How to sleep with tinnitus: building a nighttime sound environment

Tinnitus has a way of becoming louder the moment your head hits the pillow. Throughout the day, ambient noise from traffic, conversation, appliances, and weather fills the acoustic space around you. At night, that ambient layer disappears. What remains is the ringing, buzzing, hissing, or tone that your auditory system generates on its own, and in a quiet room, it can feel like the only thing left to listen to.

This is not a psychological trick. The perception is grounded in how auditory attention works. When competing sound input drops, the brain allocates more processing to whatever signal remains. Research confirms this pattern: Pan et al. (2015) found that 47.7% of tinnitus patients reported that being in a quiet place made their tinnitus worse, and Gallo et al. (2023) found that 72.2% of tinnitus patients rate their sleep quality as poor. The mechanism is straightforward: less external sound means more attention on the internal signal.

Building a nighttime sound environment does not make tinnitus go away. But it does change the acoustic conditions of the room, giving your auditory system something else to process alongside the tinnitus signal. This guide walks through how to do that deliberately and effectively.

Why tinnitus feels worse at night

Two things change when you go to bed: the room gets quieter, and you stop doing things that occupy your attention.

During the day, even a moderately quiet office or living room sits at around 30-40 dB. A bedroom at night can drop below 20 dB. That difference matters. Sound masking works by introducing external sound that occupies the same perceptual space as the tinnitus signal. When the room is quiet, there is no masking layer present, and the tinnitus signal sits alone in the foreground.

The second factor is cognitive. During the day, tasks, conversations, and decisions compete for your attention. At night, that competition drops to near zero. Your brain is free to focus on the one persistent signal it can still detect.

This is why simply turning on a fan or playing random background noise sometimes falls short. A fan produces sound, but its frequency content may not overlap with your tinnitus pitch. Random noise fills the room but may not address the specific frequency range where your tinnitus sits. Research by Perez-Carpena et al. (2021) found that frequency-targeted sound (narrowband noise centred on the individual's tinnitus pitch) produced higher rates of temporary tinnitus suppression than broadband noise. A deliberate approach, one that considers pitch, layering, and volume, tends to produce a more useful result.

Step 1: Identify your tinnitus pitch range

Before choosing sounds, it is worth understanding roughly where your tinnitus sits in the frequency spectrum. Most tinnitus signals fall somewhere between 2 kHz and 8 kHz, though the range varies widely from person to person. Moore, Vinay, and Sandhya (2010) found that tinnitus pitch correlates strongly with the "edge frequency" of the audiogram (the point where hearing loss worsens), providing a neurological basis for why pitch location matters.

You do not need lab equipment for a rough estimate. A pitch exploration tool lets you sweep through frequencies and identify the range where your tinnitus seems to interact with the external tone. When the external tone is close to your tinnitus pitch, you may notice the two signals blend, compete, or create a beating pattern. That region is your target range.

Why does this matter for sleep? Because a sound environment built around your specific pitch range is more likely to occupy the same auditory channels as the tinnitus signal. A low-frequency rumble will not do much for a high-pitched ring. A hiss centred at 6 kHz will not address a low hum at 500 Hz. Matching the frequency neighbourhood, even approximately, makes the masking layer more relevant.

Step 2: Choose your base sound layer

The base layer is the foundation of your nighttime sound environment. It should be continuous, non-distracting, and broad enough in frequency content to fill the room without drawing attention to itself.

Common choices for a base layer include:

• Broadband noise. White, pink, or brown noise each have different frequency profiles. White noise is flat across all frequencies. Pink noise rolls off at higher frequencies, producing a deeper, less harsh character. Brown noise rolls off even more steeply, emphasising the low end. A controlled trial by Barozzi et al. (2017) found no significant clinical difference between white, pink, and brown noise for tinnitus outcomes, suggesting individual preference matters more than the specific noise colour. If your tinnitus is high-pitched, pink or brown noise can provide a broad foundation without adding unnecessary energy in the high range.

• Nature sounds. Rain, ocean waves, wind, and river sounds are naturally broadband. Wang et al. (2017) demonstrated that natural sounds such as rain and spring water can effectively mask tinnitus, noting that full masking is not required; reducing annoyance is sufficient. Rain in particular covers a wide frequency range and has an irregular pattern that the brain tends not to latch onto. Waves introduce slow amplitude changes that can prevent the sound environment from feeling static.

• Engineered tones. Narrow-band noise or shaped tones centred near your tinnitus frequency. These are more targeted but can feel less natural. They work well as a component in a layered mix rather than as a standalone.

The key with a base layer is consistency. Sounds that have sudden changes (thunder, animal calls, music with lyrics) can create startle responses that work against the goal of letting your auditory system settle.

Step 3: Add a second and third layer

A single sound can work, but layering multiple sounds creates a richer acoustic texture that covers more of the frequency spectrum and is harder for the brain to "solve" and tune out.

Think of it like painting. A single flat colour fills the canvas but is easy to look past. Multiple colours and textures create depth that holds attention differently.

Practical layering combinations:

• Rain + low-frequency drone. The rain covers the mid-to-high range while the drone fills in the low end, creating a full-spectrum environment.
• Ocean waves + narrow-band noise near your tinnitus pitch. The waves provide natural variation while the narrow-band component directly addresses the tinnitus frequency range.
• Pink noise + crickets + gentle wind. Three textures that each occupy different frequency zones and have different temporal patterns.

When layering, each sound should be at a different volume level. The base layer sits loudest. Additional layers sit below it, adding texture without dominating. The goal is a single cohesive sound environment, not a collection of competing sounds.

Adjusting pitch within layers

If a sound is close to your tinnitus frequency but not quite there, pitch control can bridge the gap. Shifting a rain sound up or down by a few semitones changes its spectral centre without changing its character dramatically. The same applies to noise layers and tonal drones.

This is where precision matters. The difference between a sound layer that interacts with your tinnitus pitch and one that sits beside it can be a matter of a few hundred hertz. Tools that offer continuous pitch adjustment, rather than just preset options, give you the ability to tune each layer to where it is most useful.

Siasola Tinnitus Masking Sounds was built around this idea. Its 5-layer mixer lets you combine up to five sounds simultaneously, each with independent volume and pitch controls. Justin, the developer, built it because he has had tinnitus since he was 18 and could not find a sound customization tool with the precision control he wanted.

Step 4: Set the right volume

Volume is where most people make mistakes with nighttime sound environments. The instinct is to turn the sound up until the tinnitus is completely covered. This creates two problems.

First, masking sound that is too loud can interfere with sleep on its own. Your auditory system does not fully shut down during sleep. Sustained loud sound keeps it activated, which can reduce sleep depth even if you are not consciously aware of it.

Second, total masking, where the external sound completely drowns out the tinnitus, is not necessarily the most useful approach. Partial masking, where the external sound sits at or just below the perceived level of the tinnitus, allows the brain to distribute attention between the two signals rather than fixating on either one. This principle is central to Tinnitus Retraining Therapy, where Jastreboff and Hazell (1993) emphasised that both the external sound and the tinnitus should be perceived simultaneously. Smith et al. (1991) also found that experienced masker users chose levels that only partially masked their tinnitus.

A practical approach:

1. Start with the sound environment at a volume where you can clearly hear it but it does not feel loud.
2. Gradually reduce the volume until the tinnitus and the masking sound coexist. You can hear both, but neither dominates.
3. If the tinnitus still commands all of your attention, bring the volume up slightly. The minimum effective volume is the target: loud enough to share the auditory space, quiet enough to fade into the background as you fall asleep.

Volume and the sleep fade question

One common question: should the sound stay on all night, or should it fade out?

Arguments exist for both approaches. Keeping sound on all night maintains the masking layer through lighter sleep stages, when the tinnitus signal might otherwise pull you into wakefulness. Fading the sound out after you fall asleep reduces total noise exposure and avoids potential disruption during deep sleep.

A sleep fade mode, where the sound gradually decreases in volume over a set period, offers a middle path. You fall asleep with the full sound environment in place, and the volume drops slowly enough that the transition does not wake you. siasola Tinnitus Masking Sounds includes a sleep fade mode designed for exactly this use case. You set the duration, and the app handles the gradual volume reduction.

If you find that you consistently wake up in the middle of the night when the sound has stopped, that is useful information. It suggests that keeping a low-level sound environment running through the night may be worth trying.

Step 5: Optimize your room setup

The physical setup of your sound environment matters more than most people expect.

Speaker vs. headphones

For sleep, speakers are generally preferable to headphones. Over-ear headphones are uncomfortable for side sleepers. In-ear monitors can work but carry a risk of ear canal irritation with prolonged use. Bone conduction headphones are an option for some people, but they introduce their own frequency limitations.

A speaker placed on a nightstand or shelf near the head of the bed provides a localized sound source without physical contact. The sound interacts with the room's acoustics, creating a more natural listening environment than headphones deliver.

If you share a bed and a speaker is not practical, sleep-specific headphones (flat-profile earbuds designed for side sleeping) or a pillow speaker are alternatives worth considering.

Phone placement and screen light

If you are using a phone app as your sound source, place the phone face-down or enable do-not-disturb mode. Screen light from notifications activates the visual system and works against sleep onset. The sound environment should run without any need to interact with the screen after you set it up.

Room temperature and other factors

Sound is one component of a sleep environment. Temperature, light, and bedding all interact with it. A room that is too warm or too bright undermines even a well-designed sound setup. The sound environment works best when everything else in the room is also optimized for sleep.

Step 6: Iterate and adjust

The first sound environment you build is a starting point, not a final answer. Tinnitus perception can shift over time: different days, different stress levels, different seasons. A setup that works well for a month may need adjustment.

Keep notes on what works. If a particular combination of sounds and pitch settings produces a noticeably better night, record those settings so you can return to them. If a setup stops being as effective, that is normal. Try adjusting pitch, swapping one layer for a different sound, or changing the volume balance between layers.

The advantage of a tool with presets or saveable configurations is that you can store multiple setups and switch between them based on how your tinnitus presents on a given night.

Common mistakes to avoid

Playing the same single sound every night indefinitely. The auditory system adapts to repetitive stimuli. Jastreboff (1990) described this habituation process in the neurophysiological model of tinnitus. Over time, a single unchanging sound becomes easier for the brain to filter out, which means it also becomes less effective as a masking layer. Rotating between different sound combinations or making small adjustments to pitch and volume balance helps maintain effectiveness.

Using sounds with sudden dynamic changes. Thunder, birdsong with sharp calls, music with drops or builds. These create startle responses that work against sleep onset. Choose sounds with gradual or minimal amplitude variation.

Setting volume based on daytime listening. Your perception of volume shifts as you relax and approach sleep. A level that feels appropriate while you are alert and sitting up may feel too loud once you are lying down in a dark room. Set volume after you are already in bed, lights off, ready to sleep.

Ignoring the pitch dimension. Volume alone does not determine masking effectiveness. A loud sound in the wrong frequency range is less useful than a quieter sound in the right one. Spend time matching the spectral content of your sound environment to the frequency range of your tinnitus.

Building a consistent routine

The sound environment works best as part of a consistent pre-sleep routine. The brain responds to patterns. If you set up the same general type of sound environment at the same point in your evening routine, the auditory cue itself becomes associated with the transition to sleep.

This does not require rigid precision. It means: when you get into bed, you open your sound app, load your preferred setup, adjust volume, start the sleep fade, and put the phone down. The whole process takes under a minute once you have your configurations saved. Over time, the act of starting the sound environment becomes part of the signal that tells your brain the day is over.

References

1. Barozzi S, Ambrosetti U, Callaway SL, et al. Effects of tinnitus retraining therapy with different colours of sound. International Tinnitus Journal. 2017;21(2):139-143. doi:10.5935/0946-5448.20170026

2. Gallo KEB, Correa CDC, Goncalves CGDO, et al. Effect of tinnitus on sleep quality and insomnia. International Archives of Otorhinolaryngology. 2023;27(2):e197-e202. doi:10.1055/s-0041-1735455

3. Jastreboff PJ. Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neuroscience Research. 1990;8(4):221-254. doi:10.1016/0168-0102(90)90031-9

4. Jastreboff PJ, Hazell JWP. A neurophysiological approach to tinnitus: clinical implications. British Journal of Audiology. 1993;27(1):7-17. doi:10.3109/03005369309077884

5. Moore BCJ, Vinay, Sandhya. The relationship between tinnitus pitch and the edge frequency of the audiogram in individuals with hearing impairment and tonal tinnitus. Hearing Research. 2010;261(1-2):51-56. doi:10.1016/j.heares.2010.01.003

6. Pan T, Tyler RS, Ji H, Coelho C, Gogel SA. Differences among patients that make their tinnitus worse or better. American Journal of Audiology. 2015;24(4):469-476. doi:10.1044/2015_AJA-15-0020

7. Perez-Carpena P, Bibas A, Lopez-Escamez JA, Vardonikolaki K, Kikidis D. Systematic review of sound stimulation to elicit tinnitus residual inhibition. Progress in Brain Research. 2021;262:1-21. doi:10.1016/bs.pbr.2021.01.020

8. Smith PA, Parr VM, Lutman ME, Coles RR. Comparative study of four noise spectra as potential tinnitus maskers. British Journal of Audiology. 1991;25(1):25-34. doi:10.3109/03005369109077861

9. Wang Y, Xiao L, Li P, Cui J. Research on masking effect of multiple natural sounds for monotone-like tinnitus. Biomedical Engineering Journal. 2017;34(3):325-328. doi:10.7507/1001-5515.201512039

---

siasola Tinnitus Masking Sounds is a sound customization tool. It is not a medical device and does not claim to produce any health outcome. If you experience tinnitus, consult an audiologist or healthcare provider for professional guidance. The information in this post is for general informational purposes and is not a substitute for professional medical advice.