Woman can't sleep because ringing in her ears. Her tinnitus is keeping her up at night.

If you are one of the 25 million people in the U.S. with a medical condition called tinnitus, usually ringing in the ears, then you probably know that it tends to get worse when you are trying to fall asleep, but why? The ringing in one or both ears is not a real noise but a complication of a medical issue like hearing loss, either permanent or temporary. Of course, knowing what it is will not explain why you have this ringing, buzzing or swishing noise more often at night.

The truth is more common sense than you might think. To know why your tinnitus increases as you try to sleep, you need to understand the hows and whys of this very common medical problem.

What is Tinnitus?

To say tinnitus is not a real sound just adds to the confusion, but, for most people, that is true. It’s a noise no one else can hear and does not happen of a real sound close to your ear. The individual lying next to you in bed can’t hear it even if it sounds like a tornado to you.

Tinnitus alone is not a disease or condition, but a sign that something else is wrong. It is typically associated with significant hearing loss. For many, tinnitus is the first sign they get that their hearing is at risk. Hearing loss tends to be gradual, so they do not notice it until that ringing or buzzing starts. This phantom noise works like a flag to warn you of a change in how you hear.

What Causes Tinnitus?

Tinnitus is one of medical sciences biggest conundrums. Doctors do not have a clear understanding of why it happens, only what it usually means. It is a symptom of a number of medical problems including inner ear damage. The inner ear contains many tiny hair cells designed to move in response to sound waves. Tinnitus often means there is damage to those hair cells, enough to keep them from sending electrical messages to the brain. These electrical messages is how the brain translates sound into something you can clearly comprehend like a car horn or person talking.

The current theory about tinnitus has to do with the silence or a lack of sound. The brain works hard to interpret sound through these messages, but when they don’t come, it is confusing. To compensate, your brain fills that that lack of sound with the ringing or buzzing noise of tinnitus.

The need for feedback from the ears does explain a few things related to tinnitus. For one, it tells you why that sound is a symptom of such a variety of illnesses that affect hearing from a mild ear infection to age-related hearing loss. It also explains why the volume goes up at night for some people.

Why Does Tinnitus Get Worse at Night?

Unless you are profoundly deaf, your ear picks up certain sounds all day long even if you do not realize it. The ears hear faint noises like music playing or the TV humming even if there is no comprehension of the sound. At the very least, you hear your own voice, but at night, it all stops.

At bedtime, the world goes silent and that lack of noise creates confusion in the brain in response to it. The brain only knows one thing to do when that happens – create noise even if it’s not real.

In other words, tinnitus gets worse at night because it’s too quiet. Creating sound is the solution for those who can’t sleep because their ears are ringing.

How to Create Noise at Night

If you accept that tinnitus increases at night because there is no distracting noise to keep the brain busy, the answer is clear – create some. For some people suffering from tinnitus, all they need is a fan running in the background. Just the noise of the motor is enough to quiet the ringing.

There is also a device made to help those with tinnitus get to sleep. White noise machines simulate environmental sounds like rain or ocean waves. The soft noise soothes the tinnitus but isn’t distracting enough to keep you awake like leaving the TV on might do.

Can Anything Else Increase Tinnitus?

It’s important to keep in mind that the lack of sound is only one thing that can cause an upsurge in your tinnitus. It tends to get worse when you are under stress and certain medical problems can lead to a flare-up, too, like high blood pressure. If introducing sound into your nighttime routine doesn’t help or you feel dizzy when the ringing is active, it’s time to see the doctor.

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