Why Do I Get Tinnitus When Lying Down?
Tinnitus is a medical condition that makes a person hear a noise in their ear when there is no external noise. Tinnitus is not a real noise; it has no external source, and the patient can only hear it.
In some cases, doctors may be able to hear the sound with the aid of a stethoscope.
Tinnitus sound can be heard as a ringing, hissing, buzzing, roaring, clicking, whistling, or whooshing sound. For some persons, the noise may sound like a familiar tune.
The volume and pitch of the noise may vary. Depending on the cause, tinnitus can also be temporary or permanent.
While tinnitus is not a disease, it is often a sign that something is wrong, and if the cause is not quickly identified, the situation may worsen. In some cases, tinnitus is a symptom of an impending hearing loss.
Some people with tinnitus can go about their regular business without experiencing the effects of tinnitus, but others may find it difficult to concentrate or carry out their daily activities.
A common complaint from tinnitus patients is their inability to sleep. The majority say that the tinnitus noise becomes unbearably loud when they lay on the bed, making it difficult for them to fall asleep.
In this post, we will answer why tinnitus gets worse when you lie down. But first, let's briefly examine some causes of tinnitus.
Let's see some common causes of tinnitus.
1.Prolonged Exposure to Loud Noise
Constant exposure to loud noise is a major cause of tinnitus. Loud noise can cause permanent damage to the cells in the cochlea.
Recreational and occupational noises from sources like heavy equipment, bombs, firearms, concerts, clubs, and chainsaws can also lead to tinnitus. The effects of the noise on the ear can either be temporary or permanent.
The duration of the tinnitus is dependent on how long the exposure lasted. In some cases, the tinnitus can degenerate to loss of hearing.
2. Ototoxic Drugs
These are drugs that can have side effects that can damage the ear. These drugs are often used to treat health conditions like heart disease, kidney disease, infections, and cancers. Some pain relievers also fall in this category.
Ototoxic drugs usually cause high-pitched tinnitus, which can be temporary or permanent, depending on the degree of damage done to the ear.
Examples of drugs that can cause tinnitus are aspirin, loop diuretics, some antibiotics, antidepressants, anti-inflammatories, and quinine medications.
3. Earwax Blockage
The massive buildup of earwax in the ear can cause tinnitus. Tinnitus caused by earwax buildup is often temporary and usually goes away when the earwax clogging the ear is removed.
4. Inner Ear Hair Cell Damage
Tinnitus can be a result of damage to the hair cells in the inner ear. This is because the inner ear’s hairs are responsible for sending electrical signals from the ear to the brain. This signal is then interpreted as a sound by the brain.
When the hair cells get damaged, they begin to send random signals to the brain, resulting in tinnitus.
Tinnitus caused by damage to the inner ear hair cell is permanent.
5. Other Causes
Other factors can cause tinnitus. Some of these factors are dental problems, tumors in the head or neck, age, high blood pressure, Meniere’s Disease, Temporomandibular Joint Syndrome (TMJ), Otosclerosis, and injury the head or neck.
Why You Get Tinnitus When Lying Down
If you have tinnitus, you might have noticed that there are times when the tinnitus sound doesn't seem to bother you and times when the noise becomes unbearable.
One of such unbearable times is when you are lying down. This can be very frustrating and can affect the quality of sleep you get; this is why most tinnitus patients suffer insomnia.
Most people who experience the worsening of tinnitus sound when they are sitting or lying or turning their heads usually have pulsatile tinnitus.
Pulsatile tinnitus is often heard as a rhythmical noise in sync with the person’s heartbeat. The sound most people with pulsatile tinnitus hear is often the sound of blood circulating in their body.
Your tinnitus gets louder when you are lying down because of the pressure in the nerves, blood vessels, and muscles.
A change of posture from standing or sitting to lying posture can cause a difference in blood flow through the blood vessels. This change can intensify the tinnitus, especially if a blood vessel disorder causes the tinnitus.
Below are some blood vessel related disorders that can cause tinnitus, especially when lying down.
As you get older, major blood vessels around the middle and inner ear lose their elasticity. There is also a build-up of cholesterol and other deposits in the blood vessels. This causes the blood through the blood vessels to become more forceful and audible.
Malformation of Capillaries
The development of abnormal connections between veins and arteries, known as arteriovenous malformation (AVM), can cause tinnitus in one ear.
Neck and head tumors
The growth of a tumor in the head or neck can also cause tinnitus. The tinnitus often occurs when the tumor presses against the blood vessels in the head or neck. Or, a benign tumor in the ear that develops from repeated ear infections may cause tinnitus.
Turbulent blood flows
When there is a narrowing of the carotid artery in the neck or the jugular vein located in the neck, the blood flow can become irregular or turbulent. This turbulence results in tinnitus.
People with high blood pressure are susceptible to tinnitus. The increase in the pressure of blood flowing through the vein can cause you to develop tinnitus.
Currently, there is no medical prescription on what position or posture people with tinnitus should assume when lying down or sleeping. You are advised to sleep in whichever position you find comfortable and will help you fall asleep faster.
However, it’s recommended that if the noise is in only one ear, lying on your side with the affected ear covered or exposed can improve the quality of sleep you get.
You can also wear earbuds with a sound or music playing to muffle the noise or create a noise distraction from the tinnitus. This is called masking and can be very effective.
If you are using headphones or earbuds, you should lie on your back to avoid putting pressure on the side of your face or your ear. Also, ensure that the volume is not too high.
Tinnitus When Lying Down at Night
Bedtime is a period that most tinnitus patients are dread. This is because the tinnitus increases when they lay down to sleep. It can get so severe that you may be unable to sleep throughout the night.
The primary reason why your tinnitus intensities at night are the lack of auditory input. Even without your knowledge, your ear constantly picks up sound during the day. But you may not notice it because you have gotten accustomed to it, and the noises no longer get your brain's attention, so the sound is not interpreted or comprehended.
These background noises being picked help to drown the tinnitus noise so you may not hear the noise throughout the day.
However, at bedtime, everywhere goes quiet, and the lack of background noise makes the tinnitus noise unbearable.
Also, the brain can create noise by itself, even without external noise. This is because your brain is already used to having background noise throughout the day. The lack of noise experienced in the night doesn't tally with what happens during the day, so the brain begins to fill the silence with its sensation.
Asides from lack of auditory input, certain medications that are taken at bedtime can worsen tinnitus.
One such drug is aspirin, a painkiller most people take for relief before they retire to bed. Aspirin is an ototoxic drug, and it will worsen tinnitus.
The consumption of aspirin at night, coupled with the lack of auditory input, can make the tinnitus terrible, and it can cause psychological problems like anxiety and depression. Drinking alcohol at night can also have similar effects.
One of the best ways to manage tinnitus that worsens when you lay down is to use white noise generators in your room.
This won't only help reduce the intensity of the tinnitus noise; it will also reduce the need for the brain to create noise to fill the void created by the lack of background noise.
For tinnitus associated with blood vessels problem, certain medications can give relief by dilating the blood vessels and creating room for more oxygen to be circulated to the outer and inner ear. This enables the ears to function better. We, however, advise that you consult with your doctor before taking any form of medication.
Does your tinnitus get worse when you lay down? How do you manage it? Let's hear your suggestions in the comments section.
Drew Sutton M.D.
Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.