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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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talktobon
 
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Ruptured eardrum from CPAP

Postby talktobon on Sat Mar 21, 2009 11:24 am

I got a new mask from the DME on Monday and he went up to the upper level of my prescription (10) to show me "how the baby would hold." I've never had to have the machine up that high. My ears become clogged at 4, and I've been neti-potting which has helped, per ENT's suggestion. But 10 was too much pressure for me; I netipotted afterward and blew my nose like I usually do. Huge pain in ear, blood on pillow, and now it feels like air is going into my head through that ear.

My primary care doc thinks we ruptured my eardrum, though it's a microscopic tear. I'm seeing the sleep specialist on Friday, but I'm afraid to use the CPAP until I feel better. I've only had my CPAP for 2 months but have only been able to use it for a few weeks due to all the ear trouble. I've read it can take up to 2 months for an eardrum to heal. If you were me, would you not use the machine?

Here's another question--I've been renting the CPAP for 2 months. My insurance won't purchase the machine until I've had it for 3 months. I think I may return the machine before the third month starts so I can pick up where I left off once my ear heals. My insurance company didn't know how to answer this question. Any thoughts?

I certainly can see why people give up on CPAP!

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Additional Comments: Doc reset APAP to 4-7; titrated at 6, but keeping low due to ear pressure problems. RemZzzs. Cozyhose.

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spitintheocean
 
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Re: Ruptured eardrum from CPAP

Postby spitintheocean on Sat Mar 21, 2009 12:00 pm

Last night my pressure was 18.2 and I rarely fall below my prescribed pressure of 16; I have sneezed while wearing my full face mask and felt like John Candy in the movie "Spaceballs" but it had no effect on my eardrums. As far as I know, I have normal eardrums so perhaps your underlying condition doesn't handle the relatively benign pressure setting of 10 but I don't think it would be a serious risk for most users.

Let's hope your eardrums heal quickly and you can try the treatment again because the alternatives are not promising.

Paul

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LoQ
 
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Re: Ruptured eardrum from CPAP

Postby LoQ on Sat Mar 21, 2009 12:02 pm

talktobon wrote:If you were me, would you not use the machine?

You have both an ENT and a PCP who know about this problem! What did they say when you asked them whether or not you should continue to use your machine? We are (mostly) not medical doctors here. You have a medical problem that needs expert advice.


I certainly can see why people give up on CPAP!

A ruptured eardrum is not the normal reason why people give up on CPAP. In fact, you are the first person I've ever heard who busted an eardrum using a CPAP machine. Most people quit for other reasons.



You said your ears became clogged at 4. Many people feel like they can barely breathe at 4. I wonder if it would be a good idea for you to take your machine in and have the levels checked.

In any event, CPAP machines are not so much about pressure as about air flow/volume. I think your ENT should be able to give you an explanation of what is happening with your ears. I would suggest you start there. You might ask if a full face mask would help you to avoid the problem. I have a very hard time creating any pressure whatsoever in my eustachian tubes while breathing through my mouth, but check with your doctor.

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ozij
 
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Re: Ruptured eardrum from CPAP

Postby ozij on Sat Mar 21, 2009 12:06 pm

I would definitely not use the machine with a ruptured ear drum, unless my ENT gave me very specific permission to use it
If I were you, would also disucuss my netti pot technique with the ENT. Blowing your nose forcefully can push thing into you ear - I used to get relatively frequent ear infection as an adolescent, until I learned to be very careful about blowing my nose: never do it forcefully, and make sure not to close the nostril I'm blowing.
O.

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Last edited by ozij on Sun Mar 22, 2009 10:04 pm, edited 1 time in total.
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Raj
 
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Re: Ruptured eardrum from CPAP

Postby Raj on Sat Mar 21, 2009 12:23 pm

To reinforce what Ozij just said, you have to be particularly careful when Neti rinsing to blow your nose very gently because there's often a considerable amount of water in your nasal passages right after rinsing, taking up space and being its usual non-compressible self, which means pressure can really build up. And I believe Ozij was trying to point out that forcefull nose-blowing can easily send bacteria into the sinuses, so it's generally a bad idea all around. Alas, you probably should also put the Neti pot aside while you heal.

I hope you can recover and resume CPAP sooner than 2 months, which seems a like a long time to be without treatment.
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birdshell
 
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Re: Ruptured eardrum from CPAP

Postby birdshell on Sat Mar 21, 2009 12:30 pm

I don't know about your machine/insurance issues. I hope someone else can report their experience with that.

It cannot be any fun to be sick and fighting this! I'm so sorry that you have to go through all of these changes when you are lacking in energy. I have never heard of anyone rupturing an ear drum due to CPAP, ever.

I have had problems with ear infections and colds since I was an infant. I had my tonsils and adenoids removed at age 4, and I suffered from the infections until that age. It is interesting to note that many children's apnea is treated by this surgery. I remember that before the surgery I had an ear ache every night.

I can only say that I think your body may already be sensitized by the illness. Maybe there is some anomaly in your anatomy that allowed that pressure to make this eardrum tear? It might be wise for you to consult an ear, nose and throat specialist (aka ENT or otolaryngologist). My personal reaction would be to call my PCP, the sleep doc, and any other doctor who could refer you ENT...because even though you have seen your physician, he isn't a specialist in ear drums and their perforation. Otolaryngologists do know about such things.

Your results are DEFINITELY not typical and I hope that you will not give up on CPAP treatment. I used to have 6-8 sinus infections (which usually became ear infections and general upper respiratory infections) per year. Since starting CPAP three years ago, I have had 2 sinus infections. You may have gotten your CPAP at a bad time for you.

I hope that it all works out for the best. Please let us know how you are doing.

Karen,
Who never likes suffering

P.S. LoQ, she said that she was seeing a sleep doc, who may or may not be an ENT.
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LoQ
 
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Re: Ruptured eardrum from CPAP

Postby LoQ on Sat Mar 21, 2009 12:43 pm

birdshell wrote:
P.S. LoQ, she said that she was seeing a sleep doc, who may or may not be an ENT.


She said she was using a neti pot, per her ENT's suggestion. Later in the post she talked about seeing a sleep specialist. I'm not sure why you are commenting to me about the sleep specialist. Maybe there is other information in another thread that I am not aware of. It happens. I'm afraid I can't keep up with every thread.

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birdshell
 
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Re: Ruptured eardrum from CPAP

Postby birdshell on Sat Mar 21, 2009 6:16 pm

Sorry, LoQ...I meant no disrespect. I re-read the original post, too, before making the suggestion...and missed that the ENT had suggested the neti pot!

I sincerely apologize. It is just that the term "sleep doc" can apply to pulmonologists, neurologists, otolaryngologists, and even DOES apply to pediatricians, internists, and any other MD/DO who passes the board certification test.

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Re: Ruptured eardrum from CPAP

Postby WearyOne on Sun Mar 22, 2009 12:30 am

Just relating my experience in case it might help. I have tried a netti pot type system called SinuCleanse. Although it helped with my nose congestion, I can't use it because I get ear pain. Part of the instructions read: "If you experience ear discomfort when using SinuCleanse, try to blow your nose more gently after the wash. If the problem persists, the openings of your eustachian tubes may be particularly wide and SinuCleanse use may need to be discontinued." Sometimes I can use it once, and I'm okay. Then if I use it the next night, I have ear problems. Sometimes the ear problem happens after using it just once. (And it's not from blowing my nose too hard; I do that VERY gently!) I'm not trying to say that the netti-pot use caused the eardrum rupture, but it might have been irritating to your ears. Mine almost felt like they were stopped up sometimes after use in addition to hurting.

Pam

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talktobon
 
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Re: Ruptured eardrum from CPAP

Postby talktobon on Sun Mar 22, 2009 7:34 pm

Yes, I definitely have to check in with my ENT again. I saw him about a month ago, and he said I have Estachian Tube Dysfunction. He wants to put in ear tubes and/or repair the deviated septum in my nose. There are many risks (and no guarantees) to either of those surgeries, however, so he suggested I try the neti pot first. It's been helping, but I think it did some damage this last time with the increased pressure. My neti technique is not right, though, so now I know I need to not close up one nostril while blowing the other. That was a mistake!

The pressure on my home machine is accurate--my ears got plugged up as soon as they put the mask on me in the sleep lab, too. It's just me and my sinus trouble that's causing the problem. Due to a slew of other health problems, it's not wise for me to have surgery, so I'm between a rock and a hard place, and my problem is not typical. I just wanted to get some affirmation from the forum that it's OK to wait until my ear heals before I try CPAP again. I already know in my heart I need to wait. I just don't want to give up, and lose the ground I've gained. Now I need to start all over again when I start up again and that's frustrating. God's trying to teach me lots of patience.

My primary care doc gave me the meds to prevent ear infection, but didn't have an opinion about postponing CPAP when I asked him. He said to talk to my ENT if I wasn't feeling better in a few days. So that's tomorrow. Need to call ENT. Need to be as careful as possible with my ears. Thank God my pressure isn't any higher.

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Additional Comments: Doc reset APAP to 4-7; titrated at 6, but keeping low due to ear pressure problems. RemZzzs. Cozyhose.

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Re: Ruptured eardrum from CPAP

Postby Slinky on Sun Mar 22, 2009 8:15 pm

Do NOT use your CPAP! I wouldn't even use the NetiPot until I was SEEN by the ENT. I might well, however, just show up at the ENT's office Monday and convince the desk dragons to squeeze me in!!

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Re: Ruptured eardrum from CPAP

Postby john_dozer on Mon Mar 23, 2009 6:57 am

Please report back with what you find.

I'm interested as I've had that feeling you get with altitude change where your ears want to pop, but they can't. I've removed the mask and popped them and put the mask back. This is becoming more frequent.

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talktobon
 
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Re: Ruptured eardrum from CPAP

Postby talktobon on Mon Mar 23, 2009 7:38 pm

The ENT called back tonight. He agreed with my primary care doctor that I probably have a micro-tear in my eardrum due to my symptoms. It may have already healed since it's been a week already, but he wants me to wait another week before I try the CPAP again just to be safe. If I still have ear pain at that time, he'll need me to come in to take a look. I have to be super careful with the neti pot. I won't need to use it again until I start the CPAP--never had ear trouble before CPAP. So I'll be giving my body a break the rest of the week.

My sleep specialist told me that my apnea would improve if I lost weight. I'm about 15 lbs overweight and he said that even a 5-10 lb. weight loss would help. I need to keep my pressure down as low as possible to protect my ears. Who would have thought...Talk about incentive!

If anyone else is having trouble with your ears due to CPAP, please see your doctor. It's not normal. My friend's pressure is at 26 and her ears are fine. I can't imagine what would have happened to me at that level. I'm trying the neti pot (a regular nasal saline rinse) at the ENT's recommendation. He said it could help open my ears. Just be careful blowing and only blow both nostrils at the same time. I really have to back off of that. My ears are still clogged up even with the neti pot, but they are better. Looks like I'll be living life with clogged ears. The alternatives are ear tubes and deviated septum surgery which I don't want to consider yet. Most "normal" people wouldn't have the complications I do, though, so please discuss your case with your doctor and research the risks. For my case, it's not worth it if the neti pot can help me get by.

I hope no newbies ever have to look up this thread! PM me if you want any sympathy!!!

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Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Humidifier: M Series Heated Humidifier
Software: M Series Smartcard Module
Additional Comments: Doc reset APAP to 4-7; titrated at 6, but keeping low due to ear pressure problems. RemZzzs. Cozyhose.


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