Aerophagia
Can any one give me any pointers for the problem of "aerophagia" = swallowing air. I have been swallowing air from CPAP therapy. It is quite painful at times (gastric bloating) and I wake up frequently to burp. I was originally at 15cm, but my Dr. just backed me off to 13cm. I'm going to try the 13cm tonight for the first time.

Here is my info...

REMstar plus w/ c-flex
Heated Humidifer (set on 2)
13cm H2O (c-flex setting on 3)
Ramp start point 8
Ramp duration 25 min

F&P HC431 FlexiFit FF Mask (primary Mask)
F&P Acclaim 2 Nasal Mask w/chin strap (my first mask and my backup)

I am a terrible mouth breather and my mouth pops open all the time... even w/ a chin strap. I can crank down on the chin strap and stop it, but then I wake of with the worst splitting headache ever!

Any help that you folks can give would be greatly and MUCH appreciated.

Sincerely,


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mesocosm

OSA / PLMD / Atrial Fibrillation

Hi meso!  

If it were me, I'd ask the doctor to let me have a trial on an autopap - specifically the Respironics REMstar Auto with C-Flex and heated humidifier.

It might be that during most of the night you don't need the titrated pressure of 15 -  or even the 13 the doctor let you drop down to for awhile to deal with the aerophagia.

It might be that you spend most of your sleep with lower pressures handling you just fine.  Maybe.  Maybe not.  There's no way to know for sure unless the doctor will let you try an autopap.   The reason I mentioned that specific brand/model of autopap is that the C-Flex might also give you some welcome relief when you exhale.   It's the only autopap that currently has a feature that can drop the pressure each time you breathe out.
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My disclaimer:  I'm not a doctor, nor have I ever worked in the health care field. Those are just my personal opinions.  A mask or machine I love/hate could be completely the opposite for others. Finding suitable equipment can be an expensive trial and error experience.
 

Thanks rested Gal,

I tried and lobbied for the APAP w/cflex, but my doctor wanted to try lowering the pressure first.  He said that APAP my not necessarily help my aerophagia.   He said that aerophagia is not something that he encounters frequently and he wanted to take it one step at a time.  He didn't rule out the APAP... he is just cautious I guess.  

Last night at 13cm was a little better.  I only woke up once with a minor case of "bloating."  I slept a little better.  However, after being on xPAP therapy for nearly two months, I have yet to see a major turn of events....  but I am going to see this through.   EVen at 15cm last week, I woke up a few times gasping for air even inside the FF mask.  

regards....


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mesocosm

OSA / PLMD / Atrial Fibrillation

Well I can tel you from my personal experience that I still experienced it with an Auto.  That isn't to say that it didn't help, it very well might have been worse with straight CPAP.  

Couple of things that helped.  

Gas-X!

Moving around!!  This sounds counterintuitive, but it helps get the air out.  


after about 2 weeks, I didn't have problems.  And I was told that it can be common when you first start therapy.  How long have you been on CPAP?

MikeSus,

I have been on CPAP for about a month and a half now.  It has gotten a little better...  every now and again I have a really bad night of swallowing air and then I'll have a couple of mediocre nights...  I still have yet to sleep all night without waking up.  I haven't felt rested yet, but I am going to stick with it.   13cm seems to help ...   15 was maybe a tad too high.

--Paul


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mesocosm

OSA / PLMD / Atrial Fibrillation

mesocosm wrote:

MikeSus,

I have been on CPAP for about a month and a half now.  It has gotten a little better...  every now and again I have a really bad night of swallowing air and then I'll have a couple of mediocre nights...  I still have yet to sleep all night without waking up.  I haven't felt rested yet, but I am going to stick with it.   13cm seems to help ...   15 was maybe a tad too high.

--Paul

Another option is trying a machine that gives relief on exhalation.  I have an auto that does both and I still got it, but I think it would have been worse if it were straight CPAP.

Why are you not sleeping all night?

MikeSus,

I also have PLMD...  My legs twitch alot...  I am on mirapex for that.  0.125mg.   It seems to help some.  I also had mask issues ... leaks... and something tickling my face under the mask.

Paul


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mesocosm

OSA / PLMD / Atrial Fibrillation

mesocosm wrote:

MikeSus,

I also have PLMD...  My legs twitch alot...  I am on mirapex for that.  0.125mg.   It seems to help some.  I also had mask issues ... leaks... and something tickling my face under the mask.

Paul

Some masks seem to put the air right in your face at an odd angle and tickle... I personally like the nasal pillow type, so the therapy just goes up the nose, and not on my face...

Good luck!  I know how painful it can be...  Like I said tho, mine went away completely after a few weeks.

Regards,

I had a lot of problems with aerophagia when I first started using a CPAP approximately 10 weeks ago.  My main means of relief was constant burping (not pretty).  I was drinking Maalox by the gallon with a small amount of relief.  Anyway, I'm pleased to say that this problem has dissipated over time, so perhaps you will be lucky enough to see this problem go away soon.  Also, I start my ramping at 4 and ramp for the maximum 30 minutes on my machine.

I've had a CPAP machine (11cm) with a face mask for about 2 years.  It has worked wonderfully for me as far as the OSA is concerned.  About 2 months ago, I've started waking up early in the morning (4/5am) with a bloated, tight & uncomfortable stomach.  This condition seems to dissipate after some burping & umm... farting (& it never shows up during the day), but its kind of getting to be a drag having my sleep interrupted/shortened every night.

Before I go down the Auto-pap route suggested here,  a couple of questions on simpler remedies:

1) For no really good reason,  I stopped using my humidifier around (maybe a month before) the time the bloated stomach symptoms) started appearing.  Does anybody know if aerophagia can be caused by excessive mouth dryness (according to some other post,  you may tend to swallow more to combat dryness)?  I am going to retry the humidifier anyway,  but I'd like some experiences here if available.

2) Do nasal pillows (rather than the face mask) lower the risk of aerophagia? Has anybody got rid of aerophagia symptoms by switching to nasal pillows?

I wonder how widespread aerophagia is among CPAP users.  My sleep center doctor said he hadn't heard of CPAP users having stomach/gastric bloating & sent me down a path of checking for GERD/Acid Reflux.  After 3 weeks of messing around with acid reflux related experiments and finally, a definitive endoscopy to rule out acid reflux,  I am now back to trouble-shooting my CPAP setup.   Progress,  I guess, but frustrating...

My suggestion with your mouth popping open due to air escape is for you to move to a full face mask which will cover your nose and mouth.

Drop the chin strap thing. I had the same air mouth pop problem and moved to the full mask which has eliminated this issue....

I have a problem with air swallowing when I use my CPAP. My doctor has lowered the machine to the lowest possible air pressure that would do any good and I have put my ramp time as long as it will go. Still I have bloating, burping, and awful nausea. It is absolutely intolerable. So my doctor ordered another sleep study to fit me for a BiPap, saying that this would make a difference. The ResMed representative said he didn't understand why the doctor thinks a BiPap will help. I don't want to do another sleep study to be fitted with a BiPap if it won't do any good because my insurance only covers part of it. I have already had two expensive sleep studies.

My doctor didn't say anything about an APAP. I don't think my insurance covers this, as I have heard these machines are more expensive than the others.

Also, I am being fitted for a dental device, but I have read so much about how ineffective they are.

Paul,

I too have PLMD.  My Mirapex dose is higher.  If you are still kicking, yours may need to be higher too.  Those drugs which mess with dopamine receptors can have some terrible side effects though, so you want the lowest dose that is effecitive, and the only way to tell efficacy is to have someone watch if you twitch or a sleep study.

Also, you probably know this, coffee is going to make it worse as is an Fe deficiency.  So your sleep doc. should be checking your iron levels also.

Vicki


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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

I have an APAP and FFM and occasionally get the horrid aerophagia-last night for example. But for the most part, it is a little better. I usually put my chinstrap on when I start to feel it coming -sometimes I don't wake up in enough time and the only thing that helps is taking off the mask-then I'm really tired the next day. (like today!)
I have never had GERD-nor do I think I am developing it. My problems started only when I began CPAP therapy.
everyone says time cures it... but I'm still waiting. I've been pappin' since February.  I think there needs to be more research on this side effect as it really hurts!  
Katherine

If your doctor says he rarely encounters aerophagia, either he's lying or he's an idiot or his patients don't trust him enough to talk to him. The sleep tech who first set me up told me that it's pretty common (about half of people get it) but most of them adapt quickly (in under a month) and get over it.

It took me about a week to adapt although I still have some nights that are a bit worse than others. My pressure is quite low though (6-9).

I do have both an AutoPAP and nasal pillows, I've never used anything else so I can't comment on whether it's better or worse this way.


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Machine: Puritan-Bennett GoodKnight 420E (Auto)
Mask: OptiLife/Hybrid