Tinnitus and sleep: practical tips backed by evidence

Tinnitus often seems louder at night because the room is quiet and there is little else to listen to. Gentle background sound, steady sleep habits and less worry about sleep may help some people. When sleep problems last, cognitive behavioural therapy for insomnia (CBTi) has the best evidence.

Last reviewed: 28 October 2026

By the Tinnitus Haven editorial team. Sources are listed at the end of the page.

This guide is general information, not medical advice. If your tinnitus is new, one-sided, pulsing or comes with hearing loss or dizziness, see a doctor.

Why does tinnitus seem worse at night?

In a quiet bedroom there is little other sound to compete with tinnitus, which is one reason the NHS advises against total silence^[1]. Worry plays a big part too: worrying about sleep can keep poor sleep going^[2].

Sleep problems are common with tinnitus. Some people find it affects their sleep and concentration^[3], and sleep disorders are found more often in people with tinnitus than without^[4]. UK guidance asks clinicians to check whether tinnitus affects your sleep and, if it does, to consider a questionnaire such as the Insomnia Severity Index^[5].

Does background sound help with sleep?

Many people use a bedside sound generator, a smartphone app, a fan or a quiet radio, with sounds such as rain or waves. The NIDCD describes these as aids for relaxation or sleep, and notes that for mild tinnitus this may be all someone needs to fall asleep^[3].

Research on sound therapy is limited^[6], so think of bedtime sound as a comfort rather than a cure. Keep the volume low and comfortable. Our sound therapy guide explains the evidence.

Which sleep habits help?

The standard advice for better sleep applies to tinnitus too^[7]:

Go to bed only when you feel sleepy, and get up at the same time every day.
Relax for at least an hour before bed, for example with a bath or a book.
Make the bedroom dark and comfortable.
Avoid tea, coffee, alcohol and smoking for at least six hours before bed.
Avoid a big meal late at night, and screens right before bed.
Exercise regularly, but not in the four hours before bed.
Avoid daytime naps, and do not sleep in after a bad night.

The NHS tinnitus page also suggests a regular bedtime routine and cutting down on caffeine^[1]. Tinnitus UK points out that sleep is very much a matter of habit and routine^[2].

What can I do when I cannot fall asleep?

Try not to fight it. Because worry about sleep keeps sleeplessness going^[2], something calming often helps more than trying harder to sleep. A slow breathing exercise is one simple option: the NHS describes a calming technique you can do lying down in a few minutes^[8]. Our stress and anxiety guide walks through it.

What is CBT for insomnia, and does it help with tinnitus?

Cognitive behavioural therapy for insomnia (CBTi) is a structured therapy that works on the thoughts and habits that keep insomnia going. A GP may offer CBT face to face or through an online self-help programme^[7].

In a 2023 randomised trial with 102 people who had tinnitus-related insomnia, CBTi reduced insomnia and improved sleep efficiency more than audiology-based care, both after treatment and six months later. More than 80% of the CBTi group reported a clinically meaningful improvement, compared with 47% after audiology-based care and 20% in a sleep support group. CBTi also reduced tinnitus distress more^[9]. This is a single trial, but it is encouraging.

What about sleeping pills or melatonin?

The US tinnitus guideline recommends against melatonin and other dietary supplements for treating tinnitus^[10]. The German guideline notes three small trials of melatonin that showed some benefit, mostly in people with severe tinnitus and insomnia, but says the results should be interpreted with caution^[4]. Pharmacy sleep aids may help for a week or two but should not be used for longer, and it is best to check with your doctor first^[7].

When should I get help with sleep?

See a GP if changing your habits has not helped, if you have slept badly for months, or if poor sleep is making daily life hard to cope with^[7]. The same applies if tinnitus is affecting your sleep, concentration or mood^[1].

Tinnitus Haven brings sound therapy, a hearing check and CBT-based lessons together in one calm iPhone app, coming soon to the App Store. Learn more about Tinnitus Haven.

Sources

NHS. Tinnitus. NHS website, 2024.
Tinnitus UK. Tinnitus and sleep disturbance.
National Institute on Deafness and Other Communication Disorders (NIDCD), NIH. Tinnitus. 2023.
Mazurek B, Hesse G, Sattel H, et al. S3 Guideline: Chronic Tinnitus. German Society for Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC). HNO, 2022. English version of the German AWMF guideline 017/064 (2021).
National Institute for Health and Care Excellence (NICE). Tinnitus: assessment and management (NG155), Recommendations. NICE guideline, 2020.
Sereda M, Xia J, El Refaie A, et al. Sound therapy (using amplification devices and/or sound generators) for tinnitus. Cochrane Database of Systematic Reviews, 2018.
NHS. Insomnia. NHS website.
NHS. Breathing exercises for stress. NHS website, 2026.
Marks E, Hallsworth C, Vogt F, et al. Cognitive behavioural therapy for insomnia (CBTi) as a treatment for tinnitus-related insomnia: a randomised controlled trial. Cognitive Behaviour Therapy, 2023.
Tunkel DE, Bauer CA, Sun GH, et al. Clinical practice guideline: tinnitus. Otolaryngology, Head and Neck Surgery, 2014 (AAO-HNSF).