Hearing comes and goes

My hearing is getting worse as the day goes on, and at night when I’m ready for bed I can barely hear someone talking in front of me. I then put on my CPAP unit and go to sleep, when I wake up about 6 AM my hearing has improved 100 % and then the process usually starts all over again. Could the CPAP unit have a healing effect, drying me out? This started about 3-4 weeks ago. I’ve been to the ear doctor twice, had all the tests, MRI, a doppler test, and etc. he said your hearing is getting bad, I’m going to see a new doctor tomorrow.
Any thoughts?
PS, you would think as a former medic I would know how to treat this but ears (hearing loss) but I never thought this type of ailment would ever affect me, I know all about the heart.

It might be due to occlusion of the Eustachian tubes, causing severe middle ear pressure changes resulting in tempory conductive hearing loss during the day.

That’s interesting because my mum and I both have a conductive loss (on top of a SN loss) which responds to barometric pressure. Some weather I can hear OK, other times I can’t at all. A hearing test 3 days after I get off a plane or go up a mountain would probably come out profound, I can’t hear a thing. Would be interesting to know if some kind of pressure system would help to blow out this pressure somehow, but there may be no connection.

The other thing I find often is that my hearing is more acute when I am trying to get to sleep! To put the TV on in the daytime it’s up around volume 37 with hearing aids in. If I put it on a night-time and I am feeling a bit sleepy but I really want to catch the end of the show I end up with the volume down to 21 and no aids in and it still seems loud, though I still can’t understand a word without the subtitles on. Very odd!

Would be of preliminary interest if you could get a tympanogram at your worst hearing time and again at your best hearing of the day and see if your ear is more responsive and it would point in the direction of pressure changes, and then your doctors can take a lead from there and decide what to do next.

I first posted this on the Sleep apnoea forums about 3 years ago and in a nutshell, I am convinced that long term cpap therapy damages the eustaction tube- It’s either causing a patulous (patent) tube or there’s something going on in the Middle ear/inner ear that is not yet fully understood.
I think SN deaf people who wear hearing aids tend to notice this loss/damage more than the non deaf person- just because we have so little remaining hearing so a drop of a few db means a lot to us.

I used CPAP for over 50,000 hours over a three to four year period from 2004-mid 2008. In 2007 I began to experience the symptoms you describe and the hearing loss started. In the mornings hearing is better but by days end it’s all muffled. Full investigations revealed nothing.
I’ve lost maybe 20db in the past 3 years which is maybe a 40% drop for me and I’m profoundly deaf and I stopped CPAP but recently had to resume it after three years…My hearing has stabilized somewhat-no more yo yo days when hearing aids don’t work at all; no regaining of the sudden and progressive additional loss from but the eustaction tube problem has not sorted itself out and it’s driving me mad still. I don’t know whats going on…
It starts with pressure losses subtle at first, its like all the pressure leaving your middle/inner ear but you experience a fullness that you cannot clear and no meds will clear it and there will come a time when your ears don’t pop anymore when flying and they don’t hurt with pressure changes either. The worst bit in the beginning is the Tinnitus- it is extreme- but it quietens down over a number of months and becomes bearable.
Things got bad I now prefer not to wear the hearing aid and only wear it when necessary!

I’m curious to know if any of the sufferers have bouts of imbalance or if you have a history of Meniere’s Disease in your family? Have you been evaluated for Meniere’s Disease by your ENT or audie?

The reason I bring this up is that Meniere’s Disease has the symptoms of aural fullness (or pressure) and fluctuating hearing loss. Imbalance somtimes accompanies these symptoms, but fullness and changes in hearing are the usually the hallmarks.

The Eustachian Tube/Middle Ear Pressure problems are a viable source also, as you guys have described.

dr. amy

Well No in my case -no history of vestibular problems or Menieres.
The only hallmark symptom that would maybe make it Menieres is episodes of Vertigo or Dizziness. Having neither kind of rules that out. But that was one of the first things I looked at. Patulous was the other possibility which met the criteria (fullness etc-with one exception- deaf users cannot hear their own breathing sounds! which is a hallmark of patulous.) I had a flexible scope examination and one ENT confirmed patulous but two other ENT’s disagreed. Full CAT scans of the sinus areas and the inner ear and cochlea show no abnormalities either. The ET is partially visible as it’s both bone and cartilage- but it’s still not 100% visible
I’m convinced there is more to CPAP therapy than meets the eye- at auto pressures between 6 and 10 (useing nasal mask) and even more that we don’t yet know- I just wish we knew if it affects the Middle ear, inner ear, or ET alone or all or some of these areas.
If I didn’t have the profound loss I might have opted for grommets but piercing the eardrum (and losing even more hearing and running the risk it may not heal completely - makes going through the tympanic membrane not an option. I wish we had the technology to explore the eustaction tube from the opening without going though the eardrum- but so far studies have only been done in rats. Imaging studies don’t give a decent picture at this time either.

Would “falling over sideways every time I try to walk round the coffee table” count as bouts of imbalance? :wink: If I close my eyes I pretty much fall straight down, I need to be able to see to orient my balance.

I see RoseRodent :slight_smile: Well, without examining you myself, I would say I would explore the diagnosis of Meniere’s if I were you with an ENT and Audi. Have doctors ever thrown around that possibility with you??

dr. amy

They never mentioned it, but then again I reckon I am probably a better match for Enlarged Vestibular Aqueduct Syndrome. I started my hearing loss as a child with periods of “Glue Ear” (OME) which would leave behind a SN loss each time they cleared up. I’ve never been able to balance, I used to get in trouble at school when they’d say find a space in the gym and close your eyes and I’d fall down - I didn’t realise other people could stand with their eyes closed and not feel dizzy.

I get episodes of more severe ear fullness which either clear up and leave me with hearing as before or take with them another 5-10dB. I keep getting asked if I have had an MRI, they are terribly surprised I have never had an MRI and they then go on to fail to order an MRI. I never did anything about it before, I figured that it wouldn’t make me any less HI if I had my head in tube, but now I am not so sure. Especially I think I should get medical clearance if I should be allowed to fly or not cos I lose practically all my hearing for a week or so after a flight, and don’t want to take that risk if it may not come back one time.

I too, am surprised you’ve never had an MRI to confirm EVA, but I am not convinced that having one would affect treatment of your HL.

dr. amy

No, I don’t suspect it will, but with a daughter who has early mixed hearing loss I would like to know if my mum and I have this. She’d have to be knocked out to be scanned cos of her age, so I’d prefer to start with the two adults. And you know what some doctors are like, you can’t possibly have anything unless you’ve had the test. :rolleyes:

I’m convinced there is more to CPAP therapy than meets the eye- at auto pressures between 6 and 10 (useing nasal mask) and even more that we don’t yet know- I just wish we knew if it affects the Middle ear, inner ear, or ET alone or all or some of these areas.

I am not trying to dispel your theory as I have no data to agree or disagree except for the fact I have been using a CPAP at a pressure of 10 since 1998 and I use it every night. I have moderate loss in my right ear, and very mild in my left ear and that started before my apnea diagnosis. So, in my experience the CPAP pressure has no detrimental effect to my hearing. To me the risks of untreated sleep apnea, especially if it has been treated with CPAP therapy is are too high to forgo the therapy. In fact for me, I can not sleep lying down with out my mask.

Everyone has different abilities to clear their ears and different rates at which pressure equalises. It may be that there’s a sub-population of people who find it difficult to relieve middle-ear pressure who should then take additional care/counselling with CPAP.

Well I made an error- I’m actually talking about auto pressures between 6cm and 17cm which fluctuate. My average being 14-15cm H20
I think when you have profound loss as opposed to moderate loss the difference in further loss experienced will be felt more acutely by the one with the greater hearing loss even if it’s a few db on an audiogram.
I have no hearing without strong BTE’s and these now on some days are useless and the audiogram on these days registers a complete loss. Other days I’m maybe 40% down from pre-cpap therapyand word recognition scores are up. As I said it comes and goes. The only pathological explaination is either PET or ET dry blockage which cannot be imaged - I think like arterial plaque build up which is keeping the ET open all the time. Tgrams show mild negative pressure. CT scans show no abnormalities. Maybe MRI imaging will show something but it won’t affect the outcome.
It’s just so frustrating. I’ve had to very recently revert back to using CPAP to manage OSA because after 3 years My health is at risk and sure as sure my hearing loss HAS worsened and the instability is back. I just evaluated a naida 5 and it was fine during fitment but the two week trial was a waste because my hearing just went gatvol. There is no stability.I think we will see more CPAP related hearing loss complaints come through in the near future for sure.
I’m going to be assessed for bilateral cochlear implants shortly because I simply cannot function with this instability. All the audiologists I see are scratching their heads.