Aintree Tinnitus Support Group

October 7th 2009

Tinnitus and Sleep Loss
(Handy hints to help you sleep)

Gaynor Chittick
Chief Audiologist
Definitions of insomnia

Subjective complaints of poor sleep

Sleep onset or maintenance problems
Delay of sleep by at least 30 minutes
3 or more nights per week
Duration of more than 6 months
Affects day time functioning
Epidemiology

Affects most people

Prevalence rate from 2% - 42.5%
> 30% of pre school children
25% paediatric patients
25% of the elderly
Sleep onset problems are more common
in young adults and sleep maintenance
problems are more common in the elderly
Epidemiology cont

Twice as common in women

More common in housewives,
unemployed, separated, widowed and
living alone
Shift workers sleep still impacted upon
>10yrs later
Insomnia in tinnitus
Tyler & Baker (1983) - insomnia was the
most commonly reported problem by
people with tinnitus
Jakes et al (1985) about half of tinnitus
patients report insomnia among their main
complaints
It is important to remember that a lot of
people with tinnitus sleep well
The Nature of Sleep

Rapid Eye Movement sleep (REM)

Non Rapid Eye Movement sleep (NREM)
Non REM sleep has 4 stages
1=light sleep 4=deep sleep
Sleeping tablets affect the normal pattern
of sleep
The Nature of sleep
The importance of sleep

The purpose of sleep is unclear

Research shows that people can function
well on prolonged sleep loss
REM sleep most dreaming occurs, the
body is quite still
Non REM sleep the body moves around
a lot but the mind is less busy
Cognitive processes in Insomnia

Worry
Arousal & distress
Focusing of attention & monitoring
Distorted perceptions
Safety behaviours
Treatment

Sleep education
Sleep hygiene
Behavioural management
Sleep hygiene

Exercise
Diet
Caffeine
Alcohol
Environment
Establishing an optimal sleep
pattern
Go to bed when sleepy
Put the light out immediately
Do not read or watch TV in bed
If not asleep in 20 minutes get out of bed
and go to another room
Set alarm for the same time every day
Do not nap or take recovery sleep the
following day
Sleep restriction

Insomniacs spend an excessive amount of

time in bed
It is useful to estimate how much sleep
you actually get and then spend only that
amount of time in bed.
Relaxation

Wind down during the second half of the

evening
Set a work activity deadline 90 minutes
before bedtime
Rehearsal and planning sessions
Practice a relaxation routine whilst in bed
Dealing with intrusive thoughts
Do not try to hard to fall sleep
Tell self that sleep will come when it is
ready relaxing in bed is almost as good
Try to keep your eyes open in a darkened
room
Repeat a semantically neutral word
subvocally
Visual imagery
Sound enrichment devices
Sound therapy devices

Pillow sound generators

Bedside sound generators
Radio
References

With thanks to Lawrence McKenna PhD

and David Scott PhD, Royal National
Throat Nose & ear Hospital.
Davis 1995 National Study of Hearing
Tyler & Baker 1993
Hallam et al 1988
Thank you