[Pressure] tinnitus and ears problems with CPAP, need help

[weuw]

Hi there from Paris, France.

I've been diagnosed with sleep apnea last year when I did polysomnography which showed 27 IAH. No desaturation. I am 51 years old man, average build with a little belly, no serious health problem but anxiety (I take antidepressants) and insomnia.

I can adjust my Resmed setting, here are details :


- Resmed Airsense 10 with Auto APAP
- Full Face mask
- Humidifier 1
- Min. pressure 7.4
- Max. pressure 12
- EPR 1


My doctor initially set pressure to 10 (constant) but my sleep was not very good and I often woke up tired.
By hazard I tried autoset with the Resmed and it much improved my sleep. I always measure it with Apple Watch and Autosleep app (a very good one) and deep sleep raised up to 3 hours by night, before it was max 1h30. 

Without CPAP, well, max 1h !! Often 0min...

All seems good but in fact a new problem appeared. I am subject to tinnitus (slight) with ears problems like clogged ears. 
I have red that CPAP can causes these kind of disagreement. Mostly with pressure variation.

So what do you suggest in that case, especially with pressure settings and EPR ?

Attached is my current oscar analyze. 

Thanks a lot.
Serge

[SarcasticDave94]

Welcome to Apnea Board,

I've got tinnitus as well, but mine isn't at all linked to PAP therapy. Your stats aren't too bad as is. I think I'd turn off the Ramp as it may be a disturbance to you and in part that the pressure is too low in the ramp's duration along with that Ramp timing is very long. This variation may be causing your CA. These CA stand for Central Apnea, and yours are likely treatment emergent from beginning CPAP. Can you clarify this, as in how long you've used CPAP?

There's others that have complained about ringing of the ears when starting PAP. It might go away after using it a while. But I'd consider asking your doctor about it to bring it to his or her attention and find out if they suggest something.

[weuw]

Hi, thanks for answer.

Ok I am going to make ramp shorter, maybe 20 min ? Because I have difficulties to fall asleep so I need ramp...

I've been under CPAP therary for one year now. Last weeks only with autoset which helps me a lot to get deep sleep.

Don't you think EPR little pressure variations is a problem for ears ?

[OpalRose]

I'm not certain if EPR variations can have an affect on your ears, but you are only using EPR set at 1, so I'm doubtful.  But it wouldn't hurt to turn it off and see how you feel, plus it may cut down on some of the Clear Airways.

Also, your minimum pressure is 7.4 with a median pressure at 9.6cm with ramp set at 4.4cm.

Besides shortening the time of ramp, try moving the start ramp pressure of 4.4 up a little, maybe closer to your minimum pressure. Try a ramp setting of 5cm. Eventually by inching it up slowly, in time you would be able to stop using it.

[CorruptAlligator]

For me personally, tinitus is triggered by any one of the following:

1. lack of sleep. Not getting quality rest.

2. high blood pressure

3. sharp sounds that aggrevate it. like perhaps when listening to headphones with too much treble.

So, I can't think of direction causation from the CPAP therapy itself, unless you are not getting restful sleep from the therapy. Not getting a good night rest will likely cause tinitus to be noticible. Also, there maybe other triggers in your environment that should be considered.

[weuw]

Yes you are right. I will try small changement to my CPAP settings as indicated and I will see. Thanks

[SarcasticDave94]

OK that's fine. Let us know how it changes and if it helps any. Include at least the same OSCAR as before also.

[Hydrangea]

Personally, I think this would vary, as we are all uniquely different.

I had a lot of ear infections throughout my life, which caused my ears to become sensitive to pressure changes. So for me, I experience ear problems if I use EPR; thus I have my EPR turned off.

But I think most people's ears are not as sensitive as mine, so they aren't bothered by the minor pressure changes of EPR.

I am prone to tinnitus, but I've not noticed it be triggered by CPAP at all. I agree with the others - my tinnitus can be affected by lack of quality sleep.

[weuw]

Hi there

Some news from Paris France...

Well, my shape varies a lot. As we said last time I tried to stop EPR and ramp, I had difficulties without it, but I need to test again I think. 
I changed a little my pressure. Sometimes it's ok, but last night for instance it was bad.

I had a lot of clear airway as you can see in captured screen.

What do you recommend ? Must I try to use continuous pressure (initially I had 10 cmH2O constant but I felt not always good).
Or really stop EPR and ramp ? 

Thanks a lot for your advice.

   

   

[Ratchick]

I have tinnitus as well as cruddy ears when it comes to pressure because of dysfunctional eustachian tubes. I haven't found it's worsened my tinnitus at all, but I DID find higher pressures hurt my ears a lot at first when I got over maybe 12 or 13 cmh20, and they would pop a lot at lower pressures. I also occasionally feel like I get air through my tear ducts which is a REALLY weird sensation - but I'm more likely to get that trying to blow my nose than from PAP.

That said, when my ears are "blocked" or feel "stuffy" because of the pressure imbalance, I notice my tinnitus more - so maybe that's what you're noticing? Do your ears ever pop or crackle during therapy, especially when swallowing?