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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Breathing Difficulty At Night And Tinnitus?

Ok, I seem to have several symptoms that are all very irritating--My dentist told me I have a very strong, thick tongue, I asked him if this might be part of my sleep apnea ? He said probably, then I also have trouble breathing especially when the dentist opens my mouth and tips my head back. I wake up from naps gasping for breath also. Additionally I have very loud tinnitis, frequent water in my ears as well as itching in my ears. I this all related and is there help for me?
Thu, 12 Jul 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.
When the muscles relax, your airway narrows or closes as you breathe in, and you can't get an adequate breath in. This may lower the level of oxygen in your blood.
You consult a physician for this problem.
For milder cases of sleep apnea, your doctor may recommend only lifestyle changes, such as losing weight or quitting smoking. And if you have nasal allergies, your doctor will recommend treatment for your allergies. If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available.
Certain devices can help open up a blocked airway. In other cases, surgery may be necessary. Treatments for obstructive sleep apnea may include:1. Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.

2. Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances may be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

Surgery is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. Surgery includes- Tissue removal, Jaw repositioning, Implants etc.

Now coming to your problem of tinnitus:

To treat your tinnitus, your doctor will first try to identify any underlying, treatable condition that may be associated with your symptoms. If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce the noise. Examples include:

1. Earwax removal. Removing impacted earwax can decrease tinnitus symptoms.

2. Treating a blood vessel condition. Underlying vascular conditions may require medication, surgery or another treatment to address the problem.

3. Changing your medication. If a medication you're taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication.

Noise suppression
In some cases white noise may help suppress the sound so that it's less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include:

1. White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also may help cover the internal noise at night.

2. Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus.

3. Masking devices. Worn in the ear and similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses tinnitus symptoms.

4. Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of tinnitus retraining.

Medications:

Drugs can't cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications. Possible medications include:

1. Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success. However, these medications are generally used for only severe tinnitus, as they can cause troublesome side effects, including dry mouth, blurred vision, constipation and heart problems.

2. Alprazolam (Niravam, Xanax) may help reduce tinnitus symptoms, but side effects can include drowsiness and nausea. It can also become habit-forming.

regards- Dr Sanjay Kini
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What Causes Breathing Difficulty At Night And Tinnitus?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue. When the muscles relax, your airway narrows or closes as you breathe in, and you can t get an adequate breath in. This may lower the level of oxygen in your blood. You consult a physician for this problem. For milder cases of sleep apnea, your doctor may recommend only lifestyle changes, such as losing weight or quitting smoking. And if you have nasal allergies, your doctor will recommend treatment for your allergies. If these measures don t improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary. Treatments for obstructive sleep apnea may include:1. Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring. 2. Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances may be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea. Surgery is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. Surgery includes- Tissue removal, Jaw repositioning, Implants etc. Now coming to your problem of tinnitus: To treat your tinnitus, your doctor will first try to identify any underlying, treatable condition that may be associated with your symptoms. If tinnitus is due to a health condition, your doctor may be able to take steps that could reduce the noise. Examples include: 1. Earwax removal. Removing impacted earwax can decrease tinnitus symptoms. 2. Treating a blood vessel condition. Underlying vascular conditions may require medication, surgery or another treatment to address the problem. 3. Changing your medication. If a medication you re taking appears to be the cause of tinnitus, your doctor may recommend stopping or reducing the drug, or switching to a different medication. Noise suppression In some cases white noise may help suppress the sound so that it s less bothersome. Your doctor may suggest using an electronic device to suppress the noise. Devices include: 1. White noise machines. These devices, which produce simulated environmental sounds such as falling rain or ocean waves, are often an effective treatment for tinnitus. You may want to try a white noise machine with pillow speakers to help you sleep. Fans, humidifiers, dehumidifiers and air conditioners in the bedroom also may help cover the internal noise at night. 2. Hearing aids. These can be especially helpful if you have hearing problems as well as tinnitus. 3. Masking devices. Worn in the ear and similar to hearing aids, these devices produce a continuous, low-level white noise that suppresses tinnitus symptoms. 4. Tinnitus retraining. A wearable device delivers individually programmed tonal music to mask the specific frequencies of the tinnitus you experience. Over time, this technique may accustom you to the tinnitus, thereby helping you not to focus on it. Counseling is often a component of tinnitus retraining. Medications: Drugs can t cure tinnitus, but in some cases they may help reduce the severity of symptoms or complications. Possible medications include: 1. Tricyclic antidepressants, such as amitriptyline and nortriptyline, have been used with some success. However, these medications are generally used for only severe tinnitus, as they can cause troublesome side effects, including dry mouth, blurred vision, constipation and heart problems. 2. Alprazolam (Niravam, Xanax) may help reduce tinnitus symptoms, but side effects can include drowsiness and nausea. It can also become habit-forming. regards- Dr Sanjay Kini