Can Tinnitus cause sleep Apnea, How to Get Better Sleep with Ringing in the Ears

woman in a hospital bed holding a cpap machine

Millions of people, all over the world, experience tinnitus symptoms. For many of them, sleep disturbances are common.

The bigger question is whether tinnitus causes sleep apnea? Or, if it is the other way around? This article will dig deeper into understanding the relationship between sleep apnea and tinnitus.

Can Tinnitus Cause Sleep Apnea?

There is, in fact, a relationship between tinnitus and sleep apnea. However, there are no conclusive studies that suggest that it does. Despite this, people with Obstructive Sleep Apnea have a higher risk of tinnitus.

What is Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a condition where the muscles in your neck relax when you sleep. This causes the tongue, and palate, in the mouth to collapse and close the airway.

As a result, breathing stops for brief periods of time. During these times, the oxygen supply is cut off.

In many cases, you may not even know you have OSA. Some symptoms include:

  • loud snoring
  • frequently waking up in the night
  • feeling sleepy during the day
  • swelling of the feet

People with OSA have insomnia, dream a lot, and also have higher rates of both heart disease, and stroke.

Another way to know if you are at risk, is if you have a collar size of 17 inches or above. In women, a collar size of 16 inches is a risk factor for OSA. Additionally, if you have a large tongue and a shorter lower jaw, you may have OSA.

The Relationship Between OSA and Tinnitus

Studies have shown that insomnia is a common symptom that accompanies tinnitus. Tinnitus, or ringing in the ears, affects sleep quality. People with higher tinnitus annoyance scores, sleep poorly. In many cases, they frequently have sleep disorders.

A study has shown that 1/3 of the OSA patients had chronic tinnitus, especially those over 45.

Alternatively, when it comes to obstructive sleep apnea, researchers found evidence that people with OSA have significant tinnitus. In one such study, a third of the OSA patients had chronic tinnitus. Especially those who are middle-aged or elderly.

Other studies have shown that there is a higher risk of tinnitus in those with OSA. So, it may be that OSA can cause tinnitus.

One explanation for this is snoring. In OSA, people tend to snore loudly. This snoring is a form of noise. Snoring has a loudness of about 50 dB. That is as loud as normal conversations, and sometimes even louder.

This snoring noise, for roughly eight hours a day, daily can damage the inner ear.

Loud and continuous snoring can trigger tinnitus and can also lead to both temporary and permanent hearing loss.

Also Read: Can Earplugs Cause Tinnitus?

In OSA, people also have reduced blood flow and increased blood pressure. This means that the blood flow to the ears is also decreased. With less blood supply, the inner ear starves for oxygen and nutrients. Slowly, they can become damaged. This may lead to tinnitus.

Treatment of OSA Improves Tinnitus

For tinnitus patients, the good news is that OSA can be treated. Treatment of OSA is through CPAP therapy and weight loss. Continuous Positive Airway Pressure or CPAP therapy, allows a person to breathe more easily.

CPAP is a machine that prevents the neck from collapsing. With the help of CPAP therapy, a person breathes better, reduces snoring, and in time, tinnitus should improve.

Additionally, as a person breathes more oxygen, the blood flow to the rest of the body improves. Any vascular conditions or conditions of blood vessels are alleviated. If the tinnitus is caused by these conditions, symptoms improve significantly. This is often the case with objective tinnitus.

If a CPAP machine is too uncomfortable, you may try weight loss in the interim. Gradual weight loss reduces the need for CPAP.

The sleep center may also suggest positional therapy. This involves avoiding any sleeping on your back. Instead, the sleep center will advise you on the best sleeping position based on your sleep study results.

BIPAP (Bilevel Positive Airway Pressure) machines and surgery are other alternatives if weight loss and CPAP are ineffective.

Some mindfulness-based techniques are adjuncts to the above therapies. You can try any of them to treat OSA.

What To Do If You Have OSA And Tinnitus?

If you have OSA and tinnitus, you may want to start keeping a diary. Can you identify when your symptoms started? Ask your partner. They may have more information about your symptoms than you.

Keeping a diary of your symptoms with detailed information can be extremely helpful. Ask your partner if they have more information than you do.

Document your tinnitus symptoms. Record everything from symptom onset, to what worsens and alleviates symptoms.

Seek medical treatment for sleep apnea. This involves meeting with a pulmonologist and undergoing a sleep study. In some cases, they may check your blood oxygen levels and complete some blood tests.

After a sleep study, a CPAP machine is prescribed. You must wear this every night before falling asleep. It might be uncomfortable at first, and may have to be adjusted. Some machines can be auto-adjusted.

It takes time to see the improvement of tinnitus symptoms. Anywhere, from weeks to months. Improvement depends on the extent of the damage to the inner ear.

If OSA has been for a short period, hearing loss may be temporary. In chronic OSA, you may have permanent hearing loss. In this case, hearing aids can help.

The Verdict on Tinnitus and Sleep Apnea

The link between tinnitus and sleep apnea has not been studied in detail. There is evidence that there is a link between the two. Studies show that OSA can cause tinnitus. However, there is no proof that tinnitus causes sleep apnea.

What has been found is that treating OSA, tinnitus, vertigo, and many other sleep disorders, can improve tinnitus substantially. People have noted sleeping better and concentrating more, the day after treatment.

Treating OSA also decreases the risk of both heart disease and stroke, and lowers high blood pressure. There are many advantages to treating OSA.

If tinnitus doesn’t improve significantly, then you may want to try other tinnitus masking techniques or tinnitus retraining therapies. Sleep apnea treatment can help you get a good night’s rest.

Sleep Tight

Tinnitus does cause several sleep disturbances. In people with sleep apnea, the majority are found to have tinnitus. While a relationship between the two exists, how they are related is yet understood. What is clear is that if you treat OSA, your tinnitus symptoms can improve.

Citations

1. Fioretti AB, Fusetti M, Eibenstein A. Association between sleep disorders, hyperacusis and tinnitus: Evaluation with tinnitus questionnaires. Noise Health 2013;15:91-5

2. Liu XL, Wang J, Hong ZJ, Zhongshan MF. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018;32(8):575-578. doi:10.13201/j.issn.1001-1781.2018.08.004

3. Koo M, Hwang JH. Risk of tinnitus in patients with sleep apnea: A nationwide, population-based, case-control study. Laryngoscope. 2017;127(9):2171-2175. doi:10.1002/lary.26323