Ear Problems after CPAP trail - How to Recover?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
pj2448
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Ear Problems after CPAP trail - How to Recover?

Post by pj2448 » Sat Jan 29, 2011 8:00 pm

I need help for a friend and just signed up on the forum to ask a question. I've been impressed about everyone's knowledge here and feel someone will have the right information to help out.

I've been on CPAP for a number of years myself and do well with it and never had the problem of ear pain or hearing loss due to therapy. Recently, I heard from a lady friend saying she was offered a one week trial on CPAP for a mild sleep disturbance after a sleep study indicated such. The CPAP trail didn't go so well for her, however. She developed a fullness and partial loss of hearing in her right ear. Her doctor recommended stopping the trial and being evaluated for a dental appliance or other options, but the problem with the ear is still persisting after 9 months and has been affecting her balance too. The balance disorder has been quite a problem for her!

The question I'd like to ask: Has anyone here (who is a regular here) remember being part of any previous thread or discussion on this very same topic? Or, has anyone had this happen to them and been able to sucessfully recover from problem with either medicine or any other remedy? I would be interested in any responses or helpful information in regards to beating the ear disfunction. If you can post the link to the previous discussion that would be very helpful.

I should also say that I not posting to condemn CPAP in any way by the question. CPAP has been good for me and is still the gold standard. But CPAP can bring on un-intended side affects for a small few of those who try it and I'd like to get some help for my friend if at all possible.

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Pugsy
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Re: Ear Problems after CPAP trail - How to Recover?

Post by Pugsy » Sat Jan 29, 2011 8:28 pm

Has your friend seen and ENT doctor regarding this issue? The vertigo and hearing loss? If not, they should.
There are any number of inner ear, middle ear, etc problems that could be the culprit and sometimes the inner ear is so very fragile the least little thing can start some very annoying symptoms.

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Re: Ear Problems after CPAP trail - How to Recover?

Post by robysue » Sun Jan 30, 2011 12:48 am

Tests that an ENT may order to figure out what can or should be done to address vertigo include: the VNG, the Rotational Chair Test, and the VEMP test. The VNG is a panel of several tests and also includes a full evaluation of the patient's hearing and it is the most important of the tests. The VNG also includes a test for BVVP, one of the most common causes of vertigo and one of the ones that is most easily treated.

In addition to seeing an ENT for a full work up on the vertigo and hearing problem, your friend should also ask the ENT about whether she is a candidate for vestibular rehabilitation. This is a process that essentially teaches a person with an vestibular problem caused by a malfunction of the inner ear to learn how to compensate for the weakness.

Although my own veritgo is NOT related to CPAP in any way and, in fact appears to be migraine related, the VNG that I underwent in November revealed a minor right-sided weakness on the caloric test. Although the ENT who ordered the tests while looking for inner and middle ear causes of my vertigo could find no definitive diagnosis of an inner ear problem, he was willing to prescribe a round of vestibular rehabilitation therapy. It seems to be working. But just for full information: Part of vestibular rehabilitation involves triggering vertigo and vertigo-like symptoms under controlled conditions in an effort to re-train the appropriate parts of your brain to appropriately compensate for the bad data coming from the affected inner ear. Not all patients are particularly comfortable with this aspect of vestibular rehabilitation.

Best of luck to your friend.

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pj2448
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Re: Ear Problems after CPAP trail - How to Recover?

Post by pj2448 » Mon Jan 31, 2011 6:14 pm

Thank You both Pugsy and robysue for your response. My friend has been seeing a doctor throughout, but I will ask her specifically what's been done and get back to you.

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avi123
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Re: Ear Problems after CPAP trail - How to Recover?

Post by avi123 » Mon Jan 31, 2011 7:13 pm

[quote="pj2448"]I need help for a friend and just signed up on the forum to ask a question. I've been impressed about everyone's knowledge here and feel someone will have the right information to help out.

The CPAP trail didn't go so well for her, however. She developed a fullness and partial loss of hearing in her right ear. Her doctor recommended stopping the trial and being evaluated for a dental appliance or other options, but the problem with the ear is still persisting after 9 months and has been affecting her balance too. The balance disorder has been quite a problem for her!


Hi, what kind of doctor was it? Was he/she an MD?

If the ear canal is impacted with wax then a regular ENT (preferably MD) could clean it probably by sucking with low vacuum. But most ENTs don't deal with the following.

If the problem has to do with Benign Paroxysmal Positional Vertigo
(BPPV), Tinnitus, Balance while walking, especially in the dark [or try standing still with legs positioned in a straight line, like being tested for DWI by police, and close your eyes for one minute without swaying], loss of hearing, etc. (for all of which I have been treated recently , but not the DWI, successfully), I suggest the following:

Go to:

www. vestibular.org

and look for a local MD or a group that deal with one of these specialties.

Audiologist
Neurotologist
Otologist
Otoneurologist

In the group that I went to they have all of these plus a Sleep Study clinic and they also have physical therapists to do the needed rehabilitation.

Good luck!

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Re: Ear Problems after CPAP trail - How to Recover?

Post by Pugsy » Mon Jan 31, 2011 7:33 pm

The reason I suggested ENT specially is because there are all those very special test they do that regular doctors don't. I will use my husband as an example. Couple of years ago he started experiencing vertigo. Pretty bad vertigo sometimes. Finally got it through his thick head to see the doctor and got referral to ENT specialist. They did some tests including that one in the vertigo chair where the turn you all over the place to try to induce the vertigo. Come to find out there are little "crystal type of rocks" in the inner ear that when they move around the side effect is vertigo. There are some positional exercises that can help reduce the episodes but he still gets it occasionally when he moves quickly into certain positions. While I cannot say that this is what your friend has, in theory it is possible that the CPAP pressure caused some movement with these rocks and they just haven't moved back where they should.

There are also lots of other reasons for vertigo and an ENT guy is really the best choice to go to. Once they have exhausted all their tricks then we start really wondering. Since I didn't know exactly who she has seen then it is so hard to offer any other suggestions.
Short term symptoms we might try some arm chair ideas but not with long term problems until the experts have tried all the tricks that the have in their basket.

I don't know how often CPAP really affects the ears other than it is common to have a bit of pressure feeling initially. It isn't normal for it to continue and my short term suggestions I might make, aren't really the best thing and likely wouldn't help at this stage of the game. If she has only been seeing an MD and maybe getting meds for symptoms, it doesn't address the cause and the cause needs to be found.

I feel for her. Intermittently all my life I have had sudden episodes of vertigo that used to make me vomit for days. I never had it checked out and as time as gone by those times are less frequent and less severe. It is miserable feeling though and she certainly has my sympathy.

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avi123
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Re: Ear Problems after CPAP trail - How to Recover?

Post by avi123 » Mon Jan 31, 2011 7:45 pm

Pugsy, I agree with you. But notice that ordinary Position Vertigo (those ca crystals coming lose in the inner ear) is self limiting, i.e. go away in several days (absorbed in the body), but more could come again later.

See this conversation:

"Vertigo" from a few weeks ago.

or try this link:

viewtopic/t59817/viewtopic.php?f=1&t=59405&p=558105

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Re: Ear Problems after CPAP trail - How to Recover?

Post by Pugsy » Mon Jan 31, 2011 9:28 pm

avi123 wrote:Pugsy, I agree with you. But notice that ordinary Position Vertigo (those ca crystals coming lose in the inner ear) is self limiting, i.e. go away in several days (absorbed in the body), but more could come again later.

See this conversation:

"Vertigo" from a few weeks ago.

or try this link:

viewtopic/t59817/viewtopic.php?f=1&t=59405&p=558105
In my husband's case they never really went away or keep coming back. ENT told him to come back for some of those special things that can be done should the vertigo get worse and get to a point that he can't manage repositioning the rocks himself. For the most part he has managed and getting him to any doctor takes an act of Congress so I let him be a big boy and manage himself. When he whines too much I just ask him if he wants to see the doctor and he immediately "gets better".

Regarding the OP in this thread, I would assume that his friend should have at some time during this 9 month ordeal, seen an ENT but had to ask just in case. You never know. There are just too many inner ear things that can jump up and bite a person to be arm chair diagnosing here if a good ENT hasn't even been tried. It's just to dangerous.
My husband does not have OSA (per him) and I probably would have to agree but I have often wondered given his own history with the "rocks in his head" if the pressures with CPAP would make his symptoms worse. Me just being curious since I also have intermittent vertigo but my CPAP does not make it worse. Don't think mine is the rocks in the head though because it started when I was 15 and positional issues do not present themselves. I can't get him to hook up just to satisfy my curiosity though. Spoil sport.

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Re: Ear Problems after CPAP trail - How to Recover?

Post by Sundowner63 » Thu Feb 03, 2011 5:11 pm

I find this discussion very interesting. I started using a CPAP in the summer of 2008 and at two weeks after using it my left ear started ringing. I was sent to hearing tests and found i lost some high frequency hearing and also some low frequency hearing. So then I was sent to have an MRI and that showed everything as normal and no visible growths.
Of course the doctor says that it cannot be from air pressure.
I have had episodes of when I use it and also suspect a viral infection my eardrum feels as if it is going to burst.
Had also when I laid down under the car to change the oil and rolled my head around an immediate onset of nausea and sweats.
Fortunately after getting myself out from under the car and sitting upright and also laying down on the couch (in other words stopping head movement) it subsided.
I feel that with so many people having hearing loss and the coincidence of it coinciding with CPAP use that we will someday see evidence supporting our suspicions and a resulting class action law suit.
I am surprised that this hasn't been jumped on by some lawyer by now.

I am tired of the same answer from the doctor and am going to try other things and getting another opinion.
The pillar procedure interests me as I have only moderate RDI.
But my ear ringing is getting unbearable and I want to prevent any problems with my right ear.
Dan

pj2448
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Re: Ear Problems after CPAP trail - How to Recover?

Post by pj2448 » Thu Feb 03, 2011 9:08 pm

I've sent the link to this discussion to my friend instead of trying to pass information along and then back. Hopefully she will read this or maybe even sign up to participate.

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Re: Ear Problems after CPAP trail - How to Recover?

Post by LSAT » Fri Feb 04, 2011 11:17 am

Sundowner63 wrote:
I feel that with so many people having hearing loss and the coincidence of it coinciding with CPAP use that we will someday see evidence supporting our suspicions and a resulting class action law suit.
I am surprised that this hasn't been jumped on by some lawyer by now.

I am tired of the same answer from the doctor and am going to try other things and getting another opinion.
The pillar procedure interests me as I have only moderate RDI.
But my ear ringing is getting unbearable and I want to prevent any problems with my right ear.
Dan
Possible....TINNITUS.
http://www.medicinenet.com/tinnitus/article.htm

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Re: Ear Problems after CPAP trail - How to Recover?

Post by DreamLady » Fri Feb 04, 2011 11:27 am

avi123 wrote:Pugsy, I agree with you. But notice that ordinary Position Vertigo (those ca crystals coming lose in the inner ear) is self limiting, i.e. go away in several days (absorbed in the body), but more could come again later.

See this conversation:

"Vertigo" from a few weeks ago.

or try this link:

viewtopic/t59817/viewtopic.php?f=1&t=59405&p=558105
This is not true at all. The crystals can float around for MONTHS (in my case YEARS). I finally got tired of the world revolving around me (literally) and sought help. After one simple (though definitely sick-making) series of maneuvers by a PA, and some simple precautions for two days, my BPPV of several years subsided and hasn't returned.

Paininthear

Re: Ear Problems after CPAP trail - How to Recover?

Post by Paininthear » Wed Jul 13, 2011 2:51 am

I've up at almost 2am and have to go to work in 3 hrs, but the pain in my right ear is killing me. I had Phase I surgery for sleep apnea 12/16 by a very competent ENT. I continued to use my CPAP intermittently for over the past 7-8 months. But tonight is the first time I had stabbing pain in the right ear level 8 out of ten that occurred as a direct result of using the CPAP. What other structural problems, infection there is I don't know. I tried to use the CPAP twice tonight and twice the pain came on in only the right ear about a minute after I put it on. I immediately took it off both times and the pain persisted for about an hour and eventually died down. I will give a call to my ENT tommorrow now today. So yes CPAP can cause direct ear pain through the Eustasioun? tubes.

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Re: Ear Problems after CPAP trail - How to Recover?

Post by Julie » Wed Jul 13, 2011 6:32 am

It's also important for the doctor to differentiate between vertigo and labyrinthitis where you experience dizziness internally, vs the world going around you externally.

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Re: Ear Problems after CPAP trail - How to Recover?

Post by Guest » Wed Jul 13, 2011 9:08 am

Pugsy wrote: If she has only been seeing an MD
An ENT is an MD. Do you perhaps mean "if she has only been seeing a primary care MD"? ENTs are doctors (MD), and PCPs are doctors (MD). They just have different specialties.