Getting enough sleep is crucial when you have Ménière's disease. The immune system only works properly when we sleep, so healing and regeneration of the inner ear won’t happen if we aren’t getting enough quality sleep.

Sleep deprivation and the stress it puts on the body can trigger attacks and exacerbate symptoms. Poor sleep also increases our stress hormones, spikes blood sugar and increases inflammation (believed to be the root cause of Ménière's and autoimmunity).

It comes as no surprise then, that sleep disorders are much more common in those with Ménière's (ref). Certainly in clinic, most clients I see struggle with sleeping well to some extent. If you have Ménière's, or another autoimmune condition you should aim for 8-9 hours of quality sleep a night. But you may need more initially if you are severely sleep deprived.

Sleep hygiene is the first step towards recovery from Ménière's. Here are 5 ways to achieve it:-

5 sleep hygiene tips

1. Total darkness

Light and dark determine our circadian rhythm, the bodies internal body clock which tells us when to sleep. For this reason, our bodies are incredibly sensitive to light, particularly at night.

For total darkness try using a sleep mask or ideally fit blackout blinds or thick curtains. Use velcro if necessary to ensure blinds are fitted close to the wall.

2. No devices 90 minutes before bed

Looking at your phone, iPad or laptop before bed is the equivalent to looking at the sun. This is because the blue light they emit sends a message to the pineal gland in the brain telling it to stop making melatonin, the sleep hormone.

Ideally, switch your device off 90 minutes before bed and leave it downstairs when you go to bed. Most smartphones now also have a ‘night shift’ function which allows you to shift the colour spectrum away from blue light towards warmer red tones which have less of an effect on melatonin.

TV also emits blue light, but this is less damaging as we sit further away. Ideally turn the TV off 30 minutes before bed.

3. Caffeine before noon

Caffeine reduces the time we sleep, our quality of sleep and increases the time it takes to fall asleep. It can also cause us to wake up at night needing the toilet. Caffeine reduction is also beneficial in Ménière's as caffeine can affect the endolymph and increase stress and anxiety which can also trigger Ménière's attacks. Ideally, keep caffeine to before noon.

4. Create a bedtime routine

Adults are no different to children. Having a bedtime routine that you use most nights helps the body wind down naturally for sleep. For example:

Noon - Stop drinking caffeine
9.30 pm - Devices off
10.30 pm - TV off and do something relaxing - stretching, meditation, bath or shower, read next to a dim light.
11 pm - Lights out - Try setting an alarm to remind you to go to bed

Going to bed and waking up at the same time each day also helps re-set our circadian rhythm. For this reason, if you need to catch up on sleep it’s far better to have a quick nap later in the day, rather than sleeping late in the morning.

5. Contain worries

It’s easy to find yourself worrying when you have Ménière's. Anxiety can also cause attacks and disrupt sleep so take steps to reduce worries before bed.

For example, avoid the evening news or difficult conversations at night. Instead, a relaxing book, bath or shower, deep breathing or short meditation before bed can do the trick. Research shows practicing gratitude each night can help us feel less anxious, making sleep easier to come by. Simply write down 5 things that you are grateful for before going to bed each night.

References:

Bruderer, Bodmer, Stohler, Jick, Meier. Population-Based Study on the Epidemiology of Ménière's Disease. Audiology & Neurotology. 2017;22(2):74-82.

Kim, Jeon, Hong. Relationship between sleep quality and dizziness. 2018. PloS One2018 Mar 7;13(3):e0192705.

Sharon, Trevino, Schubert, Carey. Treatment of Menière's Disease. Current Treatment options in neurology. 2015 Apr;17(4):341

Yeo, White, Ronan, Whinney, Curnow, Tyrrell. Stress and Unusual Events Exacerbate Symptoms in Menière's Disease: A Longitudinal Study. 2018