Tinnitus is the perception of sound, often described as a ringing, buzzing, or hissing, when no external sound source exists. This phantom noise can be especially disruptive during the quiet hours of the night, leading many people to seek silence as a solution. The intuitive attempt to block out all external noise with earplugs, however, often proves counterproductive for managing the condition. Complete silence can inadvertently make the internal sounds of tinnitus seem much louder.
Why Earplugs Might Amplify Tinnitus
Relying on earplugs nightly to achieve total silence can inadvertently worsen the perception of tinnitus due to a neurological process called auditory deprivation. When the auditory system receives significantly reduced external sound input, the central nervous system attempts to compensate for this lack of stimulation. The brain acts like a stereo system with an automatic volume dial, increasing its sensitivity, or “central gain,” to detect any signal.
This increased sensitivity is a form of neuroplasticity, where the brain’s wiring changes in response to the environment. The brain amplifies its own internal signals, making the perception of the tinnitus more prominent. Studies show that even a temporary period of reduced sound input can induce neurophysiological changes consistent with central gain modulation. Instead of achieving quiet, the user may experience an amplified and more intrusive internal noise.
Physical Risks of Using Earplugs Nightly
Beyond the potential for increased tinnitus perception, the nightly use of earplugs carries several physical and hygienic risks. One common problem is the disruption of the ear’s natural self-cleaning mechanism, leading to cerumen impaction, or earwax buildup. Earplugs can push the earwax deeper into the ear canal, causing discomfort, pressure, and potentially temporary hearing loss.
The constant occlusion of the ear canal creates a warm, moist environment conducive to bacterial and fungal growth. This increases the risk of developing outer ear infections, known as otitis externa. Foam earplugs are porous and can harbor bacteria, necessitating frequent replacement for proper hygiene. Inserting earplugs too deeply can also cause irritation to the delicate lining of the ear canal.
Effective Sound-Based Sleep Strategies
Since eliminating all sound often backfires, a more effective strategy for managing sleep-disrupting tinnitus is sound therapy, also known as sound masking. The goal is not to drown out the tinnitus, but to introduce a low-level, steady external sound to prevent auditory deprivation. This background noise provides the auditory system with a signal to process, preventing the central gain mechanism from overcompensating.
Various types of sounds can be used, including white noise, pink noise, or nature sounds. White noise contains all audible frequencies played at equal intensity, making it effective for masking. Pink noise has more energy concentrated in the lower frequencies, which many people find soothing. The volume should be set just below the level of the perceived tinnitus, a point often referred to as the “mixing point.”
Consistently using a sound machine or app promotes a process called habituation. Habituation is a neurological retraining where the brain learns to reclassify the tinnitus signal as neutral and non-threatening. Over time, the brain moves the perception of the tinnitus from the conscious to the subconscious level. This makes it less noticeable and reduces associated distress, ultimately leading to better sleep.