RNID: For deaf and hard of hearing people.

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.

This factsheet explores three main subjects in relation to tinnitus and the different ways they can interact:

Read this factsheet to find out:

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 link between tinnitus and relaxation?

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.

What can I do to reduce stress and relax?

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 to reduce stress are:

  • complementary therapies
  • sound therapy
  • improving your general health
  • learning to relax in different ways.

What are complementary therapies?

Complementary therapies, also known as 'alternative therapies', aim to treat you holistically – that is, to work with you as a whole person. As well as working on the symptoms of your condition, the therapist may ask you about your emotional, physical and mental wellbeing to find out if these are affecting your health.

Which complementary therapies could help with tinnitus?

There is very little conclusive evidence to prove or disprove the usefulness of a particular therapy in relation to tinnitus. However, it is thought that they work by helping you relax – which, in turn, can help with your tinnitus. Different therapies suit different people and what works for one person may not work so well for another. It is very much a case of 'try it and see'. Try not to pin all your hopes on the success of a complementary therapy. The therapy you choose may not work directly on your tinnitus – but it may help to alleviate the stress and anxiety associated with the condition.

What should I do before starting a complementary therapy?

  • Talk to your GP about the therapy you are thinking of starting. This is particularly important if you are already taking any prescribed medications or undergoing other treatments. Your GP may know if that therapy is available on the NHS.
  • Make sure you use a qualified practitioner who is registered with the relevant professional body. A good practitioner should be happy to work alongside any treatments arranged by your GP to help you manage your tinnitus.

Will I have to pay for complementary therapies myself?

Usually, yes, because complementary therapies are not generally available on the NHS. It's also important to remember that you may need a whole course of treatments, rather than just one appointment. Some GPs and physiotherapists do offer complementary therapies, such as acupuncture, homeopathy and massage. There are also some specialist NHS homeopathic hospitals in parts of the UK. Many private healthcare insurance schemes don't cover complementary therapies, so check with your provider before undergoing any therapy.

What types of complementary therapy are available?

Below is a list of the more widely available complementary therapies. By providing this list, we are not recommending one therapy over another. They are simply to give you an idea of the range of therapies that can be used as part of tinnitus management. They include:

Acupuncture

Acupuncture is an ancient Chinese therapy. It uses very fine needles, which are inserted into precise points on your body (the most you will feel is a sensation as the needle goes into your skin). Acupuncture works by stimulating your body's own healing responses and through the release of endorphins (the body's natural painkiller) which can relax you and help to bring your body back into a "state of balance".

Aromatherapy

An aromatherapist uses a range of essential plant oils to help relax you, restore your emotional wellbeing, increase energy levels and reduce your stress. The oils are diluted – they can irritate your skin in their natural form – and are normally massaged into your skin. You can also use them in baths or inhale them. You should get professional advice before using any essential oils, especially if you are pregnant or have any other medical condition, such as asthma or skin allergies.

Chiropractic

A chiropractor diagnoses and treats conditions linked to problems of the spine, which can lead to irritation of the nerves that control your posture and movement. Chiropractors use their hands to adjust and manipulate stiff joints and tight muscles, especially those of the spine. This helps realign the spine and other joints, and helps to restore nerve function, reduce pain, improve mobility and promote health and feelings of wellbeing.

Herbal medicine

Herbal medicine or herbalism involves using plants to prevent and treat illness. The herbalist aims to treat both the symptoms and the underlying cause of your condition. They prescribe herbs in different forms including tablets, powders and ointments. You can choose between Chinese or Western herbalism.

Ginkgo biloba

You may have read about the herb ginkgo biloba and its effects on tinnitus. Although there is anecdotal evidence that ginkgo biloba can help some people with tinnitus, clinical trials have been inconclusive.

Homeopathy

Homeopathy aims to help the body heal itself. It is based on the principle that symptoms are the body's defences in action and need to be encouraged to develop and not be suppressed. When deciding on a treatment for you, the homeopath aims to find a remedy, which in high doses would produce symptoms similar to those of your condition. You then take this remedy in a highly diluted form.

Hypnosis and hypnotherapy

Hypnosis is a state of intense relaxation and concentration. When you are hypnotised, you are not asleep or unconscious. It is thought that your mind becomes remote and detached from daily cares and concerns, and that the subconscious part of your mind responds creatively to any suggestions. Hypnotherapy uses hypnosis as a treatment. It can help you focus on things you wish to change and on the best ways to do it.

Osteopathy

An osteopath manipulates, stretches and massages the affected parts of your body with their hands to correct any imbalances. Osteopathy is used to treat back and joint pain, rheumatic conditions and sports injuries.

Cranial osteopathy

Cranial osteopathy is a type of osteopathic treatment that aims to release stress and tension throughout your body. Stress and tension disrupt the body's cranial rhythm. This is a very subtle rhythm that is present in all body tissues. Practitioners compare your rhythm with what they think is ideal. This helps them find the stresses and strains in your body. The cranial osteopath gently manipulates your skull, spinal column and sacral area (the area in your lower back) to help restore the correct balance.

Craniosacral therapy

Craniosacral therapy is similar to cranial osteopathy. It treats any imbalances in your brain, spinal cord and the fluids that surround them, using gentle touch. Craniosacral therapy helps your fluids and related soft tissue move naturally and so helps your body heal itself.

Reflexology

Reflexology works on the principle that points on your feet represent energy pathways to different parts of your body. Blockages in these energy pathways are thought to lead to illness or imbalance. By working on particular points on your feet, the reflexologist aims to clear these blockages.

Shiatsu

Shiatsu is a traditional Japanese treatment. Practitioners believe that a vital energy – 'ki' – flows throughout your body in a series of channels called meridians. The practitioner gently holds and presses on your meridians with their palms, thumbs, fingers, elbows, knees and feet. It is thought that shiatsu works by stimulating your circulation and helping to release toxins and deep-seated tensions in your body.

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 – which is sometimes known as sound enrichment – works by filling silence with therapeutic sounds. It involves listening to background sound such as:

  • recordings of nature sounds such as the sea or a woodland glade
  • the television
  • music
  • a sound generator.

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.

What are the different ways to relax?

Relaxation CDs

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 also produces its own specialist tinnitus CDs – the Tune out tinnitus range.

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 don't 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:

  • Physically your muscles let go of tension so that toxins can be cleared from your blood stream. Your breathing becomes more even. Your blood pressure drops and your heart beats more regularly and slowly. Other organs, including the brain, slow down their activity.
  • Mentally you actually decrease your response to any type of symptom, including tinnitus. Concentration and decision-making become easier because you are mentally refreshed.
  • Emotionally you feel 'quieter', calmer and more confident because it does not take so much effort to cope with things. You feel able to take life as it comes without over-reacting. After a period of relaxation, many people find that they can get things back into perspective and the difficulties, which they had perceived as huge, shrink back to their right proportions.

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

Does tinnitus affect sleep?

It depends. Although a large number of people experience tinnitus, most of them are not troubled by it. About half of the people who are troubled by their tinnitus sleep poorly, but the other half sleep very well. How loud the tinnitus is, or what it sounds like, does not seem to make a difference to whether it troubles people or not. Everyone responds to tinnitus in their own way, and this includes sleep.

Can tinnitus wake me up?

This is possible, theoretically. However, it seems most likely that tinnitus does not actually wake people, but is the first thing that a person is aware of when they naturally wake up. This can create the impression that it was the tinnitus that woke them.

Do sleep patterns change with age?

Yes. As people grow older:

  • they may need less sleep at night time
  • they wake up more frequently
  • their sleep becomes lighter and more fragmented so they may nap during the day.

Most people get about seven or eight hours of sleep a night, but there is an enormous range in sleep times. If you are concerned about your general sleeping pattern, you should discuss it with your GP.

What are some tips for a good night's sleep?

Try relaxation exercises. They can be extremely helpful for troubled sleepers, and classes and tapes are widely available. Practise during the day and find a short exercise to try when you are in bed.

  • Get up at the same time each day – even at weekends. This is one of the most important things you can do to improve sleep. Try not to sleep in the day or to catch up on lost sleep, as this does not improve sleeping patterns.
  • 'Wind down' for at least an hour before bedtime – have a warm bath, a milky drink, or listen to some relaxing music. This helps to draw a line between daytime and bedtime and will help you get ready for sleep.
  • Go to bed when you feel sleepy, not just because it is a certain time.
  • Try to lower your intake of caffeine (for example, in tea, coffee, cola) and nicotine during the evening. Both are stimulants that can keep you awake.
  • Try regular exercise. Fit people tend to sleep better. But avoid exercising too close to bedtime.
  • Introduce some gentle sound into your environment, such as an electric fan, soft music (via a CD player or radio) or a clock with a prominent tick.
  • A 'bedside noise generator' or 'tinnitus relaxer' placed on your bedside table may be helpful as it will omit a variety of soothing, calming nature sounds that can help you relax and distract you from your tinnitus. (For more information on tinnitus-related products, see Where can I buy products that may help?)
  • Try to avoid over-stimulating your brain in the hour before bed time. Reading, watching television or surfing the internet should be done earlier in the evening rather than just before bed time.
  • If you have particular worries, set aside an amount of time earlier in the evening – say half an hour – to think about how to resolve your problems. Write your ideas down. Try not to think about them as you are trying to get off to sleep.

Be aware:

  • Alcohol may help some people get off to sleep initially, but it may also cause you to wake sooner and you may experience more trouble getting back to sleep.
  • Over-the-counter medicines to help you sleep may have a similar effect to alcohol. Herbal remedies and natural healthcare products may be beneficial to some people.
  • Trying to force sleep may be counter-productive. Simply resting in bed may be beneficial.
  • Eating just before bed time or during the night is not a good idea as it will boost your energy levels and you may feel more alert as a result. If you are more alert your tinnitus perception may be increased. Your body may come to expect food at these times every night.
  • Napping during the day may result in reduced night time sleep.
  • If you are too hot or too cold in bed you are more likely to wake during the night, so think about room temperature and the bedding you use. If your mattress is uncomfortable, this may also cause you to wake more easily.

Whom can I contact about complementary therapies?

British Complementary Medicine Association (BMCA)

Institute for Complementary Medicine (ICM)

Acupuncture

The British Acupuncture Council (BAcC)

The British Medical Acupuncture Society (BMAS)

Aromatherapy

Aromatherapy Council (AC)

Chiropractic

General Chiropractic Council (GCC)

The British Chiropractic Association (BCA)

Herbal medicine

National Institute of Medical Herbalists (NIMH)

Register of Chinese Herbal Medicine (RCHM)

Homeopathy

British Homeopathic Association (BHA)

Hypnosis and hypnotherapy

General Hypnotherapy Register (GHR)

Osteopathy

General Osteopathic Council (GOsC)

Craniosacral Therapy Association

The Sutherland Society

Reflexology

Association of Reflexologists

Shiatsu

Shiatsu Society

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 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.

Where can I get further information?

British Tinnitus Association (BTA)

Hush

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 the RNID Tinnitus Helpline below for details of your nearest group.

Further information about tinnitus

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

Acknowledgement

We thank Dr Laurence McKenna from the Royal National Throat Nose and Ear Hospital, London.