Aintree Tinnitus Support Group October 7th 2009 Tinnitus and Sleep Loss (Handy hints to help you

sleep)
Gaynor Chittick Chief Audiologist

Definitions of insomnia
Subjective complaints of poor sleep Sleep onset or maintenance problems Delay of sleep by at least 30 minutes 3 or more nights per week Duration of more than 6 months Affects day time functioning

Epidemiology
Affects most people Prevalence rate from 2% - 42.5% > 30% of pre school children 25% paediatric patients 25% of the elderly Sleep onset problems are more common

in young adults and sleep maintenance problems are more common in the elderly

Epidemiology cont
Twice as common in women More common in housewives,

unemployed, separated, widowed and living alone Shift workers sleep still impacted upon >10yrs later

Insomnia in tinnitus
Tyler & Baker (1983) - insomnia was the
most commonly reported problem by people with tinnitus Jakes et al (1985) about half of tinnitus patients report insomnia among their main complaints It is important to remember that a lot of people with tinnitus sleep well

The Nature of Sleep

Rapid Eye Movement sleep (REM) Non Rapid Eye Movement sleep (NREM) Non REM sleep has 4 stages 1=light sleep 4=deep sleep Sleeping tablets affect the normal pattern
of sleep

The Nature of sleep

The importance of sleep

The purpose of sleep is unclear Research shows that people can function

well on prolonged sleep loss REM sleep most dreaming occurs, the body is quite still Non REM sleep the body moves around a lot but the mind is less busy

Cognitive processes in Insomnia

Worry Arousal & distress Focusing of attention & monitoring Distorted perceptions Safety behaviours

Treatment
Sleep education Sleep hygiene Behavioural management

Sleep hygiene
Exercise Diet Caffeine Alcohol Environment

Establishing an optimal sleep pattern

Go to bed when sleepy Put the light out immediately Do not read or watch TV in bed If not asleep in 20 minutes get out of bed
and go to another room Set alarm for the same time every day Do not nap or take recovery sleep the following day

Sleep restriction
Insomniacs spend an excessive amount of
time in bed It is useful to estimate how much sleep you actually get and then spend only that amount of time in bed.

Relaxation
Wind down during the second half of the
evening Set a work activity deadline 90 minutes before bedtime Rehearsal and planning sessions Practice a relaxation routine whilst in bed

Dealing with intrusive thoughts

Do not try to hard to fall sleep Tell self that sleep will come when it is

ready relaxing in bed is almost as good Try to keep your eyes open in a darkened room Repeat a semantically neutral word subvocally Visual imagery Sound enrichment devices

Sound therapy devices

Pillow sound generators Bedside sound generators Radio

References
With thanks to Lawrence McKenna PhD
and David Scott PhD, Royal National Throat Nose & ear Hospital. Davis 1995 National Study of Hearing Tyler & Baker 1993 Hallam et al 1988

Thank you