Home >> Content >> Insomnia Worsens Tinnitus

Insomnia Worsens Tinnitus

Renee DespresFriday, June 15, 2012 - 20:39

Insomnia can worsen the effect of tinnitus on physical and emotional health, according to results of a small retrospective study by a group of investigators at Henry Ford Hospital in Detroit, Michigan. The study points to the importance of assessing and treating sleep problems in the millions of people worldwide who are living with tinnitus.

“Tinnitus involves cognitive, emotional, and psycho-physiological processes, which can result in an increase in a patient’s distress,” says study co-author Kathleen L. Yaremchuk, M.D., Chair, Department of Otolaryngology-Head & Neck Surgery at Henry Ford. “Sleep complaints, including insomnia, in these patients may result in a decrease in their tolerance to tinnitus.”

The study will be presented at the April 2012 Combined Otolaryngological Spring Meetings in San Diego, California.

About Tinnitus

Tinnitus, which affects more than 36 million people in the United States, is a condition in which people perceive noises, although no external source of sound is present. Many people hear ringing – which leads tinnitus to sometimes be called “ringing in the ears.” Other commonly perceived noises include hissing, buzzing, whistling, chirping, or clicking.

People with severe tinnitus may have trouble hearing, working or even sleeping. Causes of tinnitus include hearing loss, exposure to loud noises or medicines you may be taking for a different problem. Tinnitus may also be a symptom of other health problems, such as allergies, high or low blood pressure, tumors and problems in the heart, blood vessels, jaw and neck.

How to Protect Your Hearing


The American Tinnitus Association offers the following tips to help you conserve your hearing and protect your ears from loud sounds:

  • Walk away from loud noises.
  • Turn down the volume.
  • Limit the intensity of the noise by not standing directly near its source.
  • Limit the time you expose your ears to loud noises.
  • Wear earplugs when you’re around sounds of 85 dB and above. (Disposable foam earplugs are inexpensive, easy to insert and effective.)
  • Turn down your CD/MP3 player or car stereo system.
  • Cross the street when you hear someone operating a leaf blower.
  • Wear earplugs at concerts/go to the back of the nightclub or outside to give your ears a break.
  • Cover your ears with your hands when you’re walking past a jackhammer.


Treatment depends on the cause. Treatments may include hearing aids, sound-masking devices, medicines and ways to learn how to cope with the noise.

Although doctors do not know exactly what cause tinnitus, several risk factors for tinnitus have been identified. In people with tinnitus, these triggers may worsen the condition.  Common tinnitus triggers include:

  • Exposure to loud noises
  • Wax build-up in the ear
  • Ear or sinus infections
  • Head and neck trauma
  • Certain medications
  • Middle-ear tumors
  • Certain disorders, such as:
    • Hypothyroidism
    • Hyperthyroidism
    • Lyme disease
    • Fibromyalgia
    • Thoracic outlet syndrome

There is no cure for tinnitus. However, many people are able to manage  the condition. Hearing aids, sound masking devices, and medications may be helpful in some instances. Often, people benefit from learning stress-reduction and other techniques to help them cope with the sounds.

What the Researchers Did

Yaremchuk, study co-author George Miguel, and their team gathered information from 117 people who were treated for tinnitus between 2009 and 2011 at Henry Ford Hospital in Detroit, Michigan. They interviewed people over the telephone, as well as asking them to complete written forms.

The researchers used two scales to evaluate the relationship between insomnia and tinnitus. To assess the emotional effects of tinnitus on lifestyle and general well-being, they used the Tinnitus Reaction Questionnaire (TRQ). They used the Insomnia Severity Index (ISI) to assess sleep problems.  

What the Researchers Found

When they analyzed the results, Yaremchuk’s team found a that people who had more trouble sleeping were more severely affected by tinnitus. The more severe who had worse insomnia said they experienced greater emotional distress from tinnitus.

Conversely, the worse someone scored on the TRQ, the more likely they were also have sleep disturbances.  The greater the insomnia disability, the more severe the patient’s complaints were regarding the tinnitus.

What the Study Means

There were several limits to this study. It was small in size, and subjects were drawn largely from the population of one Midwestern U.S. city, so it's not clear that results could be generalized to other populations. In addition, the retrospective study design means that results may be influenced by participants' ability to remember sleep problems and tinnitus symptoms.

Still, the study suggests that people with tinnitus should be screened for sleep problems, especially insomnia. Screening tinnitus sufferers for sleep disorders may be a low-cost, effective way to identify people at hish risk of psychological and functional problems.

“Treating patients with tinnitus is challenging,” notes Dr. Yaremchuk. “A chronic tinnitus patient presents a challenging clinical picture that may include anxiety, depression, annoyance, or self-reported emotional distress. And one of most frequent self-reported complaint of tinnitus patients is ‘getting to sleep.’”

For people with tinnitus, figuring out how to get to sleep may be the key not only to better rest, but to lessening the din in their ears.