Luvsoccer wrote:Greetings. I was diagnosed with moderate sleep apnea about 6 months ago and have been using a CPAP device for most of the past 6 months. On the positive side, the quality of my sleep is noticeably better when using the machine. On the negative side, my GERD (acid reflux) has gotten significantly worse during the same time period and I now suspect that the CPAP use is one of the principal causes. Over the past week I slept a couple of nights without the CPAP and noticed that my reflux started to improve. I then started in again on the CPAP and the reflux is much worse again.
After doing some online research I saw reference to a small study done a few years ago that indicated CPAP use actually improved GERD so I am scratching my head. Other than acid reducers, about the only other medication I have been on during this time period has been Flomax. I stopped taking Flomax a week ago, thinking that might be the contributing factor, but now it appears that it is the machine. I go back to see the sleep specialist in a week and my ENT in a few days.
My question: have others experienced similar results, where GERD gets worse with machine use? I was scheduled for turbinate reduction surgery in two weeks but will likely now put it off so I can first find root cause for the increased GERD. If I can no longer use the machine I will have to try something else. My ENT has indicated he can do some throat work while performing the turbinate reduction. I had previously ruled that option out but now that I am having this CPAP/GERD issue I wonder if I should reconsider. The GERD gets pretty bad after using CPAP, including esophageal spasms, pain in sternum, acid throat, acid in sinuses, etc. It is not a pretty picture.
Thanks in advance for any info on similar experiences, or suggestions on how to find root cause so I can determine the appropriate remedy.
The research does show a strong relationship between GERD and Obstructive Sleep Apnea (OSA). And yes, if your OSA is well treated then the tendency toward GERD may reduce.
So you have been treated for six months. It took me about seven years to figure out that every autumn I would see a greater Apnea Hypopnea Index (AHI) and that (noticed by pictures of the back of my throat) the increased AHI was related to GERD. I try to stay away from pharmaceutical use so chose to raise the head of my bed a few inches to solve the GERD.
That seems to work except near the anniversary of a severe physical attack (I was stabbed, robbed, and beaten) which has left me with what I now know is a tendency to hyperventilate. CPAP tends to make Hyperventilation worse (this probably has to do with the increased ease of inhalation making it even easier to over breath). The doctors call this ventilatory instability brought on by a lack of CO2 reserve.
Also whatever makes the AHI go up, once it is up it tends to get worse. Also, if you have GERD your AHI will likely go up. Since the OSA increases stress hormones and since the breathing that occurs when the ventilatory instability results in the use of much more air means much less room for stomach contents and greater vacuum to bring it into the airway passage the GERD and OSA tend to help each other become worse.
To help manage this I:
Monitor my CPAP data with it's software regularly
Make time to get more sleep
Walk regularly with a eventual goal of 10,000 steps a day, often walking at a constant pace while consciously breathing less or more to achieve lowest heart rate at the constant output.
Eat a bit of fibrous veggies near bedtime (this seems to make my tummy happier).
Try to watch my weight.
Have learned to note such things as a stuffy nose as an indication I am breathing too much and use some techniques I learned to reduce my air use and stabilize my breathing at a lower healthier level (note the reference to my heart rate monitor above).
Keep my machine clean using my vibratory snoring levels (indicated by my CPAP software) as a guide for when to change filters and possibly use some O3 (ozone) to freshen the inside of the machine (of course I let it run for a couple of hours in the open air after that).
I do hope you and your doctors find good answers. You may need a better machine.