Hearing management

Updated 29 November 2017

Is it bad to sleep with earplugs all the time?

Can wearing earplugs too often cause tinnitus, infection, or headaches? Let's look at the facts.

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“Never put anything smaller than your elbow into your ear” is something we’ve been wisely cautioned against at some stage or another. But more of us are ignoring this advice.

Bothersome sounds

We use in-the-ear-headphones to listen to music, car keys and hair pins to scratch that particularly unpleasant itch, and hearing aids to enable better communication.

Many of us also use disposable foam earplugs to protect our ears against damaging noises in the workplace, or to block the noise of snoring partners, loud traffic outside bedroom windows, dogs barking and any other bothersome sounds that prevent a good night’s sleep.

If you regularly use earplugs to sleep, can it cause damage? On the internet, people ask whether doing so can cause tinnitus, ear infections or ear pain. Can regular earplug use cause wax or pressure build-up in the head? Can it cause headaches?

The facts about wax

To answer these questions, I should first explain a few things about ear wax.

Wax is good for the ear but too much can be bad for you. Wax comes from small glands in the outer part of the ear. It starts off looking like honey but the longer it stays in the ear, the darker and harder it gets as it traps dirt, grit and gunk.

Normally the wax will be “walked” out of the ear by its self-cleaning mechanism. Anything that slows down or reverses this mechanism can cause wax to build-up. Unfortunately, anything smaller than your elbow can do this, sleeping plugs included. But everyone’s ears are affected differently.

An ear full of wax works like a built-in ear plug – great for sleeping, but if it ends up resting on the eardrum, it can cause discomfort and sometimes tinnitus.

Most of the problems people associate with earplugs are actually due to too much wax in the ears, although the wax may be caused by being a consistent earplug user.

If you are a consistent user and think you may have too much wax, ask your doctor to check inside your ear. Or better still, make an appointment to see your local audiologist. They may have a camera that can show you how much wax actually is inside your ear and whether something should be done about it.

A good night’s sleep

A good night’s sleep has many health benefits, and sleeping poorly can have follow-on issues such as concentration and memory problems.

Studies have demonstrated the benefit of sleeping aids such as ear plugs and eye masks in improving sleep for patients in hospitals. In fact, the studies show the aids can reduce the need for sleeping medications.

But as with anything you wear while sleeping, comfort is crucial. So it’s important to insert the plug correctly.

Ideally, you should roll the foam plug into a skinny cylinder and then insert it deep into your ear, holding it in place until it expands (see video). If it doesn’t fall out in the night and you experience no discomfort, then everything's good!

If you can’t put it in without discomfort or it comes out with dark wax over the end, or if you feel there is a build-up of pressure in the ear, then see your doctor or audiologist. They may suggest other options if you need more silence while sleeping.

In terms of allergies, there has only been one reported case of an allergic reaction to the material foam earplugs are made of.

It is also very unlikely you will develop pressure sores. And only one paper published in the last 20 years has described certain types of earplugs (mainly silicone) breaking apart in the ear canal and requiring specialist removal.

Discard the plug

It is a good idea to discard the plugs once they start to discolour. As wax builds up on the surface, earplugs become stickier and can transfer bacteria from your fingers into your ears.

Never put saliva on earplugs to lubricate the surface so they slide in easier. You have more bacteria in your mouth than your bottom, so the last thing you want is to introduce these to your ear.

Doing so will increase the risk of developing an infection in the ear canal which can cause inflammation and affect your hearing until the infection is treated.

If foam plugs are a problem, then you can get custom-made ear plugs. They are made specifically for your ears out of a soft medical-grade silicone that is easy to clean and does not fall apart in the ear.

Custom plugs are more expensive than disposable ones, but they can work out cheaper in the long term when it comes to your health being affected by poor sleep.

Some people complain about being overly distracted by noises in general which can be even worse when they try to sleep. There may be other issues underlying this sensitivity. Rather than blocking out the sound, sometimes introducing other more pleasant sounds (like the sound of a fan or the ocean) can help distract the mind.

If you’re putting earplugs in correctly and not experiencing any discomfort, you should be able to rest easy that you are doing all you can to achieve a better night’s sleep.

Read more:

SEE: 7 noises that can cause permanent hearing loss

The strangest things found in people's ears

How a doctor would remove your earwax

Dominic Peter Power, Honorary, Audiology and Speech Pathology, University of Melbourne

This article was originally published on The Conversation. Read the original article.

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Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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