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home : columns : ask the doctors June 19, 2019

3/25/2019 7:51:00 AM
Earplugs grant better sleep, but are not without risks

Dear Doctor: I'm a 38-year-old man, and because I live in a loud environment, I've used soft foam earplugs at night for the past three years. Are they safe to wear for extended periods of time? I've lost half the hearing in my right ear and wonder if it could be from wearing earplugs for so long.

Dear Reader: Sleeping in a noisy environment is not only a challenge, but it also affects the quality of the sleep that you manage to get. Sleep is a complex process with multiple stages, each of them equally important. Not only does uninterrupted sleep help you feel rested, but research has shown the quality of the sleep we get affects our physical and mental health as well. A report issued by the Institute of Medicine Committee on Sleep Medicine and Research found that the length and quality of sleep played a role in a wide range of conditions, including hypertension, diabetes, depression, obesity and cardiovascular disease.

Earplugs can be an effective way to deal with a variety of sounds that interrupt sleep. They form a seal around the entrance to the ear canal and physically block the vibrations that would otherwise reach the eardrum and get sent to the brain to be interpreted as sound. Unfortunately, when earplugs are used incorrectly, they can lead to damage to the ears or to hearing.

One of those risks is related to earwax, a waxy oil known as cerumen. It's produced by glands in our ears and naturally finds its way into and out of the ear canal over the course of the day and night. Earwax protects the skin within the ear canal, has a role in cleaning and lubrication, and serves as a protective barrier against moisture, dust, bacteria, fungi and other unwelcome substances. Long-term use of earplugs can interfere with the self-cleaning flow of earwax; rather than letting it drain, it can result in a buildup. This can lead to tinnitus, which is ringing in the ears, or even to hearing loss. A health care professional can use a device known as an otoscope to look deep into the ear to check whether the ear canal is blocked. He or she will then remove the excess earwax by first softening it with warm water or a special solution, followed by gentle manual extraction.

Another potential risk is infection due to bacterial buildup on the earplug's surface, which then gets transferred into the ear canal. This can occur when the same pair of earplugs is used repeatedly and can lead to hearing loss. The best way to avoid problems is to be vigilant about practicing earplug hygiene. Pre-molded earplugs, which are reusable, must be cleaned daily. Foam earplugs should be discarded regularly -- daily if at all possible. It's important to store any earplugs in a ventilated case to prevent bacterial buildup due to moisture.

Reusable earplugs can be uncomfortable for sleeping, and disposables may not be in everyone's budget. In those cases, consider over-the-ear protection, like noise-canceling ear muffs, which reduce sound without touching the ear canal.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.

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