Overcoming Tinnitus

Have you ever had a ringing in your ears after a loud noise or a knock to the head, and did it go away after a few minutes? What if that noise stayed or became louder or sharper? For some people it doesn’t fade. Instead it comes and goes unexpectedly and can cause persistent and severe difficulties. This is called Tinnitus.

Some call it “ringing in the ears” or “head noise”, and sounds can include tones, whistles, hisses, static and pops, occurring individually or in combination, with patterns and changes in volume unique to each person. It is commonly known to affect experienced musicians who have listened to too much loud music, but I’ve recently discovered it affects all sorts of people and some quite severely, such as war veterans, construction workers, and even parents of crying infants. It has been suggested it will be a growing problem with increasing use of personal music players, with the volume set much too high!

The presenting issues can include headaches, reduced concentration, stress, insomnia, frustration, or anger. Depression, anxiety, panic or phobias can also develop if the condition is not properly addressed. For me, tinnitus has been the cause of restless nights with difficulty getting to sleep. I’ve had to work at not getting frustrated with the noise and agitated or worked up, at the risk of making the situation worse!

The suggested medical treatment is TRT or Tinnitus Retraining Therapy, but I was glad to discover that there are non-medical interventions for what I assumed was a purely medical condition. Cognitive behavioural therapy (CBT), exposure therapy and mindfulness have been found to be effective! These don’t remove the symptoms but help with better coping including being able to ‘ignore’ the symptoms, which is often the best outcome. For example, CBT challenges unhelpful thought patterns and replaces them with more beneficial self-talk. This more grounded and realistic way of thinking creates a greater sense of calm, and promotes habituation and adjustment to the sounds and sensations. Mindfulness similarly aims to reduce the impact of the symptoms by practicing acceptance of your whole experience, including the parts that might be unpleasant and beyond your control. For more info, speak to your psychologist.

For me I’ve learnt that psychological interventions can be more broadly beneficial than we might think!

For more about how one psychologist treated and overcame his own tinnitus see http://www.cbtfortinnitus.com/dr-hubbards-story/

Getting a Good Night’s Sleep

Everyone has experienced tossing and turning at night or having unwanted broken sleep! We sometimes go through periods where we just can’t get to sleep or have trouble staying asleep and it is really frustrating, especially in our society where our lifestyle is packed with so many activities and we feel the pressure to be alert and clear minded for the next day.

What are some of the contributors to insomnia or sleepless nights?

• Lifestyle – I believe that this is becoming a major contributor to sleep issues because we just try to do too much!!! Does this sound familiar? Whether it’s working and taking care of kids or trying to balance a busy social life as well as maintaining work or study commitments. We just don’t slow down enough for our bodies and our mind to wind down.

• Internet/Social Networking – Do you use a lot of your free time at night on the internet instead of resting? This form of time out from our busy day is actually stimulating our brains and not helping us to wind down. You may have experienced this when you decided to check your emails before bedtime and found yourself responding to it for the next ½ hour or so only to find that you then couldn’t fall asleep!

• Irregular Sleep routines – This is when you go to bed at different times and your body is not able to get into a routine which enables you to wind down mentally and physically.

• Stress – this is a major contributor to sleeplessness and can lead to secondary issues such as Anxiety or Depression which can then add another layer to sleep issues.

• Illness – Sometimes we may go through periods of insomnia which are related either directly or indirectly to health issues. When this occurs it is important to seek medical advice.

• Poor Sleep Hygiene – These are the habits that we adopt that unknowingly may lead or contribute to sleepless nights. When we are not stressed these habits may have minimal effects on our ability to sleep but when we experience times of stress these habits do more harm and may exacerbate any sleep issues.

What can you do to maintain a healthy sleep routine and enhance your ability to get sleep?

• Try to create a routine each night which includes at least one hour of wind down time before you plan to go to bed. For example wind down time can include watching TV, listening to relaxing music, reading a book, having a bath and so on.

• Try to go to bed roughly at the same time daily and go to bed when you feel tired. Listen to your body! Likewise try to wake up at roughly the same time.

• Don’t watch TV or browse the net in your bedroom. It is important to create a different environment for activities and for sleeping. In other words your bedroom should be your sleep sanctuary and it is important to not confuse your mind into thinking it is also a place of mental activity.

• If you go to bed and cannot sleep within 30 minutes it is important to get out of bed and go into another room (with dim lights!) and do some light activity such as reading which may induce sleepiness as well as take your mind away from ruminating thoughts about your day or stressing about the fact that you haven’t fallen asleep yet! Of course go back to bed when you feel tired again. Keep doing this until you fall asleep.

• Try not to eat too much before bedtime. It is hard to fall asleep when our bodies are trying to digest food.

• Try not to use alcohol as a sleep aid. Even though it initially may contribute to feelings of drowsiness it actually has proven to create a more disruptive sleep especially during the latter part of your sleep cycle.

• Anxiety and stressful thoughts need to be dealt with and if possible during the day. Set aside some time in the day to problem solve and if you feel that you need extra help it is important to work through issues with a friend/family or with a professional.

• Try not to nap during the day as this can interrupt your ability to fall asleep and stay asleep at night.

• Do not count how many hours you have slept. This can cause you to have unnecessary stress about sleep which in turn can make you feel too anxious to fall asleep again. Everyone is unique and needs a different amount of hours to feel good during the day.

• Make sure you eat healthy (cut down on caffeine if needed especially if you are anxious or stressed), get regular exercise (this can help your body to feel more tired and rested at night which are prerequisites to drifting into sleep more easily) and get a daily dose of sunshine. This is important because it helps our bodies to differentiate between day and night and can help produce hormones that induce sleep. For example melatonin which is a sleep promoting hormone gets produced when it is dark (so no bright lights from your computer at night!).

Remember a few sleepless nights on occasion happens to all of us so try not to stress about this. It is important to create good sleep habits for general health but if you feel that this is not occurring and would like additional help a Psychologist may be able to work through some issues with you. This may involve teaching you about how to challenge unhelpful thinking patterns, learning to manage stress better, and learning some relaxation skills. These are all valuable lifestyle skills.

Ivette Moutzouris

Registered Psychologist, Alpha Psychology

References

The Insomnia Workbook by Stephanie A. Silberman.

Treating Insomnia: What Health Professionals Need to Know, Australasian Sleep Association handout.

Healthy Sleep Tips

by May Lim
Registered Psychologist
Alpha Psychology and The Resilience Centre

“I can’t sleep!” is something I hear very often in my role as a psychologist.

Good sleep is so important in our lives as it helps us to function well daily. When people have difficulty sleeping, they often have problems with falling or staying asleep, waking up too early, feeling worried or depressed, racing thoughts before sleeping or in the middle of the night and often experience fatigue in the daytime.

Ongoing sleeplessness can be frustrating and can impair a person’s daily functioning at home, work or school. Sleeplessness can often occur during stressful periods of a person’s life leading to them to be awake and preoccupied with thoughts ranging from personal issues, finances, relationships, conflict, family, health, work stress, studies, important decisions and many other life concerns. If the sleeplessness continues for a period of time, it can progress to insomnia and it is common for a person to then have the added concern about having trouble with sleeping.

To promote better sleep it is useful to first apply some healthy sleep hygiene practices during the day, evening and at bedtime.

Healthy sleep tips during the day:

  • During the day, aim to establish regular times for achieving tasks, meal times, taking medication and other activities.
  • Engage in regular exercise during the day or early evening as it promotes good quality sleep at night as well as assists in being awake and alert during the day.
  • Allocate a portion of time to engage in brainstorming to solve current problems and make decisions. This can then ease pressure and decrease rumination of problems and decisions before and during bedtime.
  • Resist the temptation to take a nap during the day as long naps can make it difficult to fall asleep at night.

Healthy sleep tips during the evening:

  • In the event there are outstanding issues you are thinking about, write them down so you can deal with them the following day.
  • Stay away from beverages with caffeine after 4pm. This is because caffeine increases adrenaline production and obstructs sleep-inducing brain chemicals.
  • Engaging in light exercise in the early rather than late evening may assist with sleeping well at night.
  • Do not consume a large amount of food or smoke right before going to sleep.
  • Avoid having alcohol to assist with sleeping as it can actually contribute to fatigue the following day.
  • Before moving to your bed, relaxing activities like listening to peaceful music or reading can assist with preparation for sleeping.
  • Ensure the temperature of your bedroom is neither too cold or hot as well as not too noisy. Keep your bedroom dark. In the event you have difficulty with oversleeping, make sure there is an opportunity for the morning light to be present in your room.

Healthy sleep tips when going to sleep:

  • Develop soothing bedtime habits before going to sleep so your body and mind can prepare for rest. This can include doing relaxation exercises such as meditation and breathing exercises, listening to peaceful music or having a warm bath or shower. Refrain from watching television when in bed as this will keep your mind alert making it difficult to be relaxed and fall asleep.
  • It is helpful to only go to bed when you feel sleepy.
  • If you wake up too early in the night and are awake for more than 30 minutes, rise out of bed and engage in a relaxing activity until you feel sleepy. Avoid sleeping in to compensate for time awake during the night.
  • Aim to wake up at the same time every morning.

I’d like to invite you to practise these healthy sleep habits regularly as it can make a difference to your quality of sleep. Like any healthy outcomes, it takes determination, patience and consistency to experience the benefits of these healthy sleep habits.

If there are negative thoughts which keep popping up in your mind that seem to keep you from sleeping well, it is often useful to share these thoughts with people in your life whether it be family, friends, a GP, counsellor or a psychologist.

All the best in your goals to try and sleep well!

Reference:
 Ashfield, J.(2010).Taking Care of Yourself and Your Family. 
South Australia: Peacock Publications.

May Lim is a Registered Psychologist at Alpha Psychology and The Resilience Centre.
Visit her site @maylim

If you would like to make an appointment with May, please call (02) 9869 0377.