CPAP Therapy Shows No Impact on Eustachian Tube Function but Highlights Need for Side-Effect Awareness: Study
Istanbul: CPAP therapy does not affect Eustachian tube function, but understanding its side effects can improve patient compliance, according to a study published in the Journal of Otolaryngology–Head & Neck Surgery by Dr. Fadlullah Aksoy and colleagues from Haseki Research and Training Hospital, Istanbul.
The findings suggest that while CPAP remains an effective treatment for obstructive sleep apnea syndrome (OSAS), awareness of its subtle impacts on ear physiology can help clinicians guide patients and improve adherence to therapy.
The study was designed as a cross-sectional clinical evaluation at a tertiary referral center. It involved 51 patients with OSAS using CPAP therapy for at least six months, averaging 51.2 years of age, and a control group of 48 OSAS patients not using CPAP, with a mean age of 36 years. In total, the study examined 102 ears in the CPAP group and 96 ears in the control group. Researchers assessed Eustachian tube (ET) function using the automatic Toynbee test, a standardized method to evaluate middle ear pressure regulation.
The study revealed the following findings:
- In CPAP users, the mean middle ear pressure was significantly higher in the left ear compared to the right ear.
- When comparing CPAP users with the control group, the right ear’s mean middle ear pressure was higher in the control group.
- There was no significant difference in functional versus nonfunctional Eustachian tube between CPAP users and non-users in either ear.
- Long-term CPAP therapy does not appear to impair Eustachian tube physiological function.
The study highlights the importance of recognizing subtle effects of CPAP on the upper respiratory tract, even when they do not result in measurable dysfunction. By understanding how CPAP interacts with ear physiology, clinicians can better explain potential minor discomforts to patients, such as mild ear pressure changes, which may arise during therapy. This knowledge can be used to reassure patients, manage expectations, and encourage continued adherence to treatment.
Dr. Aksoy and colleagues emphasize that proper patient education regarding CPAP’s physiological effects may play a key role in enhancing compliance. Since consistent use of CPAP is crucial for managing OSAS and reducing associated health risks such as cardiovascular complications, strategies to minimize perceived discomfort can have significant clinical implications.
The study demonstrates that CPAP therapy for OSAS does not negatively impact Eustachian tube function in patients using the device for six months or more. While minor variations in middle ear pressure were observed, these did not translate into functional differences. Understanding these effects can help clinicians address patient concerns, improve tolerance, and support long-term adherence to CPAP therapy, ultimately optimizing treatment outcomes for individuals with obstructive sleep apnea.
Reference:
Aksoy, Fadlullah, et al. "Eustachian Tube Function in Patients Receiving Continuous Positive Airway Pressure Treatment for Sleep Apnea Syndrome." Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale, vol. 39, no. 6, 2010, pp. 752-6.
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