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CPAP causing inner ear issues - help needed
#1
Hi all,

I haven't been here for quite awhile.  When I use my CPAP machine I get ringing in my right ear (tinnitus) and slight vertigo (balance issues) and sometimes get slight nausea. When I go off the CPAP for a couple days the tinnitus nearly all disappears including the other symptoms.  I went to a couple ear/nose/throat specialist and they think maybe the pressure of the CPAP impacting my inner ear. The hearing specialist gave me an article see link and suggested this maybe happening:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896658/
Has this happened to anyone else of this forum, any suggestions to help??. I need to use CPAP but feel i can't when I get these symptoms. Any input would be appreciated.
Cheers
Steve
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#2
G'day Steve - welcome back.

Thanks for sharing that article. There's some interesting reading there but I wonder how common these cases are? Of those cited, three were due to nitrous oxide (ie nothing to do with CPAP), and two were due to the application of pressure during resuscitation. The guy who did damage to himself through "excessive titration" cranked his pressure all the way up to 20 cm H2O. You'd have to ask why he was on a constant high pressure in the first place. Your pressure is quite low by comparison.

I do know from personal experience that yawning can open the Eustachian tubes and cause discomfort in the ears. When that happens to me I have to turn the machine off and swallow a few times to equalise the pressure. Then I'm good to go.

I really don't have any advice to offer here except you could be in a situation where - if the doctors can't come up with a remedy - you might have to decide which is the lesser evil.
DeepBreathing
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#3
(04-16-2018, 08:59 AM)stephennic Wrote: I haven't been here for quite awhile.  When I use my CPAP machine I get ringing in my right ear (tinnitus) and slight vertigo (balance issues) and sometimes get slight nausea. When I go off the CPAP for a couple days the tinnitus nearly all disappears including the other symptoms.  I went to a couple ear/nose/throat specialist and they think maybe the pressure of the CPAP impacting my inner ear. The hearing specialist gave me an article see link and suggested this maybe happening:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896658/
Has this happened to anyone else of this forum, any suggestions to help??. I need to use CPAP but feel i can't when I get these symptoms. Any input would be appreciated.

Interesting article and I have bookmarked it for future reference. I have noticed one effect since I started CPAP treatment almost 4 weeks ago. That is that I feel fine when I wake up, shave, and shower. Then by the time I get downstairs and have started the coffee and sit down, I feel a slight numbness, but not really dizzy feeling. I am on blood pressure medications and if I stand up too quickly I can feel slightly dizzy (orthostatic hypertension). It is kind of like that but more sustained and not as severe. With your article I will monitor this to see if it gets worse.

As for suggestions, about all I got out of this article is that it can happen, and they blamed it on "excessive" treatment pressure up to 20 cm. However the reality is that many sufferers from apnea go up to that pressure range, and perhaps higher to 25 cm with a BiPAP. It makes me wonder how frequently this really happens. In any case it seems to me you want to stay in contact with the specialist, and look for opportunities to treat the apnea without using excessive pressure. Perhaps allow a few more apnea events, instead of running as high a maximum pressure?
Helpful Links:
Beginner Guide to SleepyHead - How to download and use SleepyHead to view your detailed CPAP Data
SleepyHead Chart Optimization - How to organize your SleepHead screen to make it more useful to view
Posting SleepyHead Data - How to post your SleepyHead screen shots to get help from others here
Adjust your own CPAP Settings - How to get into the Clinical Menus and adjust your own CPAP pressures and settings
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#4
I've experienced the same as DeepBreathing mentioned, as in I yawned while in a mask on situation. I don't recall that I turned off my ASV to equalize inner and outer ear pressure.

Coffee
Dave

Even a 1,000 mile trip requires a first step. My recommended first steps are getting good shoes and 2 cups o coffee

Wiki Info for Beginners
Sleepyhead Chart Organization
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#5
I have vertigo (BPPV) which was dormant until I started my CPAP therapy in Feb 2018. Symptoms like dizziness and headaches when I got up the am. It took a few days to a week for the symptoms to settle down. My vertigo was triggered again when my sleep tech adjusted my pressure range of 10-16 to 12-18. After a couple of nights, I dropped the minimum pressure back to 10 cm h2o which helped alleviate my dizziness and headaches.

Dave
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#6
I see you posted this on the other message boards... hope you find answers .. I too have similar issues.. best luck to you.
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#7
I haven't had those exact symptoms, but I have had a lot of ear issues since starting CPAP.

For me, what has helped the most has been to lower the amount of EPAP support. That constant changing of pressures (from exhaling, to inhaling, to exhaling, to inhaling, etc.) is too much for my ears.
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