Tinnitus Toolkit

Accurate information about tinnitus is important because the way we think about tinnitus can have an impact on how we perceive it. There are details in the end of this leaflet of where to get further information, but here are a few key points that may be helpful:

• Tinnitus is not a disease or an indication there is anything wrong with you or your body. It is electrical activity in your extremely complex and very active auditory system.
• It comes from your cochlea and auditory nerve. The role of your cochlear is to turn sound vibrations into electrical impulses. These impulses then travel up the auditory nerve to your brain to be processed. Once they are processed your brain hears them as sounds. No computer can yet do this job, and your cochlea is only the size of your little fingernail.

• Considering the complex job this tiny organ does and the fact it is filled with thousands of hair cells it is perhaps no wonder that it produces electrical signals that we have come to know as ‘tinnitus’.
• One in ten people hear tinnitus frequently and it often first becomes noticeable during a period of stress, change or illness.
• It is common for our brains to evaluate tinnitus as a negative experience since it can feel intrusive and unwelcome. Perhaps surprisingly some people who have tinnitus say they do not feel bothered by it.
• When we evaluate a sound as having a negative meaning (i.e., as a threat, something to be worried about or something we don’t like) our brains tune into it in order to monitor it. Our brains have evolved to do this in order to protect us from quiet yet potentially dangerous sounds. Therefore, it is important to consider your response to tinnitus. It may be possible for you to develop a way of thinking about your tinnitus that helps your brain tune into it less.
• See if you can observe your reaction to tinnitus and how you feel about it. Is there a way to see the tinnitus as a natural part of your complex hearing system? In other words, the sound of your ear working?
• This can be easier said than done so if this feels difficult, don’t worry. Some of the other tools below may be helpful.

Relaxation

Relaxation can be a very powerful way to help manage tinnitus. Many people report their tinnitus is less noticeable when they feel relaxed and peaceful.

By learning to relax you are taking an active and important part in your health and wellbeing. Relaxation in this context does not mean reading a book or watching TV (both of which may be relaxing). It means setting aside time each day to do a relaxation exercise that activates your parasympathetic (rest and digest) nervous system and thereby produces many of the known benefits associated with relaxation (slowing your heart rate, reducing stress hormones, lowering fatigue, boosting immunity, helping sleep, memory and concentration).

There are also lots of relaxation exercises available on YouTube and Apps containing free guided exercises (see end of leaflet). The important thing is to find one that feels right for you.

You could also try the following breathing exercise yourself:

Breathing exercise

This calming breathing technique for stress, anxiety and panic takes just a few minutes and can be done anywhere.

You will get the most benefit if you do it regularly, as part of your daily routine.

You can do it standing up, sitting in a chair that supports your back, or lying on a bed or yoga mat on the floor.

Make yourself as comfortable as you can. If you can, loosen any clothes that restrict your breathing.

If you’re lying down, place your arms a little bit away from your sides, with the palms up. Let your legs be straight or bend your knees so your feet are flat on the floor if that is more comfortable for your lower back.

If you’re sitting, place your arms on the chair arms.

If you’re sitting or standing, place both feet flat on the ground. Whatever position you’re in, place your feet roughly hip width apart.

Put one hand on your belly just below your ribs and the other hand on your chest.

Take a deep breath in through your nose, and let your belly push your hand out.Your chest should not move.

Breathe out through your mouth. Feel the hand on your belly go in and use it to push all the air out. Do this breathing 3 – 10 times. Take your time with each breath.

Next steps

After you have mastered belly breathing, as above, you may want to try 4-7-8 breathing.

You can do this exercise either sitting or lying down, as before.

To start, put one hand on your belly and the other on your chest as in the above breathing exercise.

Take a deep, slow breath from your belly, and silently count to 4 as you breathe in.

Hold your breath, and silently count from 1 to 7.

Breathe out completely as you silently count from 1 to 8. Try to get all the air out of your lungs by the time you count to 8.

Repeat 3 to 7 times or until you feel calm. Notice how you feel at the end of the exercise

Mindfulness

Mindfulness is a simple yet powerful way of paying attention to your moment-to-moment experience. It involves a conscious direction of your awareness, on purpose, in the present moment and without judgement to things as they are.

It is often practised as a form of meditation, for example, by sitting somewhere quiet and focusing on the breath moving in and out. When the mind wanders (as it will) you gently but firmly guide it back to focusing on the breath.

Why is it relevant for tinnitus?

Our minds instinctively respond to problems by trying to work out what to ‘do’ about them. This tendency is helpful for many types of problems, such as how to get from a to b. The ability of our minds to solve, fix and judge is very important and enables us to make decisions and take action.

With tinnitus however it can be unhelpful to focus too much of our mental energy on trying to fix what we are experiencing. If we do, we may spend a lot of our time searching the internet to find a cure or speaking to different health practitioners trying to find a way to make it stop.

Mindfulness offers a way of letting go of the struggle to get rid of tinnitus and gives us the opportunity to practise being with a variety of our experiences, including difficulties such as unwanted sounds.

Mindfulness can also be a very helpful way of reducing stress, anxiety and low mood which can sometimes go hand in hand with tinnitus.

There are mindfulness courses run around the country plus books, CD’s, free online resources and a course on Netflix (Headspace guide to meditation) that can help you get started if this sounds like something you’d like to try.

Further resources for practicing mindfulness can be found at the end of this page.

Sound therapy

The purpose of sound therapy is to reduce the contrast between tinnitus and silence. It’s rather like turning on a light in a dark room where there was just a candle for light. The candle is much less noticeable when there is light all around. Similarly, tinnitus can be less noticeable when there are other sounds present.

Sound therapy doesn’t mean masking or covering tinnitus for long periods of time. It is more about using sound in situations where silence may be difficult. For example, using a sound source like a CD or sound therapy system to play nature sounds in the background if you are at home in a quiet room and are finding the tinnitus intrusive (details of where to get sound therapy systems are at the end of this page).

Sound therapy is also achieved through using hearing aids if you have a hearing loss (even a mild loss). If your ear is deprived of normal levels of noise due to a hearing loss it can pick out and tune into the internal sounds of tinnitus more easily. Hearing aids often make a big difference to tinnitus where there is a hearing loss present.

General wellbeing

Tinnitus can affect the way you feel and the way you feel can affect the intrusiveness of your tinnitus. The following tips can help you feel better and take some control of your wellbeing.

Your inner ear is the most complex system in the body apart from your brain. It needs lots of nutrients to function well. Do you have a healthy balanced diet? Are you eating plenty of fresh vegetables and fruit?

Exercise is cited again and again in research as being helpful for stress and wellbeing. The NHS guidelines for adults aged 19-64 recommends 150 minutes a week of moderate intensity aerobic activity a week (such as riding a bike or fast walking) or an hour and 15 mins of vigorous intensity aerobic activity (such as jogging, running, fast swimming, skipping with a rope, football) a week plus muscle strengthening exercises on at least two days a week such as Yoga, digging in the garden, push-ups and sit ups or weight lifting. If this sounds a bit daunting, don’t worry, there are huge benefits to having a 10 minute walk a few times a week, especially if you are able to do it in nature. Exercise guidelines for people over 65 are very similar but outlined in detail at Physical activity guidelines for older adults.

Before starting any exercise program, you should talk to your GP about how to begin and what is safe for you to try given your individual circumstances.

Doing pleasant activities can also enhance your wellbeing – talking to friends, going out for dinner, walking in the park, watching a movie, going to Church. You probably have an idea of what you enjoy and what helps you feel good. See if there is a way of increasing those activities and doing less of what drains you if possible.

Learning something new, doing a gratitude list (writing down 3 things each day you feel grateful for, however small or ordinary) and being kind to others have also been shown to have a beneficial impact on our wellbeing.

Tinnitus UK

A source of support and information with a free helpline, newsletter, leaflets, a support group on zoom an online moderated forum.

Telephone: 0800 018 0527 (Mon – Fri 9am 5pm)
Text/SMS: 07537 416 841
Email: info@tinnitus.org.uk

Relaxation

• MIND have some information on relaxation
• The Calm app has lots of different relaxation resources. You can do a free trial before deciding if you’d like to sign up
• A book that includes a good CD is ‘Mindfulness – a practical guide to finding peace in a frantic world’ by Mark Williams. The voice narrating the guided exercises on this CD is male and British.
• Frantic world has lots of great information and free meditations under the ‘resources’ section. The voice is English and male.
• Frantic world app £4.99. This app has lots of short (8–15 minute) guided mediations.
• Tara Brach has lots of free meditations and a section for those who are new to meditation. The voice is female and American.
• Headspace app. There is a free 10-day beginners course.
• The Medito app is free and has lots of meditation.
• Netflix has a guide to Meditation (by Headspace) that is a series of videos.

Sound therapy resources

Tinnitus sound relaxers are sound therapy systems that can play a variety of nature sounds. These are often portable so can be moved to different rooms easily. Examples of where they can be purchased from:

• Connevans
• Puretone

Apps: Sleep Sounds by Sleep Pillow, Sound-Oasis Nature Sounds Lite, and Resound tinnitus relief are all worth trying for nature sounds.