Self-help tips for tinnitus

This information has been provided by the Hampshire Hospitals NHS Foundation Trust Audiology Department to provide Self-help tips for tinnitus.It provides information for patients, relatives and carers.

What is tinnitus and how can I help myself?

Many people experience tinnitus-sounds that have no external source. Most will not pay much attention to the condition, but a percentage may become very bothered by it and find that it affects their quality of life. They may find it difficult to sleep or engage in daily activities.

If you have ever been told that tinnitus is incurable and that you will 'have to learn to live with it', then you may feel rather helpless if your tinnitus starts to interfere with your daily life. However, there are several positive steps that you can take to help manage the condition and to minimise your awareness of it.

The negative cycle of tinnitus awareness

The brain has an important role in hearing. Although our ears detect external sounds and translate them into nerve signals, it is the brain that interprets them. It is able to do so subconsciously, by identifying sounds, deciding what importance to give them and choosing to listen to or ignore a particular sound without you een being aware of the process.

A good example of this is the noise of a computer fan or air conditioner. Although these noises can be quite loud, we tend not to notice them, because they are not impotrant to us. This process is known as 'habituatuation'.

The nerve pathways carrying sound signals extend past the auditory cortex and into the emotional centre of the brain, as well as into the brain's alarm centre. This is why a blaring car horn can give you a fright even before you have consciously heard the sound. You have already learned to associate this soundd with potential danger, so your whole body will go on full alert as soon as your brain recognises it.

This is how the negative cycle of tinnitus awareness can start up. ifyour brain hears a new sound that it decides is threatening, then your whole system will go on high alert to help you deal with the potential danger.

In this state of heightened aousal your senses are sharpened and your hearing becomes more sensitive. In fact, your brain will actually boost up this threatening sound to ensure that you notice it.

If your brain has subconsciously labelled tinnitus as a threatening sound, then it can become increasingly intrusive as your brain tries to bring it to your attention so that you can deal with the perceived danger.

You can break the negative cycle in several ways:

The subconscious perception of tinnitus as a threat can be reduced. Medical investigations may be able to reassure you that the tinnitus does not indicate a serious health problem. information from the tinnitus clinic can help you to appreciate that your tinnitus will not necessarily continue to get louder and out of control.
Relaxation techniques and exercise can help to lower stress levels. This can then reduce your state of alert and dampen your sensitivity to tinnitus.
The use of outside sound sources to compete with the tinnitus can help your brain to habituate to the sound of your tinnitus. it then becomes a background noise that you can mostly ignoe, like the example of a comuter fan.

Trying to attach less impotrance to the tinnitus

We appreciate that this is easier said than done, but this is an important step in breaking the vicious cycle of tinnitus awareness. You are aiming to give less emotional significance to your tinnitus, so that your subconscious is less inclined to label it as an important sound that must be brought to your attention.

Every time you manage to ignore your tinnitus or distract yourself from it you are helping your brain to reclassify the sound as unimportant.

You can:

Spend more time on enjoyable activities, because you are less inclined to notice your tinnitus when you are happily occupied
Stop monitoring your tinnitus and gently ask family and friends not to discuss it with you, explaining your new tactics
Plan your life around what you want to do without giving much consideration to the tinnitus. Allowing it to control your activiities gives it too much significance
Plan ways to distract yourself if you feel angry or upset as these strong emotions will reinforce the negative cycle that you are trying to break.

Sound enrichment

Quiet background noise can compete with your tinnitus making it seem less obvious> it is worth having a radio, TV or music playing quietly in the background or even an open window allowing noise in. You want the sound just load enough to lessen the impact of your tinnitus without covering it completely. You need just to be able to hear it, so that your brain continues to habituate (adjust).

if you suspect that you have any kind of hearing loss then it is worth getting your hearing tested and considering using hearing aids if this has been recommended. A hearing loss means that you hear external sounds at a lower volume making internal nioses within the hearing system seem louder by comparison. hearing aaids can be useful in covering the tinnitus and contributing to sound enrichment.

Relaxation

Relaxation can be another helpful tool in breaking the negative cycle because it will lower your heightened state of alertness and make your brain less likey to listen out for tinnitus.

other sources of stress will cause arousal too, so stress relief in general is very important. Start to look out for relaxation methods that might suit you. Meditation, stretching routines, relaxation CDs, breathing exercises, yoga, walking the dog - these can all be methoods of relaxation, but you might do some research at the library or on the internet to find a method that suits you.

Hobbies that you enjoy can be a source of relaxation, if you don't get too competitive or uptight about them! It is worth looking out for new interests if you don't have hobbies at the moment.

Physical exercise is a vital component of relaxation. When we are under stress we produce stress hormones that contribute to the constant state of alert that you want to recuce. Exercising , even just a daily walk, uses up those stress homones and removes them from your system.

Sleep techniques

In a quiet bedroom tinnitus can seem particularly loud and may make it difficult for you to relax and drop off to sleep.

A quiet sound such as a radio tuned into white noise can lessen the contrast between the tinnitus and the silence, making it seem less intrusive.

Other helpful sleep habits include:

Not using alcohol, caffeine, nicotine or even over-the-counter sleeping pills which all disrupt normal sleeping patterns
Getting some exercise during the day, but not too close to bedtime
Unwinding beforebedtime - spend ten minutes early in the evening writing down worries, if necessary, so that you are not worrying at bedtime. Have a calming routine such as a warm bath and hot milky drink before bed. A short relaxation routine can be helpfulful too and there are specialist CDs that can help.
Go to bed when you are tired and turn off the light immediately. Don't watch TV or do puzzles in bed. If you are still awake after 30 minutes, go to another room to tead or relax and go back to bed when you feel more tired
regulate your sleep pattern by always getting up at the same time and trying not to sleep during the day.

Further information

British Tinnitus Association

Helpline: 0800 018 0527

www.tinnitus.org.uk

Hampshire Hospitals NHS Foundation Trust

Audiology Department

Telephone 019622 824437

Email: audiology@hhft.nhs.uk