The tunneling path between the CuO2-layers in cuprate superconductors and a scanning tunneling microscope tip passes through a barrier made from other oxide layers. This opens up the possibility that inelastic processes in the barrier contribute to the tunneling spectra. Such processes cause one or possibly more peaks in the second derivative current-voltage spectra displaced by phonon energies from the density of states singularity associated with superconductivity. Calculations of inelastic processes generated by apical O-phonons show good qualitative agreement with recent experiments reported by Lee et al. [1]. Further tests to discriminate between these inelastic processes and coupling to planar phonons are proposed.PACS numbers: 74.25.Kc,74.50.+r,68.37.Ef The importance of the electron-phonon interaction in the high temperature cuprate superconductors has long been a matter of debate. In conventional superconductors tunneling experiments analyzed by McMillan and Rowell [2] not only unequivocally established that the exchange of phonons between electrons is the underlying mechanism for Cooper pairing but also allowed its spectroscopic determination. In the case of cuprates there are many good reasons to doubt the dominance of an attraction due to phonon exchange. These reasons range from the d-wave rather than s-wave pairing symmetry, to their electronic structure as lightly doped Mott insulators. The latter points toward a strong onsite Coulomb repulsion which cannot be treated perturbatively, violating a key postulate in the standard BCS-Eliashberg theory. A number of proposals have been made for a subdominant role for the electron-phonon interactions particularly involving the half-buckling phonon modes which couple attractively in the d-wave pairing channel [3,4,5,6,7,8].Very recently, a new set of tunneling measurements at low temperatures has been reported by Lee et al. [1] using a STM (Scanning Tunneling Microscope). Results with this local tunneling probe show considerable variations in the form and energy of the density of states (DOS) singularity associated with the superconductivity and also a peak in the second derivative current-voltage spectra which is displaced from the DOS peak by a fairly constant energy. Lee et al. [1] report further that isotope substitution on the O-ions shifts this energy consistent with a phonon origin for this peak. This raises the question whether these spectra should be interpreted analogously to those of conventional superconductors or if these peaks have another source.A series of works explain the appearence of side peaks in the DOS of d-wave superconductors in terms of localized bosonic modes [9], resonant spin modes [10,11] or the breathing mode phonons [12]. All these proposals consider inelastic processes that happen directly in the superconducting plane. In this letter we examine an alternative explanation in terms of inelastic tunneling processes. Such inelastic processes are well established in electron tunneling spectroscopy [13,14,15,16] of metal-insu...