. However, be careful not to focus on avoiding tinnitus all the time. If you do, this is a sign that you are giving it too much importance and it will thus stop you ‘forgetting’ about it.
  • take some time each day to practise switching your attention between the tinnitus noises and other bodily sensations. For example, close your eyes and take a couple of minutes to focus on the rhythm of your breathing, then switch your attention to your hands and mentally count your fingers, refocus on your breathing, switch to monitoring your tinnitus, then focus on your breathing again. Notice how you are able to control your attention.
  • build your tinnitus into a pleasant mental image - some people find this can help to reduce the distress it causes. For example, if your tinnitus sounds like waves crashing, take some time each day to shut your eyes and picture a beach. If the tinnitus sounds like whistling, try to picture a kettle boiling and making a cup of tea. The more often you are able to link your tinnitus with something pleasant, even if only for a few seconds, the more likely it is that the distress will reduce.
  • ask yourself if there is anything else that is on your mind that you need to sort out when you notice that the tinnitus is demanding your attention. Tinnitus works a bit like an ‘emotional barometer’ – it is often more intrusive when there is stress or worry around. If there is something else on your mind, try to resolve the matter. If it can’t be sorted out, acknowledge this and note to yourself that worrying will not help.
  • things that are relaxing. Being stressed makes it more likely that we will react negatively to our environment, including the tinnitus. You could practise slowing down your breathing, having a warm bath, or using muscle relaxation exercises.

Try not to:

  • avoid activities that you think may make your tinnitus worse. If you do, you won’t discover, as most people do, that the tinnitus settles down afterwards. Try to live your life in spite of the tinnitus, not because of it. Do things because you want to, rather than because you think they will help to ward off the tinnitus. By planning your life around the tinnitus, you are giving it more importance, which will stop you from habituating to it. Changing your life because of the tinnitus also makes it likely that you stop activities which make you feel good. What’s good for life is good for tinnitus.
  • feed the tinnitus by putting your life on hold while you chase a ‘cure’. There is no proven cure for tinnitus at this time – when there is, you’ll be sure to know about it! Remember though, this does not mean tinnitus has to control your life.
  • ‘test’ your tinnitus – eg listening out for whether you can hear the tinnitus over the TV or trying to figure out whether the noises you are concentrating on are the tinnitus or your sound generator. Each time you are ‘listening out’ for the tinnitus, you are guiding your attention towards it. If your tinnitus worries you, it is hard to stop monitoring it, but notice when you are doing it and move your attention to something else.

Be kind to yourself

Sometimes you may think that you ‘should cope better’ or that you are ‘not very good at dealing with your tinnitus.’ However, taming tinnitus can be very difficult. The reason is that for some people, tinnitus triggers the body’s ‘fight-or-flight’ system, also known as the sympathetic nervous system, which prepares the body for emergencies. Body and mind then process tinnitus as dangerous, threatening, and important. It happens very fast and is difficult to control.

Try to:

  • acknowledge that you are dealing with tinnitus as best as you can at this moment, given what you know and can do. If you think you could do better in the future, think about what you can do differently next time (for example, practising the steps in the ‘Forgetting the tinnitus’ section.)
  • remember that it takes time for the connection between tinnitus and danger to unravel. While the body’s fight-or-flight system reacts very fast, it is slow to modify this reaction.

Try not to:

blame yourself. This just makes most people upset and stressed. Stress is usually counterproductive. If you are upset and stressed you are less likely to perceive tinnitus as benign, non-threatening, and unimportant.

Getting to sleep

Many people with tinnitus believe that the noises disrupt their sleep. If you have difficulty getting off to sleep it may be that the shift from a relatively noisy daytime environment to the quietness of the bedroom makes the tinnitus noises more noticeable – in the same way that a candle looks brightest in a dark room.

Consider:

  • having a low-level sound playing in the bedroom (eg wave sounds, a fan or calming music) - some people say it helps them to go to sleep. However, using sound that is too loud or attention-grabbing (eg listening to a talk programme on the radio) may get in the way of falling asleep.
  • reducing your caffeine intake in the evening.
  • getting some exercise each day – but not too close to bedtime.
  • geting your head out of planning or worrying mode before bedtime. In the early evening, spend a maximum of 10 minutes writing down ideas or issues you want to tackle tomorrow.
  • making a point of winding down at least half an hour before going to bed (eg doing relaxation exercises, listening to soothing music).
  • going to bed when you feel tired rather than at a set time.
  • sticking to a set time for getting up each day.
  • using your bed only for sleeping. Try not to watch TV, eat, or work on your computer in bed.

Don’t:

  • panic if you don’t get to sleep within 25 minutes of turning the lights out - get up, move to another room, and do something relaxing until you begin to feel more tired. Then go back to bed. Be careful not to do something too stimulating. Repeat this process until you get to sleep.
  • cat-nap in the daytime. If you can’t resist then keep it short, say 15 minutes.
  • stimulate your mind in your winding-down period before going to bed or in bed by watching TV, doing crosswords or listening to talk programmes on the radio, for example.

Getting back to sleep

Some people believe that tinnitus wakes them up during the night. This, however, is unlikely to be the case. Sleep naturally goes in cycles broken up by brief periods of waking, although we do not normally remember them. When people feel that their tinnitus has woken them up, it is likely that they have tuned into the tinnitus noises during one of their natural waking periods. It is the same natural waking periods in which people might feel the need to go to the toilet.

If you are having difficulty returning to sleep after waking in the night:

Try to:

  • drink less or no alcohol. Whilst even a small amount of alcohol makes falling asleep easier, it will also disrupt the second part of your sleep cycle and wake you up.
  • whisper a nonsense-word (eg ‘dah’) over and over – this may help to distract from intrusive thoughts or worries.

Try not to:

  • panic if you wake up. Your body will ensure you get the minimum sleep you need, but you can help it along by staying calm and relaxed. If you don’t get to sleep within 25 minutes of turning the lights out, practice the tips in the ‘Getting to sleep’ section.

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