Whether your adversary is a noisy heater, a busy street, a roommate’s TV, or standard insomnia, earplugs have always been an innocuous go-to for the sleep-hungry. They’re not meds, they’re not vitamins, they’re not patches, they’re not hi-tech blankets. In fact, as cures for insomnia go, earplugs are kind of no-tech: they’re just bits of molded rubber that are mashed into the ears. It’s not far from putting your fingers in your ears when someone’s trying to spoil the Game of Thrones episode you missed. Harmless, right?

Well, not quite. Earplugs carry a few little-known risks that can have a big impact on your health, especially if you use them every night. But with the right remedies and a little foresight, you can continue to (safely!) tune out the world and tune into dreamland.

Impacted Ear Wax

You may not even know it, but ear wax drains from your ears on a daily basis. That’s sort of its purpose: ear wax is produced by hair follicles and glands within the ear in order to trap bacteria, germs, or anything else that might happen to make its way into your inner ear. It then leaves your ear, bringing the unwelcome substances with it.

Normally, the wax (proper name: “cerumen”) dries and falls out of the ear on its own, but when ear wax is compressed by earplugs or Q-tips and is pushed deep into the ear canal, you can wind up with hardened, impacted ear wax.

That’s bad. Impacted ear wax can cause worsened hearing, dizziness, itching, and ear pain—and in extreme cases, it can lead to a perforated eardrum or…

Ear Infections

Bacteria thrive in warm, moist places. Plugging your natural wax outlet for eight hours per day prevents the wax from leaving your ear, but it also traps the bacteria and germs that the cerumen has dutifully caught. This can cause inflammation of the external ear canal or the middle ear canal, which in some cases leads to rupturing the eardrum and even hearing loss. In extreme cases, an ear infection can even spread to the sinuses, causing conditions like meningitis, cerebral abscess, or fistula, which causes vertigo.

With all that said, we’re talking about extreme situations that usually manifest symptoms long before any serious, long-term damage takes place. You’re more likely to get an ear infection from swimming in dirty water than from earplugs, and if you aren’t wearing the earplugs every night, you have even less to worry about.

If you want to be as certain as possible that your ear wax is draining properly, you may want to consider over-the-counter wax softening drops like Debrox or Murine. Regular earplug usage also demands good hygiene, so if you’re plugging on the daily (are we cool enough to say this?)wash them with lukewarm water and soap to minimize your risk.

If even the scant possibility of impacted, infected ear wax gives you the heeby-jeebies, consider trying a white noise machine to drown out background sounds and cure your insomnia. And if you’d like to throw caution to the wind and use earplugs that play white noise, you’ve got options there as well!

So is it safe to sleep with earplugs?

Ultimately, the risk of problems from responsible earplug usage is too low to recommend not using them at all, but if you experience a severe loss of balance, ringing in the ears (tinnitus), hearing loss, or vomiting, high tail it to a doctor and reconsider your earplug habit.