Tinnitus and sleep: practical tips for quieter nights

Why tinnitus seems louder at night

During the day, everyday sounds partly cover tinnitus and keep your attention elsewhere. At night the contrast changes: the room is silent, you are lying still, and there is nothing else for your brain to focus on. The tinnitus is not usually any louder, but it is far more noticeable.

Worry makes it worse. Lying awake listening to the ringing and worrying about not sleeping keeps the brain alert, which makes the tinnitus more prominent still.

Add gentle sound

• Use a fan, a white noise machine or a sleep sound app with rain, waves or soft static.
• Set it just below the level of your tinnitus, so it blends with it rather than drowning it out.
• Use a pillow speaker or a timer if you share a bed.
• Avoid complete silence, and avoid sleeping with earplugs every night unless you need them for noise, as silence can make tinnitus more noticeable.

Build a calmer bedtime

• Keep regular sleep and wake times, even at weekends.
• Cut down on caffeine after midday, and on alcohol in the evening.
• Wind down for an hour before bed, away from screens.
• Try relaxation, breathing exercises or a guided body scan.
• If you cannot sleep after about 20 minutes, get up and do something quiet in another room until you feel sleepy.

Get help if it is not improving

If tinnitus is regularly stopping you sleeping, it is worth getting help. A hearing test checks for hearing loss, which is often behind tinnitus. Hearing aids with tinnitus sound programs, worn in the evening, can help. Your GP can refer you to NHS tinnitus services and talk about sleep support, including cognitive behavioural therapy for insomnia.