If ringing makes it difficult to settle at bedtime, you may start worrying about sleep hours before you get into bed. Cognitive behavioural therapy (CBT) for tinnitus can help reduce the distress the sound causes and make it easier to get on with everyday activities. You may still hear the sound while finding that it interrupts your day less often.
CBT is a talking therapy. It can form part of tinnitus care after a clinician has assessed your symptoms. If you’re preparing for that first appointment, see what happens during a hearing test.
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What Does CBT for Tinnitus Focus On?
A therapist may ask you to describe a recent time when tinnitus bothered you. You might say, “I heard it as soon as I got into bed. I thought I’d be awake for hours, so I kept checking the clock.” That gives you something specific to work through together.
You may discuss what went through your mind, how it affected what you did next, and what you could try the next time the same situation comes up. The goal might be to spend less time checking the clock, return to a task more easily, or feel less anxious about going to bed. Read about tinnitus and stress.
What Might a Session Involve?
The format varies by provider. You can ask whether sessions are individual, in a group, or delivered online, and whether the programme is designed specifically for tinnitus. It helps to bring one example of a situation you want to handle differently.
| What you want to improve | What you might discuss |
|---|---|
| Getting to sleep | What happens between noticing the sound and feeling too alert to sleep. |
| Concentrating at work | How to return to a task after the sound draws your attention. |
| Enjoying a quiet activity again | How to ease back into reading or another activity you’ve started avoiding. |
| Spending less time worrying about the sound | Which thoughts tend to come up and how you might respond to them. |
You and your therapist may agree on something to practise between sessions. For instance, if you’ve stopped reading in the evening because of the ringing, you could try a short reading session and talk about what helped you stay with it. If sleep is the main issue, our bedtime routine for tinnitus offers examples to bring into that discussion.
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How Can You Tell Whether It’s Helping?
Pick an outcome you can describe without repeatedly checking how loud the ringing seems. You might track whether it takes less effort to return to work after noticing the sound, whether you spend less time worrying before bed, or whether you’ve resumed something you used to enjoy.
Bring an example to your next session. “I still heard the ringing, but I finished reading the chapter” tells you more about that particular goal than a rating of the sound alone.
If you also struggle to hear conversations, tell your audiologist. Depending on your hearing results, hearing aids may be another option to discuss. Read about hearing aids for tinnitus.
What Should You Ask Before Starting?
- Do you work with people who have tinnitus? Ask how the sessions address the situations that bother you most.
- How will we decide what to work on? Give an example, such as difficulty falling asleep or returning to a task.
- What will I practise between sessions? Ask how that fits into your normal week.
- When will we review progress? Agree on what you’ll look for and when you’ll discuss it.
When to Get the Ear Symptoms Checked
Arrange a medical appointment if tinnitus keeps returning, gets worse, or affects your sleep, mood, or concentration. Arrange an urgent medical appointment if the sound beats in time with your pulse. Read about pulsatile tinnitus.
Seek emergency medical care if tinnitus occurs with sudden hearing loss, facial weakness, or spinning dizziness, or starts after a head injury. Read about sudden hearing loss.
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