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OSA and Middle Ear Problems
Posting this on behalf of Joe in the UK:
have been using an resmed a/pap for around 1 year.Although it an a/pap it is set to between 10 and 16 as I was averaging osa at around 13. I am 80% deaf in one ear but started having noises in my good ear when I woke up in the morning (not tinnitus) after using the machine for 3 months.I lost some of my hearing and the sound in the morning went but left me with distorted hearing. My own voice seems load and distorted and I can hear any base sounds in excess ( my car exhaust sounds like it is blowing ) of 20. I have been to a specialist who did a hearing test and a tympanogram and bone oscillator test and says it is an inner ear problem.He says he has never heard of a a/pap affecting an ear, and the test confirms it is inner ear.I am still convinced it is to do with the a/pap machine giving middle ear problems so bought an "Otovent" which when used does change the sound of my hearing=20 And Dr Parks article re people with osa can have ear problems seems to confirm that it could be the middle ear.I a seeing my consultant in 2 weeks time can anyone suggest any other tests I should ask for?Thanks In advance Joe
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Replies to This Discussion
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Permalink Reply by Henning on
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I have had (big) problems with both the middle ear and inner ear. It proved however that it was due to two different reasons.
My middle ear problem was related to my CPAP. My problem with the inner ear was related to my sleep apnea.
It is well known that CPAP may provide Eustachian tube dysfunction. This will give a negative pressure in the middle ear. This is completely as when you are landing in an aircraft.
Can you "pop" your ears?
Do you have any kind of dizziness, or even true vertigo attacks?
Henning
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Permalink Reply by joe on
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Hi Hennning,
thanks for the reply.
I have had menieres disease in my left ear which was corrected by brain surgery.
My right ear was diagnosed with Menieres 7 years ago but stopped after a short period.
My doctors think it is Menieres in the left ear but cannot confirm. They do say it is the nerves in the inner ear.
I am convinced it is the middle ear due to using the a/pap.
The Otovent that i am using is a device that is to help make your ears "pop"
I take Serc tablets since my Menieres attack and so this helps stop dizzyness.
I am a complicated case
Joe
Henning said:I have had (big) problems with both the middle ear and inner ear. It proved however that it was due to two different reasons.
My middle ear problem was related to my CPAP. My problem with the inner ear was related to my sleep apnea.
It is well known that CPAP may provide Eustachian tube dysfunction. This will give a negative pressure in the middle ear. This is completely as when you are landing in an aircraft.
Can you "pop" your ears?
Do you have any kind of dizziness, or even true vertigo attacks?
Henning
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Hi Joe,
Sometimes complicated cases can be very simple if you know the problem.
I am not a doctor, but I've spent two years to unravel my own situation.
There is a connection between the middle ear and inner ear. It is the oval window. If you have Eustachian tube dysfunction in only one ear it may cause a situation where you have a condition called "Alternobaric Vertigo". This state can occur when you have a different pressure between your two ears.
That is a condition which is known only by a few ear specialists. In reality it is a condition known among diving and aviation medicine.
Often this condition will be diagnosed as Meniere’s or Perilymph Fistula.
I will suggest you to try an ear tube in your ear drum into your "good" ear. I would assume that this will remove your symptoms immediately.
You can otherwise read my story at this link:
http://www.sleepguide.com/forum/topics/apnea-pressure-harmful-effects
You are welcome to ask further questions.
Henning
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Permalink Reply by RockRpsgt on
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Good post guys. Always a pleasure to read your stuff henning. I know I have not posted much, but I am on here almost everyday. You guys are keeping me sane being so far from home.
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Hi Henning,
Thank you so much for your caring help and advice.
You put so much time and effort in to helping other people for no financial gain
You are wonderful!
You are not a doctor but you have answered many questions my “Specialist” have not answered
Could I please ask for some more advice?
DIZZY
I only have around 20% of hearing in my left ear .
As I have had a vestibular nerve resection (cut balance nerve in my brain) for Menieres in my left ear so I would think I could not have Alternobaric Vertigo
I ask this because 3 years ago I was having dizzy spells when I looked up. an otolaryngologist did the halpyke manoeuvre said that I had nystagmus which he said confirmed I had BPPV in my right ear.
I did the brand daroff exercises and it stopped after 1 year.
I still sometimes have just slight dizzy spells so I do the cooksy exercise and this seems to have helped but wondering if it could be Alternobaric Vertigo?
EAR
I have around 80% hearing in my right ear but it is now very distorted.
I have been using an “otovent” which basically actions the valsalva maneuver when I do this my right ear pops and my hearing slightly improves.
The hospital did a tympani test and said the inner ear pressure was correct
They also did a hearing test with the headphones on the skull and said this confirms It is inner ear as the hearing results were the same as from headphones testing from the ear.
So do you think I could still have a Eustachian tube dysfunction
When you suggest a tube for my ear do you mean grommets as used with glue ear.?
When I revisit the hospital next week is there any other tests you think I should ask them to do to confirm or disprove my suspicions?
OSA
I had fatigue, muzzy head and feeling sick plus palpitations.
I saw a heart specialist with said I had arrhythmias and I then saw an ent specialist who gave the home test and said I had osa. Every time including now I have always have a very low Epworth score around 6 or 7 !
After using the a/pap for a few months I had a PolyGram as I still felt unwell.
They said my apnoeas were around 13 and the a/pap was set at zero so by the time it reached 13 my apnoea had happened so they adjusted the a/p/ to 10 min- 16 max
I us it every night without fail all night but have left it off twice as a test and felt much worse the next day so it is obviously doing something but I still wake up very tired feeling sick muzzy headed and often have fluttering of the heart after normal 10 hours full sleep I drop off with 10 minutes and get up 1 or 2 times and straight back to sleep .
I sit in the chair for an hour or so then have breakfast and feel like I want to go back to bed but I force myself to have shower and usually feel 80% better till around 5p.m. when I cannot keep my eyes open. If I have a 20 minute nap when I wake up I will have bad palpitations feel very muzzy headed and feel like I should go to bed (sometimes I do) I go through the day looking forward to bed time as I always feel tired but not enough to drop off but if I consciously shut my eyes and say go to sleep very quickly I do. I have most days at 70% of feeling well and the I might have 2-3 days of feeling 50% really much worse when I have 2-3 days of feeling really good.
100%
It seems like one half of me says “you are so tired you must have more sleep” THE OTHER HALF OF ME SAYS “ YOU HAVE HAD TOO MUCH SLEEP IF YOU HAVE ANOTHER SLEEP YOU WILL FEEL EVEN WORSE”
I am happily married and my wife understands but we do not make arrangement s to go or go on holidays etc because I never know how bad I am going to feel.
Sorry for very long posting but I wanted you to have the full picture as I am desperate to get this corrected.
I have spent thousands of pounds on tests and still feel unwell I know there are people far far worse than me but I feel there is an answer to this and get back to normal.
I am sure with your help I will get there. Thank you again Joe
Remstar auto m series with a-flex (511m)
Auto statistics
Auto-crap mean pressure 11.2 cm H20
Auto-crap peak average pressure 13.9 cm H20
Average device pressure < = 90% of time 13.4 cm H2O
Average time in apnea per day 6.6 minutes
Average time in large leak per day 34.7 mins
Average AHI 3.3.
Henning said:Hi Joe,
Sometimes complicated cases can be very simple if you know the problem. I am not a doctor, but I've spent two years to unravel my own situation. There is a connection between the middle ear and inner ear. It is the oval window. If you have Eustachian tube dysfunction in only one ear it may cause a situation where you have a condition called "Alternobaric Vertigo". This state can occur when you have a different pressure between your two ears.
That is a condition which is known only by a few ear specialists. In reality it is a condition known among diving and aviation medicine.
Often this condition will be diagnosed as Meniere’s or Perilymph Fistula.
I will suggest you to try an ear tube in your ear drum into your "good" ear. I would assume that this will remove your symptoms immediately.
You can otherwise read my story at this link:
http://www.sleepguide.com/forum/topics/apnea-pressure-harmful-effects
You are welcome to ask further questions.
Henning
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Hi Joe,
This is many questions and I cannot answer them all. As I have mentioned already, I am not a doctor, so my recital must be viewed in this light.
But about your dizziness and your ear problems I can give you some further information.
I do not think that because you have had a vestibular nerve resection it means something to the possibility of Alternobaric Vertigo. In any event, it is important that the pressure between your ears can be equalized.
The tube in your ears I'm talking about is a small plastic tube inserted in your eardrum. This will serve as an alternative Eustachian Tube, and will fall out by itself after 1-2 years.
If you read the articles from Dr. Hain, many ear problems could be alleviated by this.
BPPV gives the same symptoms, so it is obviously difficult to assess, but BPPV is usually quickly cured.
But I would give it a chance in getting your ears compensated for the pressure in your ears. This is a very small procedure - about five minutes in local anesthesia. This eliminated my dizziness totally, which gave me a better quality of life.
It might even give you a better hearing in your good ear. This it did for me. Today I have a normal hearing. (I don’t think you ever will have this in your left ear)
It is fine that you use Otovent instead of a manual Valsalva maneuver. This can by manual execution cause damage to the inner ear (Perilymph Fistula), if it is too hard.
It seems like you (like me) are "fallen between two chairs." You need a team of specialists to assess your situation.
Regarding your OSA problems otherwise, I am sure there are others here on the forum who can better answer you. But arrhythmias is very associated with OSA.
You are still welcome to ask further questions.
Henning
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Thank you very much for your Henning.
If anyone else can help me with my osa questions I would greatly appreciate it.
If my osa is fully under control would I still have arrhythmias ?
Thanks Joe
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