1. Tinnitus activities THERAPY
Session 3
Sleep

2. Session Plan Normal and Disrupted Sleep Strategies to facilitate sleep
Preparing for sleep
Waking up
Activities for home
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3. Normal and disrupted sleep
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4. What is “normal” sleep? Key Concepts
Normally, the amount of sleep required varies greatly from one individual to another. Generally 6.5 to 9.5 hours per night.
Normal sleep includes several periods of light sleep or awakenings. Older adults have more awakenings. The sleep cycle from light sleep to deep sleep can repeat many times through the night.
Tinnitus doesn’t usually wake people. But when they wake normally and hear tinnitus it may create difficulties getting back to sleep.
Jane Doe Hearing Clinic. Chicago, IL

5. What disrupts your sleep?
Stress and emotions
Environment
Irregular schedule
Learned sleeplessness
Time zone changes
Medications
Caffeine
Nicotine
Alcohol
Key Concepts
There are several factors that impact the quality of sleep.
Ask patient which of these factors disrupt their sleep if any. Discuss opportunities to change behaviors if needed to reduce sleep disruptions.
Jane Doe Hearing Clinic. Chicago, IL

6. Strategies to facilitate sleep
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7. Daytime Strategies Avoid napping Get regular exercise
Maintain your routine even if/when tired
Key Concepts
Avoid napping: don’t modify behavior after a poor night sleep
Get regular exercise. Best time is 3-4 hours before going to sleep
Lead life as normally as possible, even if tired
Jane Doe Hearing Clinic. Chicago, IL

8. Evening Strategies Create a curfew at least 1.5 hours before bedtime
After curfew, avoid:
Stress
Exercise
Eating
Alcohol
Caffeine
Follow a bedtime routine
Go to bed when you’re tired
Key Concepts
Sleep is best when you make the least effort
Jane Doe Hearing Clinic. Chicago, IL

9. Try This! – Reduce worrying at bedtime
Set aside time before curfew to write down your worries so you can deal with them in the morning
If you think of additional concerns while in bed, write them down and go back to sleep
Do this approximately one hour before bedtime so your mind is not still buzzing from making the list
Jane Doe Hearing Clinic. Chicago, IL

10. Try This! – Arrange your bedroom for great sleep
Eliminate: TV
Computer
Food
Drinks
Add:
Comfortable mattress, pillows, and bedding
Darken bedroom
Set temperature to degrees F
Jane Doe Hearing Clinic. Chicago, IL

11. Jane Doe Hearing Clinic. Chicago, IL
Preparing for sleep
Jane Doe Hearing Clinic. Chicago, IL

12. It’s helpful to be able to control to volume level.
Strategy 1: Sound
Add low-level background sound
CD player
Radio
Relaxing sound player (nature sounds)
Fan, humidifier, etc.
It’s helpful to be able to control to volume level.
Key Concepts
Choose soft, pleasant sounds you enjoy
Music (calm, soothing, steady, classical, piano)
Nature sounds (waves, waterfalls, raindrops)
Broadband noise (shhhhh)
Jane Doe Hearing Clinic. Chicago, IL

13. Strategy 1: Sound Sound options: Always present On all night
On a timer
Notice whether sound on a timer wakes you when it turns off. If so, it may prompt you to think about your tinnitus when turning the sound back on, which is counterproductive.
Key Concepts
Sound options
Sound present all the time: You don’t have to think about it, it’s just part of your bedroom
Sound all night: helpful if wake up during the night.
Sound as you go to sleep on timer: can be easier for spouse.
Jane Doe Hearing Clinic. Chicago, IL

14. Strategy 1: Sound Considerations: If you share a bed with someone –
Find a sound you both agree is pleasant to play 24/7
Use a pillow loudspeaker that only you can hear
Go to sleep first with sound on a timer
Jane Doe Hearing Clinic. Chicago, IL

15. Strategy 2: Relaxation Progressive Muscle Relaxation Technique
Deliberately apply tension to a muscle group
Stop the tension
Notice how the muscles feel when they relax
Key Concepts
Review strategy
Learn to systematically tense and relax muscle groups
With practice you will recognize a tensed muscle or a relaxed muscle
This skill allows you to produce physical muscular relaxation at the first signs of tension
Jane Doe Hearing Clinic. Chicago, IL

16. Strategy 2: Relaxation Let’s try it:
Make a fist and tense your arms for 15 seconds
Release tension
Breathe deeply and notice how your arms feel
Jane Doe Hearing Clinic. Chicago, IL

17. Strategy 2: Relaxation Let’s try it:
Make a fist and tense your arms for 15 seconds
Release tension
Breathe deeply and notice how your arms feel
Continue tensing and relaxing muscles
Face
Shoulders
Stomach
Legs and feet
When finished, release any remaining tension in your body
Jane Doe Hearing Clinic. Chicago, IL

18. Strategy 3: Imagery Training
Key Concepts
Imagery training is similar to daydreaming. Attention is focused on some type of sensory experience.
Creating novel mental images
Recalling past places and events – warm and cozy, smell of roses, etc.
Jane Doe Hearing Clinic. Chicago, IL

19. Strategy 3: Imagery Training
Let’s try it!
Close your eyes
Think of a relaxing scene (like a beach)
Try to imagine the scene as clearly as you can – add details!
How does it feel? Smell? Sound?
Allow yourself to relax as you imagine the location in your mind
Jane Doe Hearing Clinic. Chicago, IL

20. Jane Doe Hearing Clinic. Chicago, IL
Waking up
Key Concepts
Do you wake at night?
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21. Waking up at night – what to do?
Try these tips:
Don’t lie in bed if you’re unable to fall or stay asleep
Find something to do and return to bed when you feel tired
Use background sound
Jane Doe Hearing Clinic. Chicago, IL

22. Waking up in the morning
Try these tips:
Get up at the same time every day
Use sunlight – it triggers wakefulness
Jane Doe Hearing Clinic. Chicago, IL

23. Jane Doe Hearing Clinic. Chicago, IL
Activities for home
Jane Doe Hearing Clinic. Chicago, IL

24. Activities for Home
Keep track of which strategies you use and how they help you sleep better.
Are there habits you could change to facilitate sleep?
What may need to change in your bedroom to facilitate sleep?
How do the daytime/evening activities help?
Which background sounds work best?
Rehearse relaxation strategies.
Jane Doe Hearing Clinic. Chicago, IL

25. Thank you for attending!
Questions?
Thank you for attending!
Jane Doe Hearing Center. Chicago, IL

26. Jane Doe Hearing Center
555 Michigan Ave.
Chicago, IL 01010
(555)
Monday-Friday
9:00 AM to 5:00 PM
Contact Us
Jane Doe Hearing Center. Chicago, IL