Waking up feeling tired, even after a full night’s sleep, can be one of the most frustrating symptoms of sleep apnea. But many people find that their symptoms go far beyond sleep-related issues. Some even say that sleep apnea affects their hearing or causes other ear problems.

If your ears feel full, your hearing has changed, or you have ringing in your ears, these symptoms could be related to sleep apnea. Keep reading to learn what researchers say about the possible link and how to manage these symptoms.

How Does Sleep Apnea Cause Ear Problems?

Sleep apnea may cause:

• Daytime fatigue
• Dry mouth
• Trouble focusing
• Morning headaches
• Mood changes
• Daytime sleepiness

Less often, sleep apnea may affect the eustachian tube. This tube connects the back of your throat to your middle ear. It helps balance pressure in your ear, which supports healthy hearing.

One study found that people with obstructive sleep apnea (OSA) were much more likely to have eustachian tube problems than those without OSA. OSA is the most common type of sleep apnea.

The link between OSA and eustachian tube issues may involve the adenoids. These tissues sit at the top of your throat, just behind your nose.

Adenoid issues can contribute to eustachian tube problems and OSA. That’s because enlarged adenoids can block your nasal airways and irritate the eustachian tube.

Ear Issues Related to Sleep Apnea

Eustachian tube issues can cause symptoms, including:

• Ear pain
• Hearing loss
• Tinnitus
• Fullness

Ear problems in people with sleep apnea may have other causes, too.

Hearing Loss

Hearing loss may be more common among those with sleep apnea than those without it. One study found that people diagnosed with sleep apnea had a 30 percent higher risk of hearing loss than those without sleep apnea. Researchers aren’t certain about what’s behind the link, but they have several theories.

Part of the reason may be that OSA causes breathing to stop and start many times during sleep. This can lower oxygen levels in the blood.

Low oxygen levels may affect hearing by:

• Damaging the fragile hair cells inside your ear that allow you to hear
• Causing inflammation and blood flow disruptions in your inner ear
• Slowly affecting how your body processes sound over time

Hearing loss and sleep apnea also share several of the same risk factors. Both conditions are more likely to affect people with high blood pressure, diabetes, and obesity.

These shared risk factors may help explain why hearing loss is more common in people with OSA. Researchers are still working to find more concrete links between hearing loss and sleep apnea.

Tinnitus

Tinnitus is when you hear a sound that isn’t coming from around you. These sounds may include:

• Ringing
• Hissing
• Buzzing

Tinnitus is closely linked to sleep disorders. If you don’t sleep well, tinnitus can get worse. If you’re experiencing chronic tinnitus, you may not be able to sleep soundly.

For those reasons, tinnitus and poor sleep quality can lead to a cycle of symptoms that make each other worse.

Some research has linked sleep apnea with tinnitus, but the connection is still unclear. A newer study found that tinnitus may be more closely related to hearing loss that can happen with sleep apnea, rather than sleep apnea itself.

For example, hearing loss that happens with OSA may lead to tinnitus. That means tinnitus in people with OSA could be caused by hearing loss instead of OSA itself.

Ear Fullness

Some people with OSA feel fullness in their ears, as if their ears are clogged. This can happen for several reasons, including eustachian tube problems or changes in middle ear pressure.

When pressure builds up inside your ear, it can cause that feeling of fullness. Pressure changes inside the ear may be linked to sleep apnea.

One study found that middle ear pressure was significantly higher in people with severe sleep apnea than in those without it.

Addressing Hearing Symptoms

If you’re having issues with hearing or other ear problems, talk to your doctor. Some research suggests that sleep apnea treatment may improve hearing symptoms.

Treating Sleep Apnea

Continuous positive airway pressure (CPAP) is usually the first treatment for sleep apnea. CPAP therapy involves wearing a mask over your mouth and your nose. A CPAP machine delivers consistent air pressure through the mask.

The air from the machine flows into your airway so it stays open and doesn’t collapse while you sleep. When used correctly every night, CPAP helps keep your breathing steady so your body gets the oxygen it needs.

Studies indicate that using a CPAP device may help relieve middle ear pressure. But research on CPAP and hearing loss or tinnitus hasn’t found similar results. More research is needed to find out whether using a CPAP or another OSA treatment may help ease hearing symptoms.

Other sleep apnea treatments include custom oral appliances, surgery, or lifestyle changes, such as losing weight or changing your sleep position.

Treating Hearing Issues

If you still have hearing problems after treating sleep apnea, your doctor may refer you to an ear specialist. These healthcare professionals, called otolaryngologists, specialize in disorders of the ear, nose, and throat (ENT).

Your otolaryngologist might ask about your hearing loss, ear fullness, and tinnitus symptoms. They may perform a physical exam and ask about your overall health history. For example, they might want to know if you have a history of ear infections or other problems with your auditory system.

After gathering more information, the ear specialist may perform testing to find the cause of your symptoms. Certain tests can help pinpoint the type of hearing loss or other ear problems you have. These tests are often performed by audiologists, who specialize in hearing and balance problems.

After your exams and tests, the ENT team can suggest treatment options that may help.

Taking care of your hearing health can help improve your quality of life. Call your doctor if you’re having ear problems. Fixing these issues, along with treating OSA, may even help you sleep better in the long run.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

Have you had any hearing issues along with sleep apnea? Let others know in the comments below.