Spring 2010 | Tinnitus Today
The neurology of aging is challenging and bestaddressed with a holistic medical approach.
6. Sleep Studies.
Undergo a sleep study if snoring,fatigue, daytime sleepiness or weight is an issue.Many patients report louder tinnitus after a napor a poor night’s sleep. Worse yet, many patientshave not enjoyed a night of rejuvenating sleepfor years! Sleeping pills are not ideal; they mayprevent deep sleep and mask underlying sleepdisorders. A dual nighttime sleep study is best –night one for diagnostics and night two fordetermining effective therapeutic devices.Untreated obstructive sleep apnea increasesthe risk for heart attack and stroke. Do notdelay. Good sleep is extremely important.
7. Physical Therapy.
Seek physical therapy foryour jaw, neck and shoulders when indicated.Some people report tinnitus for the first timeafter sustaining a whiplash injury.Physical therapy can help reduceneck and shoulder muscle toneimbalances and possiblyreduce tinnitus loudness.Temporomandibular joint(TMJ) disorders are common;many patients who grindtheir teeth at night, or have jaw clicking, popping, painand limitations in motion,experience fluctuations oftinnitus loudness. Nervescarrying information from the jaw,head and neck can send signals tothe hearing center in the brainstem. Thisincreases or decreases tinnitus loudness duringa particular muscle contraction, which physicaltherapy and/or oral splinting may improve.Some patients have reported tinnitus afterundergoing forceful, rapid neck manipulations.Gentle chiropractic manipulations are preferred.
8. An Active Brain.
Keep your brain active withdifferent types of activities, for example: speakingforeign languages, mathematics, puzzles, reading,writing, singing, social interaction, new adven-tures, outdoor activities or pursuing a passion.Tinnitus perception usually diminishes as one’ssurrounding space enlarges. So get out there.Exercising outdoors and the sounds of naturecan be very good for the body and mind – plusafford tinnitus relief.
9. Ear Protection.
Use appropriate, well-fitted earprotection. However,
do not overprotect
yourears all day long – this can worsen hyperacusis.Try to reduce unwanted noise: 1) replace yournoisy hair dryer with a quieterone; 2) have your air condi-tioning and heating systemscleaned and serviced; 3) putfelt pads on all cabinet doors;4) upgrade your TV speakersfor better clarity at a lowervolume; 5) pay attention to theacoustics in your home; 6) turndown your cell phone volume;and 7) be very careful aroundlive bands, weddings, sportingevents, outdoor festivals, fire-works, hunting expeditionsand even MRI scans andcertain audiology tests.
10. Cognitive Behavioral Therapy.
Seek cognitive behavioraltherapy (CBT) if you are motivated to tackleyour tinnitus intellectually and you feelemotionally well balanced. This type oftherapy challenges distorted thoughtsabout tinnitus. Patients gain insightinto over 20 different ways theirminds might catastrophically viewa particular problem. They thenlearn how to substitute accuratetherapeutic thoughts to calm theirtinnitus perception. See the NationalAssociation of Cognitive BehavioralTherapists (NACBT) online roster ofcertified therapists at www.nacbt.org/searchfortherapists.asp.
Consider medication only as alast resort, once you’ve tried hearing aids, physicaltherapy, nutrition, diet, lifestyle modification andsleep interventions. Medications have no nutri-tional value; can deplete the body of nutrients;are often loaded with side effects; and have thepotential for drug dependency and drug tolerance.They can be a crutch that prevents you from reallyknowing whether habituating to your tinnitus ispossible. For those who do require medication,a discussion with your tinnitus specialist aboutrisks, benefits and alternatives is essential.If one approach does not work for you, another justmight
Do not give up on the power of yourbrain and nerves to make new connections necessary toovercome tinnitus distress. With appropriate counselingand sound therapy, the meaning of tinnitus can beneutralized and the brain stops constantly monitoringthe tinnitus. Lifestyle changes plus balanced dietary andnutritional support can offer additional health benefits.
Do not be discouraged;countless peopleovercome physicaland mental adversityto accomplishamazing goals.
Michael J. A. Robb, M.D.
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