So I want to talk about sleep and tinnitus,
And this is a big topic.
And I'm only going to cover some of the basics.
So this will be,
I think,
Have the most interest if you're relatively new,
But even if you've been dealt with sleep before.
I think you know a lot about it as it relates to tinnitus.
You might learn a few things in this video,
So you may want to stick around.
So the issue of sleep is,
I think,
The number one on the list of issues that those of us with tinnitus deal with.
And what I want to do is outline some strategies here.
That might be useful.
There are a variety of different things that you can try and I'll talk a little bit about my own experience and maybe you might find that useful.
And I guess the first thing I want to say is the first thing to do is go see your doctor.
If you're having difficulty sleeping,
I'm not going to touch on medications here.
Outside of my sphere of excellence,
Sphere of knowledge.
But that's really a place to begin in working with sleep,
I would say,
Is talk to your physician.
So when we're talking about sleep difficulties,
It might be useful to distinguish between kind of basic issues with sleep and what is technically known as insomnia.
And I'll give you the definition of insomnia,
The technical definition of insomnia.
In the literature.
One,
Difficulty falling asleep,
Staying asleep,
Or non-restorative sleep,
Where you don't feel rusted afterwards.
Two,
This difficulty is present despite adequate opportunity and circumstance for sleep.
So if you're not sleeping because you're working or you have a crying baby keeping you up all night,
That wouldn't qualify as relevant to insomnia.
Third,
Disappearance in sleep is associated with daytime impairment or distress.
And for this difficulty,
The sleep difficulty occurs at least three times per week and has been a problem for at least one month.
Now sleep is a big problem across the nation,
A big health concern.
Estimates of anywhere from 10 to 30 percent of the population are dealing with some version of insomnia at any particular time.
So we're not alone in having difficulty sleeping,
Although the difficulties that we deal with with tinnitus are unique.
Nevertheless,
Some basic sleep hygiene protocol.
Is crucial for those with tinnitus.
It's just setting the main bar we all need to cover and the chances are before you got the tinnitus you probably weren't very good with your sleep protocol.
I think the Number I saw is like 10% of people have good sleep hygiene or follow sleep rules.
So is worth reiterating some of those basic rules and making sure you're following these as part of your sleep routine.
So I'll read you,
And you can Google sleep hygiene,
You can get various lists of these,
And they're all gonna look pretty similar.
I may make a couple of comments.
So the first piece of sleep hygiene is to keep a consistent sleep schedule.
Get up at the same time every day,
Even on weekends or during vacations.
Pretty obvious.
And fairly important.
Set a bedtime that is early enough for you to get at least seven to eight hours of sleep.
Now it doesn't say any particular bedtime,
But you want to make sure you're aiming for that seven to eight hour window.
Don't go to bed unless you're sleepy.
If you don't fall asleep after 20 minutes,
Get out of bed.
Go do a quiet activity without a lot of light exposure,
Especially important not to get on electronics.
I'm going to modify this a little when I come back later and talk about other things to do.
I think this is a good thing for maybe the first first part of the evening,
But I'm going to talk about some other strategies that might be worse,
That would want to maybe violate this rule and try that out.
Establish a relaxing bedtime routine,
Things you do before bed that prepares the body to sleep,
That tells the body it's time to get ready for bed.
So this should have no mental activity that's stressful,
Lower the lights,
Maybe doing some light stretching,
Yoga or meditation before bed just to inform the body what is about to happen.
Use your bed only for sleep and sex this is really kind of the same principle is your this is classic behaviorism is your want to associate being in the bedroom.
With being relaxed.
So you're not reading in there.
It's not a library.
You know,
You're not watching TV.
It's a bed and you go in there to sleep and you want to train the body that this is the place that we go to sleep,
Just like you train your body with a nighttime routine is,
Oh,
We're getting the body ready for bed.
So keep that routine,
Keep the bedroom for sleep and sex.
Pretty obvious,
Make your bedroom quiet and relaxing.
Limit exposure to bright light in the evenings.
Keep your lights dim.
And keep the screen.
You can usually put a protector on your screen if you're using it and you shouldn't be using it at least for an hour before bed.
Avoid consuming caffeine in the afternoon or evening.
Rule that.
It's going to get called a 10-3-2-1 rule and the 10 part of this is no caffeine 10 hours before bedtime.
I think three is no food three hours before bedtime.
Two is no work two hours before bedtime and one is no screen one hour before bedtime.
Um.
.
.
Avoid consuming alcohol,
And reduce fluid intake before bedtime.
So those are just some basic strategies you want to make sure you're following to set a bare minimum.
That you make sure you're doing this at least.
Then we'll talk about some other things specific for tinnitus.
But you want to make sure you're doing these at least because chances are you weren't doing all this before.
You've got tinnitus.
In fact,
As I said,
You may have been having,
Probably had some form of sleep problems for tinnitus.
Most people do.
So this may not be a unique event,
Although the scope of it is definitely more extreme.
So once you have that sleep hygiene,
Which is basic to everyone.
There are some specifics that have to do with tinnitus.
And the most important one is you probably are going to be listening to something besides the sound of your tinnitus.
And we'll talk about what the options for that are.
Then how are you going to listen to it?
A couple of devices.
This is a nice headband that you could plug into an MP3 player,
Put on your head.
Speakers in there.
You should keep your partner from hearing it.
You can just use basic.
Good set of headphones,
Good set of plugs should prevent your partner from hearing it.
There's also something called a sleep pillow,
Which I don't have,
But many people have found it useful.
It plays sounds as an mp3 player or whatever sounds you want out through the pillow that is supposedly unable to be heard by your partner.
And again,
Many people I know I've worked with have found great benefit in the sleep pillow.
Now,
What do you want to be listening to?
That's generally up to you.
I'll give you some basic strategies.
Many people,
Again,
Find white noise,
Pink noise,
Brown noise.
I don't find that a very appealing thing to listen to.
Um.
.
.
There are a lot of apps that play that as well as that play nature sounds.
Which sometimes I do listen to.
There is also a lot of podcasts.
To give you an idea of how widespread the problem with sleep is there are literally dozens of podcasts that help people fall asleep.
So,
You know,
We're not alone in having the sleep difficulty.
It is,
We have a unique angle on it.
But we're in league with a lot of other people having problems with sleep.
So there are one branch is,
I don't know how to describe it.
Do very boring things or non sequiturs to kind of turn the logical mind off and they give you a sense of what goes on in these podcasts.
It's kind of like reading a phone book or reading weather reports.
Actually,
One of them does read,
I think,
Weather reports from around the country.
So it's just to give your mind a place to be and when the tinnitus is going having another direction for the mind can be very useful and I urge you to try these off.
Try these out.
So those are all good.
And there's also more in the formal meditation.
Area that you can use as well.
Formal meditation practices that you can get off of like Insight Timer is a wonderful free app with literally 10,
000 of free meditations on it that you can listen to.
I'm going to talk about one particular type in a Breathing practices is another area outside of meditations.
A little bit different because you're particularly working on the breath.
And so you can find a lot of these,
Again,
Apps that will run you through breathing practices that you can also do on your own.
Although I think training with the apps can be a good place to start.
And just doing breathing in bed,
Focusing the attention on the breath can be a very calming thing to do.
There is something known as,
A formal treatment known as CBTI,
Cognitive Behavior Therapy for Insomnia.
There's actually been a study,
So this is just a protocol for anybody,
It doesn't really necessarily have to be those with tinnitus,
But there was a study a little while ago showing that people with tinnitus who engage in this protocol,
And I'm not going to describe it here,
I might do it in another video,
Actually reduced their tinnitus distress just by following the sleep protocol of cognitive behavior therapy for insomnia.
App that you can kind of do this by yourself,
Although it is advised you work with a therapist in doing this.
The last thing I want to talk about is a practice called yoga nidra.
Which has been shown to really mimic in some ways the effects of sleep.
And it's a practice I would encourage you to at least give a try when you're lying in bed.
And rather than getting up after the 20 minutes,
Do some yoga nidra practices.
It's kind of like a body scan,
Only a little more complicated.
You do a little more stuff and just focus on the body.
But it is a practice that you can do and yoga nidra literally means yogic sleep.
And you can actually get sleep-like effects by just lying there.
And doing this practice.
Keep your mind at ease.
If you do this,
You're going to get better.
Enough to get through the day.
If you just sit there and lie there and do nothing else but this practice,
Your body will get restored.
You can kind of look up yoga nidra meditations.
Again,
You can find these in a lot of places,
Especially Insight Timer.
If you just put yoga nidra in the link,
You'll find literally dozens,
If not hundreds of yoga nidra practices.
But it's a practice that I think can help give a little peace of mind when you think,
I can't do this is if I just lie here.
And follow this,
The body will get restored.
I can't go on.
This doesn't mean it's the end of the world if I can't sleep.
There is a yogic sleep.
That will give me enough.
And what that also does,
I think,
Is break up some of the anxiety about not sleeping.
And it's the anxiety that can be as bad as the insomnia.
So if we can just relax into the yoga nidra practice and put ourselves in that place,
That can really be a useful tool.
So I'd urge you,
Just give it a try.
When all else fails,
Engage in a yoga nidra practice and tell yourself it's not the end of the world.
If I just lie here in meditation all night,
Great.
Yogic masters would have,
You know,
That was their goal to stay up all night and meditate and you get to do by.
Fault what they have tried their whole life to do.
And that is see what happens when you just sit and engage in practice.
What's more likely to happen is that will release enough of the anxiety that you are going to fall asleep anyway.
So give that a try.
So those are just some of my suggestions.
