• Site Supporter

Long term problems with Cpap therapy and inner ear problems

This area is for Sleep Apnea questions and general Sleep Apnea Discussions.


Hearing lose, dizzyness, and fluid on the ears

Postby nlsndenny » Tue Sep 08, 2009 6:05 pm

I have experienced all of these and blamed it on the c-pap but don't know what to do. My family doctor gave me medicine for fluid on the ears and it didn't work. Then he gave me a stronger medicine and it didn't work. Any ideas??? I have never had any problems before the c-pap. The problem started shortly after using the c-pap.
nlsndenny
 
Posts: 1
Joined: Tue Sep 08, 2009 5:58 pm

Tinitus and CPAP

Postby Laurbrad » Sat Feb 19, 2011 8:14 pm

I have used a RESMED CPAP for 1.5 years. 6 months ago I developed tinnitus in both ears. It gradually worsened over the course of a week and then lessened. At it's worst point it felt like I was under water. This has been transitory, occurring 5 times since. I had an MRI and have discussed this with an ENT. He was sure that the CPAP was not the cause of the hearing loss but had no other rationale for the cause. I now live with moderate ringing on a regular basis and hope for this to stop. Quite frustrating.
Laurbrad
 
Posts: 1
Joined: Sat Feb 19, 2011 4:50 pm

Postby Mrs Rip Van Winkle » Sat Feb 19, 2011 9:17 pm

I find my issues are worse when I use my nasal pillows. with the full face mask..set at a higher humidity I find my ear issues less of a problem.
I'm only a sufferer, not a medical pro. What I post are my thoughts as a sufferer, not that of the ASAA. As a moderator on these forums I oversee the posting rules. This is the internet, always discuss what you read with your medical team.
User avatar
Mrs Rip Van Winkle
 
Posts: 4246
Joined: Thu Jun 08, 2006 11:54 am
Location: Nature Coast, Florida
Machine: M Series Auto BiPAP
Mask: Masks Vary
Humidifier: Yes

Postby MyOwnSunshine » Sun Feb 20, 2011 11:32 am

I wonder if everyone's ear issues are more the result of their nasopharyngeal anatomy, which contributes to their apnea, as opposed to their CPAP machine. The reason I say this is that in the past few years I began experiencing the ear issues everyone is describing: inability to "pop" ears in response to changing pressure, tinnitus, vertigo, "clogged head" feeling and slight hearing loss. I even had tubes inserted last year, which worked while they were in and open, but now that they're out, my ears are acting up again.

After hearing of others with this issue, I suspect that whatever causes our airways to relax/collapse also contributes to our eustachian tubes collapsing and being obstructed.

I was just diagnosed with OSA and haven't received my CPAP yet.

Jami
MyOwnSunshine
 
Posts: 11
Joined: Sat Feb 12, 2011 6:28 pm

Tinnitus

Postby AngieKat » Sat May 21, 2011 9:53 am

Hello,

I'm new here. I did a search on google for CPAP tinnitus and it led me to this thread.

My history: I have been sleeping with ear plugs for 20 years. I am a very light sleeper and the slightest whisper will wake me up. I have also suffered from tinnitus since childhood. Ten years ago I suffered a 'bout of strep throat which migrated to my right eustachian tube and I've had problems with that ever since. And sleeping with earplugs seems to make it worse, stuffiness, pain, irritation. I continue to sleep with the earplugs because without them it takes hours to fall asleep and as I said before, I am awakened by noise very easily. I wake up with itchy ears which I attribute to the earplugs. I first read that my ear canals may need lubrication as the ear plugs wipe out the ear wax, plus I'm always using q-tips to scratch inside my ear canals (I know I shouldn't but sometimes I can't help it). Then I read it may be a fungus in my ear canal due to overuse of earplugs. I wear them when I read, to block out the noises in the house like the squawking bird, barking dog, bickering kids, neighbors yard equipment, etc.... So I started using tea tree oil and lavender oil. The drops seem to take the itching away for the day so I suppose I must develop a consistency when using them and not just wait until the itching starts again. I am also renewing my Flonase prescription today for the post nasal drip that contributes to the ear issues.

I was diagnosed with restricted air flow-not sleep apnea (because I couldn't sleep during the sleep test, even with Ambien) in Jan '11. Fortunately, that was enough to prescribe CPAP with my insurance. I've been using CPAP for 2 months now and although I am sleeping better because of it, I have been noticing louder tinnitus. I used to be able to ignore it for the most part but now it's so loud I can't ignore it, at least not upon waking. It seems worse in the morning on nights that I sleep well with CPAP as I'm still adjusting to the whole new set-up and don't always sleep continuously through the night. I have also continued getting migraines though it was hoped that CPAP would eliminate those. So my main problems are the headaches and the tinnitus. It is discouraging to read that CPAP may be the reason and that no one has really gotten distinct answers or help. I too am tired of multiple trips to the doctors and the charges that come with them, especially when you are no better off after you leave. And I am not particularly fond of my sleep doctor. I know this is terrible to say(don't want to offend the deaf) but sometimes I get so frustrated with all the noise I wish I could turn my ears off.

I suppose it's a toss-up now...get sleep using CPAP and earplugs, but suffer louder tinnitus, headaches and constant ear issues, or sleep without them, still get headaches, keep others awake with my snoring, get very little accomplished in life due to the extreme fatigue then get depressed.

I appreciate a place to vent my complaints.

Angela
AngieKat
 
Posts: 2
Joined: Sat May 21, 2011 9:05 am

Re: Hearing lose, dizzyness, and fluid on the ears

Postby Todzo » Sat May 21, 2011 11:11 am

nlsndenny wrote:I have experienced all of these and blamed it on the c-pap but don't know what to do. My family doctor gave me medicine for fluid on the ears and it didn't work. Then he gave me a stronger medicine and it didn't work. Any ideas??? I have never had any problems before the c-pap. The problem started shortly after using the c-pap.


Hi nlsndenny!

First I think I would check out the effectiveness of the CPAP therapy. I have and use the software that captures the data from my machines SD memory card and produces reports. If my therapy does not seem to be working well, and from time to time I look at these reports. Using this kind of information I was able to find out that I did have a problem. Looking a bit further at myself I used a small camera to take pictures of the back of my throat which reveled inflammation. More research determined that stomach juices getting up into my airway passage likely caused the inflammation and raising the head of my bed a couple of inches cured that particular problem. My ears also seemed to open up and work considerably better.

Sleep apnea tends to thicken ones blood. What they think happens is that the body produces more blood cells to maximize oxygen transport. Since the blood is thicker its moving about in the very small vessels of the inner ear is harder. Beyond keeping my CPAP therapy working well, I do cardiovascular exercise, eat blood thinning and/or circulation helping foods, and work hard to keep hydrated to help with this.

May we hear many beautiful things!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
Todzo
 
Posts: 685
Joined: Tue Jul 15, 2008 6:41 am
Location: Seattle, WA

Re: Tinnitus

Postby robysue » Sat May 21, 2011 12:34 pm

AngieKat,

First, there are many, many causes of tinnitus, most of which seem to have little or no "medical" significance in the sense of your overall health. The biggest cause of tinnitus in the US is repeated exposure to loud noises by the way. And noises loud enough to cause problems with tinnitus may not strike people as being "Loud" because we are so accustomed to a rather loud background noise environment---particularly if we live in a urban area.

I've had tinnitus for years. And migraines. And in the last few years, I've developed vertigo, which has now been diagnosed as "migraine related vertigo." So the things that I say below are simply based on my own experiences and they may or may not work for you. But I offer them as things you might try.

My history: I have been sleeping with ear plugs for 20 years. I am a very light sleeper and the slightest whisper will wake me up. I have also suffered from tinnitus since childhood. Ten years ago I suffered a 'bout of strep throat which migrated to my right eustachian tube and I've had problems with that ever since. And sleeping with earplugs seems to make it worse, stuffiness, pain, irritation.

Earplugs definitely are the reason your tinnitus is worse when you've got the earplugs in you ears. Here's why: Tinnitus is essentially caused by your middle and inner ear and brain deciding there is NOISE present, when in fact there is no noise present. It is often there (in the background) ALL the time, but as long as there is REAL noise, the brain filters out the tinnitus---i.e. the tinnitus fades into the background and is not as noticeable. But when you put the earplugs in, you block out all the REAL noise and hence there is nothing the brain can use to filter out the tinnitus. So the tinnitus is interpreted by the brain as REAL noise and it becomes very noticeable---sometimes to the point of being painfully loud for some folks.

The standard "treatment" for tinnitus is "Avoid ABSOLUTE silence". Literally---avoid silence. Many tinnitus sufferers find that having some low volume white noise ALWAYS present in the background is all that's needed to take the edge off the tinnitus. So you might want to try a white noise machine both during the day AND at night when you are trying to get to sleep. It's important, however, to realize that the VOLUME of the white noise needs to be very soft: You do NOT want to turn the volume up so that it seems louder than the tinnitus---that too will likely make the tinnitus worse because LOUD noises damage the middle and inner ear and are a frequent cause of tinnitus. Rather, you want the white noise volume to be very quiet---quieter than the tinnitus actually. But just that wee bit of white noise at a barely audible level lets the brain start filtering out the tinnitus----i.e. "ignoring it" because there is some real noise competing with the tinnitus.

Nature sounds cds by the way are very useful for trying to deal with tinnitus. As are very quiet fans---if the airflow bothers you point the fan so that it doesn't blow directly on you. An AM radio turned on to a part of the band where there is NO station can also be used---if the volume is kept really, really low---just barely on the threshold of your hearing. If you must use music, the volume has to be VERY, VERY low---again just barely on the threshold of you hearing.

Now I know this idea of using white noise to fight the tinnitus SOUNDS counter intuitive to you because you go on to write:
I continue to sleep with the earplugs because without them it takes hours to fall asleep and as I said before, I am awakened by noise very easily.
So the questions that I have are these:
  • What kinds of noises are present in your sleeping environment on a REGULAR basis?
  • Other than earplugs what have you attempted to do in order to muffle or block out the noises that are particularly irritating?
  • Are you sure the tinnitus itself is not what's waking you up?
I ask because I really think you need to start weaning yourself from using the earplugs every night and sometimes during the day when you are NOT being exposed to loud noises.

So where would I start if I were you? Well, first I'd start by trying some white noise CD's and making sure that the windows are CLOSED at night. Heavy drapes and a decent rug will also help muffle the level of noise in your bedroom. Shut the door to the bedroom to minimize hearing creaks from the rest of your house or apartment at night.

Then I'd tackle the "it takes hours to fall asleep without earplugs" problem.
  • First: Go to bed ONLY when you are SLEEPY and learn to distinguish being sleepy from being tired or exhausted.
  • Second, make sure you CANNOT see the clock when you are in bed. You can start by simply turning the clock so it faces the other way. But if you find you keep turning it around to look at it because you feel like you've been lying awake for hours, you will need to move the clock away from the bed so you can't keep looking at the clock---that "look at the clock" behavior pattern FEEDS the problem with falling asleep in a timely fashion.
  • Third, when you think you've been lying in bed for more than 30 minutes and it's clear you are no longer sleepy enough to get to sleep soon, get out of the bed and do something soothing and relaxing in a DIFFERENT room for a few minutes until you start to feel sleepy again. It might help to do a bit of (light, boring) reading. Or maybe a nice cup of of warm milk or an herbal "sleepy time tea" will help. But don't get on the computer and web browse. And don't watch TV. I find listening to quiet music in my living room in the semi-dark helps.
  • Fourth, kick the electronic gadgets out of the bedroom. That means "no tv, no computer, no cell phone accessible from the bed, etc." You want to reserve your bed for sleep and nothing but sleep (and sex).

I wake up with itchy ears which I attribute to the earplugs. I first read that my ear canals may need lubrication as the ear plugs wipe out the ear wax, plus I'm always using q-tips to scratch inside my ear canals (I know I shouldn't but sometimes I can't help it). Then I read it may be a fungus in my ear canal due to overuse of earplugs. I wear them when I read, to block out the noises in the house like the squawking bird, barking dog, bickering kids, neighbors yard equipment, etc.... So I started using tea tree oil and lavender oil. The drops seem to take the itching away for the day so I suppose I must develop a consistency when using them and not just wait until the itching starts again.
All this points to overuse of the earplugs in my opinion. If you are worried about a fungal infection in you ears or excess wax and itching, you NEED to get to an ENT to discuss proper ear hygiene.

Also using the earplugs to block common background noises like "squawking birds, barking dogs, bickering kids, neighbors yard equipment" MAKES the tinnitus much, much WORSE. That is as long as these "blocked" noises are NOT right outside your window or in the very next room. And if it's difficult to concentrate with these common background noises, that's where the soft, white noise of your choice always being present in the background comes in: Use it to distract yourself from the irritating noises rather than trying to create pure silence through the earplugs. Remember: Complete and total silence makes the tinnitus WORSE by making it IMPOSSIBLE to ignore!

I am also renewing my Flonase prescription today for the post nasal drip that contributes to the ear issues.
In addition to the Flonase, you might also want to start using a neti pot or NeilMed Sinus Rinse Bottle once or twice a day to help clear those sinuses out. Neti pots and the Sinus Rinse Bottles really do work in reducing congestion substantially and they are nowhere near as uncomfortable as you might think they are.

I was diagnosed with restricted air flow-not sleep apnea (because I couldn't sleep during the sleep test, even with Ambien) in Jan '11. Fortunately, that was enough to prescribe CPAP with my insurance. I've been using CPAP for 2 months now and although I am sleeping better because of it, I have been noticing louder tinnitus. I used to be able to ignore it for the most part but now it's so loud I can't ignore it, at least not upon waking. It seems worse in the morning on nights that I sleep well with CPAP as I'm still adjusting to the whole new set-up and don't always sleep continuously through the night.
Please be aware of this (not very welcome) fact too: You may be noticing the CPAP noise and the sound of your own breathing and thinking of those as tinnitus since you are sleeping with earplugs every night. The reason is this: Most of the noise of the machine itself is conducted through the hose and the sound of your breathing is often amplified by the mask and the hose and is also then conducted through the hose. The earplugs cannot block this conducted noise: It gets into your middle and inner ears by traveling through the hose and your bedcovers and pillows and then into your head through your skull. Because the ambient noise conducted through the air has been blocked by the earplugs, the only REAL noise being detected by your ears is the conducted noise. And it can seem incredibly loud when you're lying there in bed trying to get to sleep.

The ONLY fix for this conducted noise problem is to ditch the earplugs and have some benign, neutral or pleasant white noise in the background that is barely audible. For me, I find that I have to use my iPod: I have it in an iHome (so I don't have to wear earphones or earbuds) and I play a playlist consisting of Gregorian chants by monks all night long. (When I had it on a timer, I'd wake up once the music STOPPED.) The trick is I have the volume very, very low and all the Gregorian chants sound enough alike that I can't pick out where in the playlist the iPod is when I wake up at night. Because the chants are in Latin I also can't focus or start "singing along" in my head when I'm first getting to sleep at night.

I have also continued getting migraines though it was hoped that CPAP would eliminate those. So my main problems are the headaches and the tinnitus.
As I said at the beginning, I'm a life long sufferer of migraines and tinnitus. In my case both conditions long predate my estimated onset of my OSA. And I don't believe my OSA had anything to do with my developing these conditions.

It is discouraging to read that CPAP may be the reason and that no one has really gotten distinct answers or help.
While I think CPAP pressure CAN aggravate the ears via the eustachian tubes and cause ear pain, I'm not sure that CPAP itself is the reason you are noticing migraines more. Or rather, I should say this: In my own case, loud noises and over stimulation in general can trigger migraines. And in the early going I certainly had more than my fair share of sleepless nights with the accompanying stress induced tension headache and the occasional migraine headache. I don't think I ever recall the CPAP triggering a migraine, but if I had a migraine already going when I went to bed, the CPAP would certainly aggravate the migraine---sometimes significantly. Are you under medical treatment for your migraines? If not, you might want to ask your PCP for a referral to a neurologist that specializes in headaches. There are things that can be done for migraine headaches. If they are very frequent (two or three times a week) or very severe and disabling when they occur, there are prescription medicines that can help. But they must be taken exactly as prescribed, or the headaches can get worse instead of better.

As far as the tinnitus is concerned: Again, I think if you would ditch the earplugs at night, the tinnitus would likely become much more tolerable and in time you might even not notice it on a day-to-day basis. But as long as you are blocking out significant amounts of ambient noise in an effort to make the inside of your head seem SILENT, that tinnitus is going to continue to get worse, not better.

And I also think conducted noise from the hose is aggravating the tinnitus and possibly the headaches. And the earplugs are the major reason you'd be hearing the conducted noise.

I too am tired of multiple trips to the doctors and the charges that come with them, especially when you are no better off after you leave. And I am not particularly fond of my sleep doctor.
I know how you feel about multiple trips to the doctors without feeling like you have gotten anything out of them. Since August 2010, I've been to doctors (PCP, ENT, neurologist, sleep doctor, etc) for a grand total of 20+ times, not counting 4 sleep tests, an MRI, a CAT scan, and two rounds of vertigo testing. With very little to show for it in terms of making me feel better.

But if you are not fond of the sleep doctor, you might want to get a referral to a different one.

I know this is terrible to say(don't want to offend the deaf) but sometimes I get so frustrated with all the noise I wish I could turn my ears off.
Are you aware that MANY deaf people complain BITTERLY about the tinnitus they live with on a CONSTANT basis? As I said, the silence you crave and are trying to acheive through the use of earplugs is making the tinnitus WORSE, not better.

I suppose it's a toss-up now...get sleep using CPAP and earplugs, but suffer louder tinnitus, headaches and constant ear issues, or sleep without them, still get headaches, keep others awake with my snoring, get very little accomplished in life due to the extreme fatigue then get depressed.
In the long run, I think you need to learn how to sleep without the earplugs since I think it's the earplugs that lead to your noticing the conducted noise and tinnitus which are in turn causing problems with your sleep.

The ear problems too may decrease substantially if you manage to wean yourself off the earplugs. It could be that having the earplugs in at night with the CPAP on makes it more difficult for the eardrum and eustachion tubes to work on equalizing the pressures between the inner, middle, and outer ears. Not being able to equalize the pressure is what typically leads to ear pain in a person without a genuine middle ear infection.

And who knows, maybe it was your own snoring that was causing you to wake up to the "slightest" noise pre-CPAP. And in that case, maybe the fact that you are no longer snoring with CPAP will be enough to let you sleep without the earplugs once you are more completely adjusted to the CPAP.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
User avatar
robysue
 
Posts: 1330
Joined: Tue Aug 24, 2010 6:47 pm
Location: Buffalo, NY
Machine: PR System One BiPAP Auto
Mask: Swift FX for Her
Humidifier: System One Heated Humidif
Year Diagnosed: 2010

Postby xenosfrog » Tue May 24, 2011 1:14 pm

What an interesting and educational post Robysue. I was going to post a suggestion for using the earmuffs style hearing protectors to get a break from the earplugs, but that of course would make the tinnitus worse, also, based on the phenomenon you explain. I am glad I didn't post that before your in-depth information. I don't suffer from tinnitus, but I have a hearing impaired friend who does suffer from, I believe moderate tinnitus. I will have to ask him if he uses white noise. I think I remember a fan on in his house alot. Thanks again, Scott.
xenosfrog
 
Posts: 82
Joined: Fri Mar 05, 2010 3:04 pm

Postby AngieKat » Sun Jun 26, 2011 9:57 am

Hello robysue,

Thank you for taking time to reply to my post. I appreciate the effort you put in to addressing my concerns.

I attribute my tinnitus to loud music as a teenager, although my mother had it as well and was a teen in the 40's....don't think loud music caused hers....maybe all the bombing from WW2 (she lived in London at the time). She is no longer alive so I can't ask her what she believes brought it on. I wonder of I have a genetic predisposition to it? I understand that my tinnitus is louder with earplugs in and it's more noticeable in silence, but I'm talking about when I'm just going about my day when I have no earplugs in. The onset of this higher volume tinnitus upon waking and taking my plugs out and throughout my day definately coincided with my nightly CPAP usage. I suppose it could be the sounds of the machine coming up through the hose and the air flow causing this increase in my tinnitus during the waking hours.. And maybe the earplugs exacerbate the situtation in combination with the CPAP. I used to be able to ignore the tinnitus fairly well at anytime day or night, earplugs in or not, rarely noticing it unless I focused on it. It screams in my head for attention now as I go about doing dishes for instance and the radio is on, times when it didn't bother me much before. Fortunately, I can still manage to ignore it most of the time.

I have desired to ditch the earplugs for a long time now. It's just so very difficult since I'm dependent on them helping me sleep. It's not the tinnitus waking me up...it's the collapsing of my throat which leads to my own snoring, or my husband's snoring. Or just his breathing sometimes. I can hear the cat walk into the room. The dog barking down the street, the frog in the irrigation ditch...these are the sounds that keep me awake, not the tinnitus in my head. I can sleep with that believe it or not. Last night I had to ditch the earplug in my right ear, though. I am experiencing pain in it and am planning on visiting another doctor this week. My sleeping conditions are pretty close to what you describe: very dark room, cool, no clocks on my side, have a bean bag to cover the lights on the CPAP machine, humidifier. We have a tv in there but rarely watch it and never before bed. There is a phone on my side and an alarm clock on my husband's side. I've tried fans for white noise but often get irritated with the inevitable rattling of the screws or motor or plastic. I had an air-conditioner in my room as a child and had about 15 tissues stuck in the air flow directional blades to stop the rattling. I'm just hyper-sensitive to noise. Yes, I've been desiring a white noise machine. Hopefully, my husband will be okay with it on all night. I think I'll get one today! Gotta do something to block out the noise besides earplugs.

Besides the increased volume of my tinnitus during the waking hours, I am only having issues with the right ear...always have since I developed Strep throat and it migrated to my right ear about 12 years ago. I went to an ENT years ago at the suggestion of my GP after experiencing continual problems even after the Strep infection cleared up, but he was a major disappointment. Seriously, he was more interested in impressing his protege with his knowledge then figuring out my problem and promptly (and I might add, erroneously) diagnosed me with TMJ and wouldn't give me a moment when I asked him why I could hear "swooshing" in only my right ear when I blinked. The protege looked at me with interest but the doctor just dismissed me. I also hear the the fluttering or swooshing when a piece of silverware is dropped or dishes bang against each other, or my daughter plays piano or I read out loud to my girls. I've just put up with it all these years. It's so hard to explain what is going on so that a doctor will help me beyond saying it's TMJ or Eustachian Tube disorder. And then again... maybe that is all it is: ETD as a result of the strep infection and there really isn't much they can do. Honestly, I have lost my confidence in the conventional medical system and the doctors that practice by its rules. For years I have tried to convince my doctor that I had hypothyroidism but because my doctor would only go by published official guidelines he said my tests indicated my thyroid was normal, though it runs in the family and I had most of the physical symptoms. Instead he prescribed Provigil to keep me awake and Prozac for my depression. I have finally kicked the Prozac after 9 years and I don't use the Provigil since it gave me headaches as well. I FINALLY went to a naturopathic doctor this past week for my fatigue, depression and she immediately diagnosed low thyroid and gave me meds. I am so thrilled! Anyway, I digress.

That's is for now...

AK
AngieKat
 
Posts: 2
Joined: Sat May 21, 2011 9:05 am

PostThis post was deleted by Daniel on Sat Oct 15, 2011 3:43 pm.
Reason: Posting Guidelines regarding self treatment

Previous


  • Site Supporter

  • Similar topics
    Replies
    Views
    Author

Return to SLEEP APNEA HELP!

Who is online

Users browsing this forum: Google [Bot] and 3 guests

  • Site Supporter