Tinitus Stress Reduction Techniques

Audiology Department – Aintree Hospital 

This leaflet is designed to give you some basic relaxation exercises to help you with your tinnitus.

Relaxation exercises can help you manage the stress that is often associated with tinnitus.

Many people notice their tinnitus more when they are worried or tired, and this can increase their levels of anxiety and stress.

You can learn to control your responses to stress by using regular relaxation techniques.

Relaxation does not mean zoning out and doing nothing. To effectively combat stress, we need to activate the body’s natural relaxation response.

Relaxation exercises need to be practiced routinely.

We recommend that you spend some time every day practicing these techniques in order for you to learn to relax effectively.

Most people find that the more they practice these techniques the better they become at relaxing and so notice a bigger improvement in their tinnitus.

You will get the most benefit if you do these exercises as part of your daily routine.

You can do them standing up, sitting in a chair that supports your back, or lying on a bed or yoga mat on the floor.

How do we breathe?

When air is inhaled through your nose it passes into your lungs through your trachea (wind pipe). Your diaphragm is a dome - shaped muscle that separates your chest from your abdomen. It helps to move air in and out of your lungs.

Using different breathing techniques can affect how relaxed you feel.

What sorts of breathing techniques are there?

There are different techniques for different situations.

These are:

• Calming breathing
• Diaphragmatic breathing
• Rhythmic circular breathing
• Shoulder release
• Progressive muscle relaxation.

All these exercises will take time to learn and you may find some of them more useful than others.

Please keep trying with these exercises, as the results will improve over a period of time and with continued use.

Calming breathing

Make yourself as comfortable as you can. If possible, loosen any clothing that restricts your breathing.

If you are lying down, place your arms a little bit away from your sides, with the palms facing up.

Either keep your legs straight or bend them slightly at your knees so that your feet are flat on the floor.

If you are sitting, place your arms on the arms of the chair.

If you are sitting or standing, place both feet flat on the ground roughly hip-width apart.

Let your breath flow as far down into your stomach as is comfortable, without forcing it.

Try breathing in through your nose and out through your mouth.

Breathe in gently and regularly. Some people find is easier to count steadily from one to five. You may not be able to reach to a count of five at first.

Then without pausing or holding your breath, let it out gently, counting from one to five again, if you find counting is helpful.

Repeat this for three to five minutes.

Diaphragmatic breathing

It is best to practice this at home first:

Lie down on the floor with a small pillow under your head and another comfortably under your knees.

Place your hands flat across your stomach with just the tips of your fingers touching. Now bell out your stomach as you breathe in, and press your fingers down with flattened stomach as you breathe out.

As your stomach bells out, filling the lower part of your lungs with air, your fingers will separate and be drawn apart. They come together again as you breathe out.

Practice this belling out and deflating, moving your stomach muscles and your diaphragm as much as possible, but keeping your shoulders and the tops of your lungs as still as you can.

This allows your diaphragm to do all the work.

When you have practised this well you will be able to do it anywhere without attracting attention.

Rhythmic circular breathing for sleep

This method of breathing is useful for those people who find it difficult to switch their mind off from the problems of the day.

Your mind becomes focussed to the rhythm of your breathing instead of the problems of the day, and so your sleep centre is encouraged to take over.

Make yourself as comfortable as possible in the position in which you want to sleep. Close your eyes and settle down for sleep.

Now breathe deeply but gently in the same way as you would for diaphragmatic breathing.

Breathe in from your diaphragm slowly through your chest to your mouth, counting to four and blow it out back to your diaphragm in another count of four.

Pick your most comfortable, fairly slow rhythm. The most important part of this is the full involvement of the mind in the circular process of breathing.

Keep a mental picture of the circle in your mind and follow it round at all times, making sure that your mind focuses on and thinks only of this circular rhythm.

Then, as there is nothing more interesting going on, you will eventually fall asleep. You will find that your eyes will automatically follow the circle from your mouth out and back to your diaphragm, and this is good, as it shows that your mind is involved.

Shoulder release (three minutes)

Do this during a break during the day such as a tea break. You will not have realised that your shoulders are tense until you stop and attempt to loosen them.

You can do this sitting down, but it is better to stand to give free movement to your arms. Stand. First stretch high above your head with both arms, and then with each arm separately.

Now stand with your feet just a little bit apart to give you a good firm base and raise your arms in front of you to shoulder level.

Then loosely and lazily swing them down and behind you and then back again. Do not put any effort into this as you are aiming to loosen shoulder joints and reduce tension. Effort only increases tension.

Slowly and easily let your arms flop down and back, forward and up, repeating these swings rhythmically ten times.

Finish by moving the shoulder joints in a vertical up and down circle, five times forward and five times backwards for each shoulder.

Progressive muscle relaxation

Progressive muscle relaxation involves a two-step process in which you systematically tense and relax different muscle groups in the body.

With regular practice, progressive muscle relaxation gives you an intimate familiarity with what tension, as well as complete relaxation, feels like in different parts of the body.

This awareness helps you spot and counteract the first signs of the muscular tension that accompanies stress. And as your body relaxes, so will your mind.

You can combine deep breathing with progressive muscle relaxation for an additional level of stress relief.

Practicing progressive muscle relaxation

Before practicing progressive muscle relaxation, consult with your doctor if you have a history of muscle spasms, back problems, or other serious injuries that may be aggravated by tensing muscles.

Most progressive muscle relaxation practitioners start at the feet and work their way up to the face.

Loosen your clothing, take off your shoes, and get comfortable.

Take a few minutes to relax, breathing in and out in slow, deep breaths.

When you’re relaxed and ready to start, shift your attention to your right foot. Take a moment to focus on the way it feels.

Slowly tense the muscles in your right foot, squeezing as tightly as you can. Hold for a count of ten..

Relax your right foot. Focus on the tension flowing away and the way your foot feels as it becomes limp and loose.

Stay in this relaxed state for a moment, breathing deeply and slowly.

When you’re ready, shift your attention to your left foot. Follow the same sequence of muscle tension and release.

Move slowly up through your body, contracting and relaxing the muscle groups as you go. It may take some practice at first, but try not to tense muscles other than those intended.

Progressive muscle relaxation sequence

· Right foot, then left foot

· Right calf, then left calf

· Right thigh, then left thigh

· Hips and buttocks

· Stomach

· Chest

· Back

· Right arm and hand, then left arm and hand

· Neck and shoulders

• Face.

Further support and information

Aintree Tinnitus Support Group

Further support can be obtained from the Aintree Tinnitus Support Group.

Meetings are held on the first Wednesday of the month (excluding January and August) at Aintree University Hospital.

Time 6.00pm – 7.30pm Venue Room 2.11

2nd Floor Clinical Sciences Building

Talk Liverpool

Self refer to Talk Liverpool https://www.talkliverpool.nhs.uk/contact-us/Central Office

1. Dale St Liverpool L2 2AH

0151 228 2300 (Mon – Fri 8 am – 6pm talkliverpool@merseycare.nhs.uk

Ground Floor Unit 5 Acorn Business Park Woodseats Close Sheffield S8 OT