Tinnitus and Sleep Loss

8/12/2019 Tinnitus and Sleep Loss

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Aintree Tinnitus Support GroupAintree Tinnitus Support Group

October 7October 7thth 20092009

Tinnitus and Sleep LossTinnitus and Sleep Loss

(Handy hints to help you sleep)(Handy hints to help you sleep)

Gaynor ChittickGaynor Chittick

Chief AudiologistChief Audiologist


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Definitions of insomniaDefinitions of insomnia

Subjective complaints of poor sleepSubjective complaints of poor sleep Sleep onset or maintenance problemsSleep onset or maintenance problems

Delay of sleep by at least 30 minutesDelay of sleep by at least 30 minutes

3 or more nights per week3 or more nights per week

Duration of more than 6 monthsDuration of more than 6 months

Affects day time functioningAffects day time functioning


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Epidemiology contEpidemiology cont

Twice as common in womenTwice as common in women More common in housewives,More common in housewives,

unemployed, separated, widowed andunemployed, separated, widowed and

living aloneliving alone

Shift workersShift workers sleep still impacted uponsleep still impacted upon

>10yrs later>10yrs later


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Insomnia in tinnitusInsomnia in tinnitus Tyler & Baker (1983)Tyler & Baker (1983) -- insomnia was theinsomnia was the

most commonly reported problem bymost commonly reported problem bypeople with tinnituspeople with tinnitus

Jakes et al (1985)Jakes et al (1985) about half of tinnitusabout half of tinnituspatients report insomnia among their mainpatients report insomnia among their maincomplaintscomplaints

It is important to remember that a lot ofIt is important to remember that a lot ofpeople with tinnitus sleep wellpeople with tinnitus sleep well


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The Nature of SleepThe Nature of Sleep

Rapid Eye Movement sleep (REM)Rapid Eye Movement sleep (REM) Non Rapid Eye Movement sleep (NREM)Non Rapid Eye Movement sleep (NREM)

Non REM sleep has 4 stagesNon REM sleep has 4 stages

1=light sleep1=light sleep 4=deep sleep4=deep sleep

Sleeping tablets affect the normal patternSleeping tablets affect the normal pattern

of sleepof sleep


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The Nature of sleepThe Nature of sleep


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The importance of sleepThe importance of sleep

The purpose of sleep is unclearThe purpose of sleep is unclear Research shows that people can functionResearch shows that people can function

well on prolonged sleep losswell on prolonged sleep loss

REM sleepREM sleep most dreaming occurs, themost dreaming occurs, thebody is quite stillbody is quite still

Non REM sleepNon REM sleep the body moves aroundthe body moves arounda lot but the mind is less busya lot but the mind is less busy


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Cognitive processes in InsomniaCognitive processes in Insomnia

WorryWorryArousal & distressArousal & distress

Focusing of attention & monitoringFocusing of attention & monitoring

Distorted perceptionsDistorted perceptions

Safety behavioursSafety behaviours


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Sleep hygieneSleep hygiene

ExerciseExercise DietDiet

CaffeineCaffeine

AlcoholAlcohol

EnvironmentEnvironment


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Establishing an optimal sleepEstablishing an optimal sleep

patternpattern

Go to bed whenGo to bed whensleepysleepy Put the light out immediatelyPut the light out immediately

Do not read or watch TV in bedDo not read or watch TV in bed

If not asleep in 20 minutes get out of bedIf not asleep in 20 minutes get out of bedand go to another roomand go to another room

Set alarm for the same time every daySet alarm for the same time every day Do not nap or take recovery sleep theDo not nap or take recovery sleep the

following dayfollowing day


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Sleep restrictionSleep restriction

Insomniacs spend an excessive amount ofInsomniacs spend an excessive amount oftime in bedtime in bed

It is useful to estimate how much sleepIt is useful to estimate how much sleepyou actually get and then spend only thatyou actually get and then spend only thatamount of time in bed.amount of time in bed.


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RelaxationRelaxation

Wind down during the second half of theWind down during the second half of theeveningevening

Set a work activity deadline 90 minutesSet a work activity deadline 90 minutesbefore bedtimebefore bedtime

Rehearsal and planning sessionsRehearsal and planning sessions

Practice a relaxation routine whilst in bedPractice a relaxation routine whilst in bed


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Dealing with intrusive thoughtsDealing with intrusive thoughts

Do not try to hard to fall sleepDo not try to hard to fall sleep Tell self thatTell self thatsleep will come when it issleep will come when it isreadyreadyrelaxing in bed is almost as goodrelaxing in bed is almost as good

Try to keep your eyes open in a darkenedTry to keep your eyes open in a darkenedroomroom

Repeat a semantically neutral wordRepeat a semantically neutral wordsubvocallysubvocally

Visual imageryVisual imagery

Sound enrichment devicesSound enrichment devices


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Sound therapy devicesSound therapy devices

Pillow sound generatorsPillow sound generators Bedside sound generatorsBedside sound generators

RadioRadio


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ReferencesReferences

With thanks to Lawrence McKenna PhDWith thanks to Lawrence McKenna PhDand David Scott PhD, Royal Nationaland David Scott PhD, Royal NationalThroat Nose & ear Hospital.Throat Nose & ear Hospital.

Davis 1995Davis 1995 National Study of HearingNational Study of Hearing Tyler & Baker 1993Tyler & Baker 1993

Hallam et al 1988Hallam et al 1988


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Thank youThank you

Tinnitus and Sleep Loss

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