Tinnitus and Sleep Apnea: Is there a connection?
I have sleep apnea and sleep with a CPAP machine so my wife doesn't complain.
I also have tinnitus and it's quite noticeable.
I have a Philips REMstar auto (now called System One) with a swift fx mask. The combo is stunning.
order of magnitude better than any other combination I had before. The
Philips really adapts well to my breathing pattern so it is very silent and
comfortable (it is more APAP than CPAP). The Swift FX is by far the most
Get this: If I take a nap without the CPAP machine, I can wake up an hour later with
tinnitus. Sleep with the machine, no problem with tinnitus at all.
Internet searches show I'm not alone!
Tinnitus Decreases Seen With
Treating Sleep Apnea WITH ORAL APPLIANCES
Buzz on Tinnitus (see comments by Steven Y. Park, MD):
This may have been total coincidence, but many years ago, a handful of
patients that I treated for sleep-related breathing disorders have told me
that their ringing improved after either simply changing their sleep
positions or not eating late. So for the past 4-5 years, I’ve noticed that
almost every patient that comes to see me specifically for ringing or
mention it as an additional symptom all have significant upper airway
anatomic narrowing. Anatomically, they all have narrowing of the space
behind the tongue due to smaller than normal jaws or enlarged tonsils, or
both. All these people have various degrees of sleep-breathing disorders,
the more severe kind being obstructive sleep apnea, and the lesser version
being upper airway resistance syndrome.
There have been numerous reports of severe post-combat PTSD that resolved
completely after an underlying sleep apnea condition was picked up and
treated appropriately. I won’t be surprised if I see more people being
helped for their tinnitus by treating an undiagnosed obstructive sleep apnea
condition (80-90% of people with obstructive sleep apnea are not diagnosed
in this country).
Obviously, not all people with tinnitus will have these issues. However,
if you have tinnitus and can’t sleep on your back, get checked out for a
sleep-breathing problem. Being able to sleep better will have many other
significant health benefits.
For example these two comments from two different people noticed the
In my case, I have a complete relief about one day in a week (two days is
I am lucky). On such occasions, if I dose off --even for 20 min.-- in an
afternoon -say--, the tinnitus comes back. Also, tinnitus is most felt upon
arising in the morning. (see
I have both sleep apnea and tinnitus. I sleep with a cpap machine (8
years now). If I take a nap on sunday afternoons, in a chair without the
machine, I usually wake up with much stronger tinnitus, and probably a
headache. (You'd think I'd learn by now!) Just started to look for a
connection between the two.
Also, if my cpap mask is adjusted to reduce the outgoing ventilation , the
tinnitus is quite bad when I wake up. Normally i leave a small air gap in my
nose which reduces re-breathing. If I fully engage the mask so it is air tight and go to
sleep, I wake up with loud tinnitus.
Speculation: So that can explain why tinnitus gets WORSE with some people using CPAP and
better with others...it all depends on the pressure and mask used. If you use
too low a pressure on certain masks, you'll increase re-breathing and make your
tinnitus worse. If the mask, etc. is working, it should make it better.
I've had this happen way too many times to be a coincidence. It seems very
much a cause and effect.
Has this happened to you? Contact me using the contact info on
my home page and I'll post your story here.
I am fairly certain there is a relationship between tinnitus and sleep
apnea for me. I don't use a mask, but I do go to some lengths to prevent
myself from sleeping on my back. On ~10 occasions, I have woken up to find
myself on my back (despite my precautions) and with both a headache and
pronounced tinnitus, which slowly improves over the next 4-5 days.
Interestingly, I have also noticed that intense exercise near max heart
rate exacerbates my tinnitus. Both sleep apnea and intense exercise cause
blood oxygen saturation to decrease. Brain in general, and auditory hair
cells in particular, are highly metabolically active tissues and require a
lot of oxygen. So, it makes sense to me that sleep apnea could cause
I'm having surgery in a few weeks. If it is successful in treating my
sleep apnea, it will be interesting to see whether it also improves my
Regards, Dan Pierce
Noted your story on the web regarding
Tinnitus and sleep apnea.
My story is not much different. I have
used a CPAP machine but now after losing some weight I do not need
it as much.
What I have noticed is that every time I
take a short nap - say 5-20 minutes duration, I wake up with
tinnitus categorised by a higher frequency and amplitude. Up until
August 2009, my tinnitus could only be described as low intensity
say 1-2 on a scale of 10 - sometimes hardly noticeable. I have had
this for many years and never really worried me.
However after falling asleep for a short
nap (about 10 minutes) in front of the TV last August, I woke up
with Tinnitus on a scale of about 8-9. Extremely disturbing and
could not get any sleep for weeks. Tried everything but nothing
worked until I started to use the CPAP machine and improved my
Now I seem to have it more under control
using a variety of methods. I have kept an accurate diary starting
from January this year. The following represents the factors that
trigger my tinnitus.
Short naps - these are worst of all - I
try to avoid these as much as possible
Electromagnetic radiation - mostly high
frequencies - purchased a meter and I try to avoid being close to
emissions particularly when sleeping
Stress - I try and reduce life's
stressors as much as possible
Poor sleep - I make sure I get a good
night's sleep and use systems to prevent snoring as well as trying
to keep my weight down
If you know anyone that can solve the
short nap mistery - let me know. My ENT thinks it has something to
do with levels of melatonin.
Google led me to your web page. For the
past 4 months I have had intermittant tinnitus which lasts 1-2 days at a
time, then vanishes for a day (or rarely 2 days) and then the cylce
repeats. I have kept logs, stopped all meds I am on (including
vitamins), stopped caffeine and alcohol and other supposed stressors
without any change, found no correlation with exericise or anything else
I can think of.
What is most surprising is how a brief nap,
as short as 20 minutes, can bring on the tinnitus in the midst of a
non-tinnitus day. That's what led to my google search and your
experience. I never thought of sleep apnea, as I don't think Ihave any
other symtoms of it, but am going to look a little deeper. My other
hypothesis is that tinnitus is more of a neurologic problem akin to a
seizure disorder and that even brief episodes of sleep may turn off some
inhibitory mechanism in the brain. But that would not explain the
changes you have noted with different pressure settings on your
machine. You have definitely given me something else to think about.
Thanks, and good luck with your tinnitus. I think only a fellow
sufferer can understand how troublesome it is. Please keep up your web
page on the topic.
I have read, with great interest, your
blog on Tinnitus and Sleep Apnea. I also seem to have a similar
I am not a doctor but I've been doing
a lot of research on health and medecine.
Let me explain my situation:
I do not drink alcoholic beverages but
I do intake cafeine and smoke. Why do I mention smoking? Because, I
suspect, it may be directly related to my problem. Here are my facts
I suffer from sleep disturbances.
I frequently wake up 2 to 3 hours after falling asleep, and not able to
go back to sleep for a few more hours. I suspect I have mild sleep apnea
due to smoking. Smoking can cause hypoventilation, meaning I do not
breathe deeply or sufficiently (and even occasionally stop breathing)
while sleeping. When my brain recognizes there is not enough oxygen
inhalation, the heart races trying to bring in more oxygen in the body.
When my heart races, I wake up with tinnitus and also with elevated
blood pressure (I checked with a BP monitor). My BP goes down after a
few minutes of walking around, but the tinnitus stays for a while.
My solution would be to stop smoking,
and to do mild cardiovascular exercise (such as running) to exercise my
lungs, and to balance the "oxygen/carbone dioxide" ratio in my body.
But my problem is, with years of many short night sleep, I have develop
CFS (chronic fatigue syndrome). Being always tired saps my will power,
which makes it almost impossible for me to stop smoking. It's a vicious,
I am in the process of trying
Melatonin to see if it will improve my sleep. If it works, and I feel
more rested, I may try to stop smoking cold-turkey and start mild
running (with breathing exercises). I'm crossing my fingers.
You didn't mention if you smoke. You
may not be a smoker, but you may be (or may have been) exposed to second
hand smoke which could possibly have the same negative effect on your
Anyway, I hope my letter is of some
use to you. Stay well...
Moncton, New Brunswick, Canada
I goggled under Apnea
and Tinnitus and came across your link and find your experience
interesting and want to share mine. I have had continuous tinnitus for
the past 11 months due to allergies and /or an infection. Lost some
hearing n the low tones (5000)
I also just had a
sleeping test last Sunday for Apnea and a deviated septum. By 2 am. in
the morning the technician put on a CPAP mask because I was experiencing
apnea. I noticed after the test concluded the next morning that I woke
up with out tinnitus and after driving home my tinnitus was somewhat
reduced. The technician adjusted the mask to ensure that there was flow
also escaping. I am waiting for my Apnea/nose ENT to visit after test
results and perhaps get a CPAP
By the way, I have
been able to lower my tinnitus from the time it first appeared. My
noise was very loud similar to a woodpecker. What have worked for me is:
Low sodium diet of
no more than 1000 to 1500 mg a day
Diuretics of 50 mg
a day hydrochlorothiazide
Cymbalta 60 mg,
to ease the ear nerve
I also noticed that
the ENT for the deviated septum prescribed me nose spray that besides
opening my ear helped me with alleviating the Tinnitus further. The name
of the prescribed nasal spray is;
OMNARIS – contains
ciclesonaide (probably steroids). Medicine says that can be taken
Things that have not
done much for me and have tried
in my ears – probably did it too late after first notice minor loss
Bethahistine – 12
-24 mg/day – only good for Menaire’s patients.
Steve – like others I came
across your site with the search linking Apnea and Tinnitus. I was
hit with Tinnitus about 8 months ago and experience ringing, in various
levels of intensity, about 5 out of each 7 days. As it happens I have a
background in empirical research, though no longer work as a scientist,
and have been attempting to track variables that seem to have an impact.
The one factor that is absolutely undeniable is that sleeping is the
key variable for triggering or releasing tinnitus episodes. For some
time I assumed the trigger was tied to prolonged periods in vertical or
horizontal positions, impacting blood pressure, flow, inner ear, etc.
However several recent experiences have convinced me that is not so much
orientation, but rather blood oxygen levels. Thus, the google search
yesterday and this email today.
First off, congratulations on all of your work – pleased to discover
your site and causes and will follow with interest.
I have been trying to find the cause of my Tinnitus and have gone
the usual routes to try and sort it out including Temporal
Mandibular Joint (TMJ) assessment, Chiropractic, Hearing Tests, but
wasn’t 100% sure of the connection between sleep and Tinnitus.
However I definitely have had the cause and effect of taking a nap
and waking up with strong Tinnitus quite a few times and recently
had a very clear episode where my Tinnitus had disappeared for a
couple of days and came back when I had a nap. Reading through the
various stories on your page completely resonates with my
I recently visited a TMJ specialist as I have a minor click/lock in
my jaw, and after examining me and asking some questions (one of
which was whether I woke up tired), they recommended that I have a
sleep assessment done. That’s when I started to really put the
pieces together. I suspect I may have some kind of sleep disorder,
maybe not severe, but the nap connection is definitely there.
So, I can definitely add another example to the list – very helpful
to know there are others out there.
I’ll send a follow up after my sleep test also.
I was pleased to find your blog on apnea and hearing issues. I am a
retired psychology prof. who has done a little research on apnea and the
psychological effects of treatment. Our research revealed strong
positive impacts on attention and mood. It is unfortunate that positive
airway pressure therapies cause problems. I believe the problems I am
having with tinnitis and hearing loss are at very least exacerbated by
my APAP. The problem is, in my opinion, that the apap puts unequalized
pressure on the middle ear. This has to cause the eardrum to flex
outward carrying all of the attached and articulated ossicles with it.
Since there are small muscles with associated reflex pathways that have
been designed by nature to protect the inner ear by dampening too loud
sounds, it seems likely to me that any prolonged unbalanced deformation
of the eardrum could cause problems with the function of the ossicles
thus interfering with hearing. One example that I am experiencing is
low-frequency hum in my left ear. That seems to be related more to
spasms of my middle ear muscles than anything else, but in any case, I
can't hear outside low-frequency sounds when this is happening.
This whole issue reminds me of some common computer problems. We often
can't be sure if the problem is due to I/O equipment failure, processing
hardware, network software/hardware or OS/application software.
Diagnosing a problem sometimes requires a team of such sophistication it
is easier and less costly to replace the entire system! I wish I could
do that with my auditory system.
At this juncture my ear Dr. says it is probably meniere's disease, but
the fact that I don't have vertigo (or only have very slight vertigo),
doesn't fit that pattern. I did discover that my apap's max pressure
setting was set at 20, so that could be a contributor. I fixed that
today, so we shall see how things go with that.
Please keep working on this issue. In my opinion what we need is a
treatment for apnea that does not involve positive airway pressure
I've got a rare strain of sleep apnea, oxygen
shortages done damage to the body and brain, it brought on secondary
Before I started C-pap treatment I had tinnetus quite often, then it
dissappeared. I was shocked to hear it again in March this year as I
thought it had gone away, it was a once off till July then I had it
again. For the past 2 months it's been with me on a regular basis only
in my other ear. The polycytheamia hasn't gone away yet either, but it's
slowed down considerate. I mentioned the tinnetus to a sleep specialist
and she told me it's got nothing to do with sleep apnea. She told me the
same thing about my vitamin
B12 deficiency and restless leg movement. I know she's wrong, she
actually told me sleep apnea doesn't cause oxygen shortages that do
damage. This decease runs in my family and killed half of them. On the
internet it's documented under Pickwikian syndrome. It's taken me 2
years to find a sleep specialist that knows about this strain of sleep
apnea. The only advice I can give people is don't believe everything a
specialist tells you.
Michael Strong, Australia
is my series of events.
- Light swooshing tinnitus in right ear in July
- Had severe insomnia in July; Diagnosed with moderate OSA in August
- Used CPAP from August thru January
- Tinnitus went away
- Switched to Oral appliance in January thru March
- Tinnitus went crazy in March; Loud swooshing in right ear, light
ringing in left
- Went back to CPAP for last week; Swooshing is gone but now have
ringing in both ears
I am waiting on MRI to check for tumors and if there is a specific cause
for the tinnitus. I'm hoping that staying with CPAP will help it go
away. I'm in my early 30s, not overweight at all. In fact, I exercise
and run frequently. The sleep apnea (according my doc) is due to a
small jaw and I've never had tonsiles removed. There seems to be a
definite link to tinnitus. I will keep you posted if you'd like to share
on your website.
Great article, by the way. Very helpful.