This factsheet is part of RNID’s tinnitus range. It is written for people who have tinnitus, their families, friends and the professionals who work with them.

Tinnitus is a medical term to describe noise(s) that people can hear in one ear, both ears or in the head – such as ringing, buzzing or whistling. The sounds heard can vary from person to person, but the common link is that they do not have an external source.

If you would like this factsheet on audio tape, in Braille or in large print, please contact our Information Line.

Read this factsheet to find out:

At the end of this factsheet, we give you details of organisations you can contact for further information.

Medical disclaimer

The information given in this factsheet is not medical advice and by providing it neither RNID nor our tinnitus and medical advisors undertake any responsibility for your medical care, nor accept you as a patient. Before acting on any of the information contained in this factsheet, or deciding on a course of treatment, you should discuss the matter with your GP (family doctor) or other medical professional who is treating you.

What is the relation between tinnitus and stress?

Most people have some stress in their lives – it is almost unavoidable. Although it is unlikely that stress can actually cause tinnitus, we do know that it can make it worse. Many people notice their tinnitus more when they are worried or tired, which may increase stress and anxiety levels further, triggering a cycle of stress and worry.

Learning to relax will help you break this cycle. As you become calmer and more relaxed, you will be better able to manage your tinnitus. This factsheet gives you some simple tips and ideas to help you manage stress and includes a six-lesson relaxation exercise plan.

What can I do to reduce stress?

Although tinnitus can sometimes be distressing, it is not life-threatening. You may not be able to get rid of tinnitus completely and you may still be able to hear it if you are listening for it. However, the tips and ideas we give you in this factsheet are designed to help you make your tinnitus less noticeable. One of the ways you can do this is by reducing stress.

Some of the things you could try in order to reduce stress are:

Which complementary therapies are best for tinnitus?

There is no clear-cut answer to this question. You may even find that some people question whether complementary medicine has any role at all in tinnitus management. However, there is very little conclusive evidence to prove or disprove the usefulness of any particular therapy, but it is thought that each works by helping you relax and sleep.

If a therapy works for you – use it. But be wary of leaping from one type to another in the hope of finding the ‘miracle cure’. Repeated disappointments will not be good for you or the tinnitus.

Before you begin any course of complementary therapy, you should consult your GP. If necessary, they will refer you to a specialist who can explore your condition in full. Some complementary therapies should be avoided if you have other medical conditions. Your GP will be able to advise whether the type of therapy you are considering would be suitable for you. Also, make sure you use a qualified practitioner who is registered with the relevant professional body.

For more information about complementary therapies, see our factsheet Complementary therapies and tinnitus.

What is sound therapy?

Many people find that they are more aware of tinnitus in quiet environments. In these, tinnitus sounds may seem louder and are more likely to become a problem. For this reason, many people find it helpful to avoid silence.

Sound therapy – or sound enrichment – works by filling silence with therapeutic sounds. It involves listening to background sound such as:

Having these background sounds may help to distract you from listening to tinnitus and reduce the contrast between the tinnitus and silence. This will make the tinnitus seem less noticeable. Try not to use the sounds to ‘mask’ tinnitus, because this will make it more difficult for you to cope with tinnitus in the long run.

Sound therapy can be used in many situations – for example, during a daily relaxation session, at bedtime, or while driving.

Can improving my general health help with tinnitus?

Yes. Ensuring you have a well balanced diet with regular exercise will help your overall wellbeing and give you a more positive outlook. Your GP can give you advice about exercise and improving your diet. For example, some people find that reducing their caffeine intake (by drinking less coffee, tea, chocolate and cola) helps their tinnitus.

If you sleep poorly because of tinnitus, try not to worry about being awake. The more you worry, the more difficult it will be for you to get back to sleep. For more information, see our factsheet Tinnitus and sleep.

What are the different ways to relax?

Relaxation tapes

Listening to relaxation CDs and CDs of soothing sounds such as the sea or other sounds of nature may help tinnitus. Talking books can also be a relaxing and enjoyable way to take your mind off tinnitus. You can buy these kinds of CDs in bookshops, music shops and some health shops, or try your local library (you may have to pay for borrowing talking books). Several organisations have also produced CDs specifically for people with tinnitus.

RNID sells CDs that are recommended by people with tinnitus. Contact the RNID Tinnitus Helpline for more information.

Relaxation exercises

Simple relaxation exercises can help relieve tension in your body and can be done by yourself before you see your GP or a specialist. You can learn how to do these exercises from books, CDs or relaxation classes. You do not need expensive equipment or a special place to practise relaxation. If you are patient and gentle with yourself, you, and the people around you, will soon benefit.

When you are relaxing, the following changes take place:

By learning to relax, you are taking an active part in controlling tinnitus. Although relaxation may not reduce the tinnitus, it can change your response to it and will help you deal with it.

The following is a six-lesson course in relaxation exercises. The exercises have been adapted from a course written by Eileen Hewitson of the Birmingham and District Tinnitus Group and reproduced with her kind permission. To find out more about the Birmingham and District Tinnitus Group (external link, opens new browser window).

Work through these exercises at your own pace, over several weeks or months, if that is what works for you.

A six-lesson relaxation exercise plan

Lesson one

There is only one rule in relaxation – find the time. Reading books, talking about it and resolving to do it are all quite empty efforts unless you set aside the time to relax. The aim of this exercise is to help you let go as much as you can in the time you have.

So, find two minutes, preferably three times a day, when you can sit down in a comfortable chair. Settle your body into the chair, rest your head on the back of the chair and your arms and hands where they are comfortable. Place your feet on the floor and a little bit apart. Now, tell your muscles to relax, let go and become soft and at ease.

You can work through your body, starting at the top of your head and working down. Direct your attention to your forehead, eyes, cheeks, lips, jaw, neck, shoulders, arms, hands, fingers and thumbs, back, chest, abdomen, legs, feet and toes. If you prefer, reverse the process and start at your toes and work up through your body. Do concentrate on those areas of the body where you feel you may have unnecessary tension – these might be the jaw, shoulders, neck or abdomen.

You may have been taught – in class or on CD – to tighten up groups of muscles before relaxing them. That is a different and much lengthier exercise and you may not always have the time to do it. So just tell your muscles to let go.

It is important to spend no longer than two minutes doing this exercise, and when it is complete you can get up and carry on with your normal routine. Or, if you prefer, you can continue to sit for a moment or two and enjoy being still and at ease.
Don’t worry if you do not achieve much at first, if you forget to practise, or if you don’t get the time to practise. Like any other skill, relaxation has to be learned gradually, a step at a time. Concentrate on today. Above all, be gentle with yourself.

When you feel you have made this a part of your daily routine, move on to lesson two.

Lesson two

Try to maintain the practice of letting go for just two minutes a day, for example:

You can also help your body by paying particular attention to your breathing. Breathing is something that you tend to take very much for granted. Instead, from time to time, concentrate on your breathing – just ‘watch’ it enter and leave your body. Notice the gentle rhythm that comes easily and effortlessly with breathing.

Now try to slow your breathing down by taking three or four slow, even breaths, in and out through your nose. Try to breathe in for the same amount of time as you breathe out. As you breathe out, let go of tension, particularly in your jaw, neck, shoulders and abdomen. This is calming and can be combined with other natural rhythms, such as walking. For example, you can breathe in for three steps and out for three steps.

Another exercise you can do when you are sitting or standing still is to breathe in and out through the nose and then just stay quiet without breathing in again, for a few seconds. Notice the space between that breath and the next. Let no strain enter the body, just breathe in again when you feel the need. This will help you control and slow down your breathing for a couple of minutes.

The beauty and strength of breathing exercises are that you can do them anywhere and at any time – standing, walking, sitting or lying down. As you get better at the exercises, you will be able to extend them and start using your abdominal muscles to help you control your breathing.

You will find more breathing exercises in books on stress management, relaxation or yoga. Practise when you feel good, so that when you are feeling stressed you will be able to restore calm and balance almost automatically.

When you feel ready, move on to lesson three.

Lesson three

If you want to learn to relax more deeply, you will need to set aside more time. You should try to practise every two or three days, but even practising just once a week can bring benefits. Ideally, you should spend at least 15 minutes on the following exercise. You should aim to reach a point where your body feels as though it is hardly a part of you and your mind feels relaxed and uncluttered.

First, make sure you are comfortable and that you are not going to be disturbed. Make sure that you are somewhere warm because the skin gives out heat as the body winds down. Your head, back and legs should be totally supported, so use the floor, a bed, couch, a good high-backed chair with a footrest or whatever suits you best. Treat yourself to this special time. If you find background noise helpful, play music, natural sounds or a relaxation CD.

Relax the muscles in each part of the body, working from head to toe or toe to head, paying particular attention to those areas where you know you may have tension. If you have been practising the two-minute relax from lesson one, you will be able to do this quite naturally. If any muscles do feel tense, then gently stretch them and let them move back quite easily into a comfortable position. If, when you relax, you feel any discomfort anywhere, then adjust your position. This will help you to relax even more deeply.

Close your eyes and spend a few moments noticing your breath entering your body and then leaving it. As you breathe out, tell yourself to let go. Do this a couple more times, saying to yourself ‘Relax, let go’ each time you breathe out.

In the same way that you notice your breathing, also begin to notice your thoughts. Try not to become involved in them – just let them go. If you find your attention wandering to everyday things or if you are troubled by a problem, then very gently, but quite firmly, bring your concentration back to your relaxation and let go a bit more as you breathe out. Check that your body has not tightened up in response to these intrusive thoughts, and then let yourself drift once more.

Try not to judge how well you are relaxing – just aim to enjoy it. Relaxation is a state of doing absolutely nothing and being at peace. No effort is required on your part. If you let go, all your tension will leave your body and mind.

You can, if you wish, imagine you are in a place where you feel totally at ease and completely at peace with yourself and the world around you – maybe on a seashore, or beside a lake, in a garden or on a mountain.

When you have spent as much time as you wish on yourself, gently stretch your body. In your own time and in your own way, become alert and active once more.

Lesson four

Remember, relaxation is a technique that you will need to practise regularly. Set time aside. You will not be able to learn to relax overnight.

If you have a relaxed attitude to everything you do, you will benefit even more. The next time you are sitting watching the television, reading a book, or listening to the radio, think about the way you hold yourself. Are your legs crossed? Are your shoulders raised, instead of being relaxed? Is your jaw tight and forehead creased, perhaps in an effort to concentrate, or to hear and understand more clearly? When you are talking to someone, do you tap your foot?

The next time you walk down the road, notice the way you hold yourself. Are your shoulders hunched as you hurry to reach your destination? Are your teeth clenched? Is your back bent?

Raised shoulders, a tight jaw, creased forehead, clenched teeth and bent back will not help you relax. Indeed, they use up precious energy. If you can learn to use only the muscles and energy that are necessary to sit or to walk, the rest of your body can relax. You can use the energy you save to enjoy yourself just that little bit more.

Avoid rushing when you walk – just take everything in your stride. While you are sitting, use only those muscles that are necessary to sit. No matter where you are, whom you are with, or what you are doing, only use the energy and effort necessary to complete the task in hand. At the end of the day you will not be so tired and sleep will come much more easily and naturally.

Think about the way you are holding yourself as you read this information. Get used to doing this several times a day for the next few weeks, whatever you are doing. You will start automatically to notice when you are unnecessarily tense.

Learn to use these moments when you are waiting for something for your own benefit – waiting for the kettle to boil, for someone to answer the telephone, for the bus or train to come or for a visitor to arrive. Instead of becoming frustrated at the delay, let your shoulders roll down a little bit, smooth your forehead and let your jaw relax so that your teeth are a little bit apart and your lips just softly touching.

Lesson five

Do you still find yourself sometimes going round in circles, despite all your efforts to calm down and stay cheerful?

If you feel down, everything else requires much more effort to cope with, and this includes tinnitus, which then seems louder. Maybe you are worrying about your family, a friend, work, money or a journey. This uses up a lot of your mental energy so you feel tired. At the same time, these thoughts stop you from sleeping well, so you begin each day feeling tired. This in turn makes you more aware of tinnitus, which makes you more worried. And so it goes on, round and round in an endless circle of worry, tiredness and tinnitus.

If you can recognise that this is happening to you, then you have made the first important step towards preventing this circle turning faster and faster and sweeping you along with it. All you have to do is to break the negative circle and then replace it with a positive one.

Here is one for you to try. It does not actually matter where you start, because, since it is a circle, you will always come back to where you started.

Lesson six

Your imagination is a wonderful tool for helping you create a feeling of well-being. You are probably already pretty good at imagining the worst that can happen. You can also use this same ability to imagine the best possible scenario. You can ‘talk yourself up’ and your body will respond appropriately by releasing tension.

Start by imagining you are in a place where you feel utterly at ease and completely calm. It may be your favourite spot or somewhere you have visited on holiday. It may not be a real place at all, but one you have made up with your own imagination. Try to make the picture as complete as possible, so pay attention in turn to colours, shapes, sounds, smells, tastes that are on the air, the feel and textures of things beneath your feet and above your head, even the feel of the clothes on your body. Maybe you are sitting by some water – imagine you can dip your hand in and sense how cool and fresh it is. Maybe you are on a beach. You can hear the waves and feel them gently lapping over your feet and feel the sand between your toes. Maybe you are in a garden, or in the country, and the smell and sight of flowers and blossoms is overwhelming.

Work on this image over several sessions, so that it becomes clearer and more familiar each time. Add more details as you get better at using your imagination. Learn to link the image with feelings of calm, strength, security, comfort, happiness, harmony and well-being. Gradually, without any effort on your part, your body and mind will relax. With practice, the images will come more easily and quickly, so that eventually you will be able to transport yourself to this wonderful place instantly and feel yourself relaxing immediately.

You will then be able to recreate the feelings that you have in this special place at other times during your daily routine. When you find yourself becoming unnecessarily tense, worried, angry or frustrated, you will be able to bring your special place to mind and the unhappy feelings will fade away. It really does work!

How do I manage tinnitus if I’m severely or profoundly deaf?

Staff at your ENT department will be able to discuss the options available to help you manage stress. You may like to try learning relaxation exercises from a book or class, or see whether complementary therapies can help you relax and sleep.

Where can I buy products that may help?

RNID Products sells a range of equipment for people with hearing loss and tinnitus. Visit the RNID Shop at www.rnid.org.uk/tinnitusproducts (external link) to buy items of equipment online. Alternatively, you can request a copy of the Solutions catalogue by contacting RNID Products directly or by contacting RNID Tinnitus Helpline.

RNID Products, 1 Haddonbrook Business Centre, Orton Southgate, Peterborough PE2 6YX
Telephone: 01733 361199
Textphone: 01733 238020
Fax: 0870 789 8822
Email: solutions@rnid.org.uk
RNID Shop website (external link, opens new browser window)

Where can I get further information?

British Tinnitus Association (BTA)

The BTA campaigns for better services for people with tinnitus. It supports a network of local tinnitus groups around the country, has a range of publications and produces a quarterly magazine, Quiet.

British Tinnitus Association (BTA), Ground Floor, Unit 5, Acorn Business Park, Woodseats Close, Sheffield S8 0TB
Telephone: 0800 018 0527
Textphone: 0114 258 5694
Fax: 0114 258 2279
Email: info@tinnitus.org.uk
BTA website (external link, opens new browser window)

Hush

Hush is the name of the Hull tinnitus self-help group. They run a helpline and produce information and cassettes for people with tinnitus.

Hush, 109 Southella Way, Kirkella, Hull HU10 7LZ
Telephone: 01482 656033
Email: hush@btinternet.com
Hush website (external link, opens new browser window)

Contact a local group

If you feel you need more help with tinnitus directly from other people who also have it, you could contact a local tinnitus support group. They are set up and run by people with the condition or by professionals who work with tinnitus patients. The type of support and help they are able to offer varies between groups. Contact RNID Tinnitus Helpline for details of your nearest group.

Further information from RNID Tinnitus Helpline

RNID Tinnitus Helpline offers information and advice to people with tinnitus, their families and friends, and the professionals who work with them. You can contact us for further copies of this factsheet and the full range of our products for people with tinnitus. We also sell a book, "Understanding tinnitus – managing the noises in your ears or in your head", and a range of relaxation CDs and cassettes.

RNID Tinnitus Helpline

19-23 Featherstone Street, London EC1Y 8SL
Telephone: 0808 808 6666
Textphone: 0808 808 0007
Fax: 020 7296 8199
SMS: 0780 0000 360 (supported by Lloyds TSB)
Email: tinnitushelpline@rnid.org.uk  
Tune out tinnitus website (external link, opens new browser window)
Available Monday-Friday, 9am-5pm