Have heard that aerophagia can also be caused by a hiatal hernia - the flap at the end of the esophagus is weak and opens as the air goes into your body.  This sends the air into your stomach and then down through your digestive system.  The doctors will tell you that you can "cure" it by:  1) raising your head; 2) lowering your head; or 3) taking Gas-Ex or a similar product.  They don't tell you (without some prodding) that lowering your pressure initially or adding a humidifier may help.  For me, none of these "remedies" worked although the lower pressure did provide some relief as did going to a full-face mask.  The only thing that really helps is to roll over on your left side to let the gas pass out of your system in a burp.  The right side of your stomach is higher than the left and by lying on your right gravity helps the gas escape.

Has anyone come up with other remedies?  Sure would love to see some.  I am still fighting the "mask battle" and am going on Monday to get a smaller one that will fit my face.  This "one of three sizes (small/med/lrge) fits all" hooey is driving me nuts.  Maybe the next mask will work better.

A education bulletin from the ASAA says that to reduce aerophagia, you should sleep with your head aligned with your body--not pointed up or down or sideways.  A pillow that is too high can cause your head to roll sideways so try using a relatively thin pillow.

Tried both high and low positions with my head.  The problem is that like many apnea sufferers I also have TMJ which causes the first three fingers in my hands to go numb (pinched nerve in my neck).  If I sleep with two pillows such that my shoulder is on the mattress and my head is on the pillow it minimizes the numbness and reduces but does not eliminate the gas.  Have heard there is a pillow that helps CPAP users and wonder if it would also help the TMJ.

I truly believe there is a connection between TMJ and apnea but have yet to find anyone who knows how to cure both.

I have now been on CPAP for 2 years and still have problems with swallowing air most nights.  My best remedy is the Gas X at night and then move in the morning to get rid of what is left.  Mostly it goes rather quickly.  My doctor says it is partly due to a hiatal hernia that I have.  My pressure is at 16, and I use the humidity at a medium setting during the summer and a higher one during the winter.  I am not sure there is a good answer to this one.  I have noticed that when I make sure that my head is level with the rest of my body--neither up higher or down lower, I seem to have less of a problem.  

Good Luck
Madre


_________________
Believe in yourself--you are fantastic!!

To those who have been told by the pundits that the gas you experience is from swallowing air at night, there might be a better explanation.  If you have a hiatal hernia you aren't swallowing gas to cause the flatulence and belching.  Instead it's the fact that your hernia is allowing gas to more easily enter your stomach as a result of having the air pumped into your system by the CPAP machine.  My experience last night was the final proof I needed.  At 10PM when I went to bed I put on a "new" mask, the ComfortFull 2 in the hopes of sleeping better (the previous one had leaks).  What a mistake it was to change.  In the two hours between 10 and midnight I lay awake trying to stop the whistling, fluttering, buzzing sounds of the leaks.  At the same time my stomach began to fill up like a baloon as the CPAP machine chugged air right into my stomach.  At midnight I sat bolt upright and belched a huge amount of air out of said stomach, pulled the mask off and replaced it with my FlexFit 431 and finally slept.

To put this more succinctly, the inhilation therapists and doctors may be all wet if they tell you that swallowing air is causing the gas.  Funny how they tell some patients to raise their heads so the gas isn't as bad....isn't that the same thing they say if you have a hiatal hernia?  

One thing I found that provides some relief is to roll over every so often on your left side.  It seems your stomach is higher on the left side.  If you have gas during the night it tends to go to the top of your stomach and can be more easily belched out if you are lying on your left side, preventing the pain that results when that same gas goes down your intestinal tract.

mesocosm,

I agree completely with tillymarigold. Where has your doctor been, in a cave in Afghanistan?

I strugged with both swallowed air and waking gasping for breath for more than three years before I discovered the delights of a properly configured Respironics APAP with C-Flex turned on to its maximum of 3.

I've had one for going on four months and both problems are totally solved. I'm getting the best sleep I've had in years.  If you can talk your doctor into the APAP make sure the lower bound setting is at least a 6, but preferably a 7 or 8 because of your titrated pressure. Setting the lower bound too low will negate its effectiveness and might actually increase your problem.

For the leg problems my doctor recommended a multivitamin with iron. I had both leg twitching and cramping for years. Within a month both were gone and have not returned.

Hope this helps, good luck.

Runningbare



Last edited by runningbare on Fri Aug 17, 2007 3:26 pm; edited 1 time in total
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I am an engineer not a doctor. All of my suggestions are from my own experience and not medical advice. All information should be discussed with your doctor before implementation.

Respironics M Series APAP w/C-Flex & heated humidifier & Optilife Mask

WOw,

Thanks everyone for the pointers on this thread...   that I started TWO years ago!  I made that first post back in June of 2005.  It is funny how some of these old threads get revived.  

My update:  The aerophagia is now virtually gone ...  I guess I got used to it after a month or so.   I also switched to CPAP with CFLEX and I use the Hybrid mask and things are much improved.

I take Mirapex for the RLS/PLMD now and it helps a lot.

Thanks everyone!

Paul


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mesocosm

OSA / PLMD / Atrial Fibrillation

OMG I am so glad I found that this may be the cause of my pain.  I have been a "successful" C-pap user for several years now and had experienced "bloating" gas in the am etc.
  But on Monday I experienced a sharp excrutiating pain that shot from my abdomen and around to my back. I had to go see my doctor in fear of some abdominal infection as I had been in Grand Cayman for the prior week and thought maybe I ate something bad.  She prescribed an antibiotic and vicodin (they give these away like candy it seems).  I went home in pain and later went to bed only to a rough night of pain and when I awoke the pain had traveled to my back and was unbearable.  3 vicodin later and the pain laughed at the supposed pain meds.
  My wife took me to the ER where I took short breaths and steps so as to not cry or go into shock.  I know it sounds dramatic but it fealt worst than I could even describe here.  They gave me 2 then 4 more milligrams of morphine and the pain subsided a little bit but frankly not that much.  They drew blood, had chest xrays and when I finally went back to the ER room a little relaxed.......the relief of GAS...from flatulance began quite frequently.  Wow.  I knew in my heart it was a gas bubble but it accompanied a fever and high white blood cell count so they admitted me for "further testing".  
  They did it all.  Blood, sonogram, xrays, CT scan, the works.  Turns out I'm pretty healthy.  The next day I awoke very relieved and wanted to go home but a slight fever kept me there.  I go to bed, now with my cpap that wifey brought me and lo and behold the pain comes back toward the same general area but more toward the front still shooting up to the shoulder (right side).
   My goodness, I cannot believe this is happening but I was also constipated and had not had a bowel movement.  Shortly after BM I began to feel relief and slept well and was released today.

So now I'm writing to you at 4 am because could you believe 3 more BM's later the fricken' bubbles came back after 2 hours of sleep?  I now am horrified to go back to bed because I cannot sleep with the apnea but if the Cpap is going to give me these bubbles I simply CANNOT take the pain.  And sadly pain meds won't do anything.

So, I am BEGGING this forum to be my savior.  I will do ANYTHING to get rid of this pain that after countless belching and gases I cannot get rid of.  PLEASE PLEASE someone have an answer for me.

Alex

Have you been checked for a hiatal hernia?  If not, have your doctor check you out.  It seems that acid reflux can cause some really intense pain, often mimicking a heart attack.  The CPAP causes the flap (already weakened by the hernia) to open and gas pours into your stomach.  I am battling both - gained a few pounds and the hernia has returned.  You could also be having esophageal spasms (caused by both the hernia and reflux).  These can really be painful, too.  I have taken antiacids for the reflux and strangely enough ibuprofen helps the spasms.  I started the CPAP earlier this spring and have had continuous problems with gas caused by my hernia.  My next step will be to have my doctor prescribe something to heal the hernia, with the hopes the gas will decrease.  Am using a full-face mask as that seems to work better than the nasal pillows with a chin strap.  Good luck - the whole apnea thing seems to be a long battle that the doctors just don't know enough or care enough about to really help those of us who suffer.  And it doesn't seem that they are concerned about the gas, either - their solutions don't work!

fritzgla wrote:

Have you been checked for a hiatal hernia?  If not, have your doctor check you out.  It seems that acid reflux can cause some really intense pain, often mimicking a heart attack.  The CPAP causes the flap (already weakened by the hernia) to open and gas pours into your stomach.  I am battling both!

Which doctor should I go to for this???  My GI doc???  It is perfectly evident to me that it is gas because upon release of gas I feel somewhat alleviated.

I just don't know what or why all of a sudden I have this issue.  The C-Pap answer seemed a possible one as last night's pain came a few hours after going to bed.  Now I am scared to use it again because it takes all day before I feel better again.

How often should one be going back to the sleep specialist for correct pressure etc.?    I have never gone back since 2003.

You've asked some good questions.  The Mayo Clinic site says "Hernias occur when one part of the body protrudes through a gap or opening into another part. And although a hernia can theoretically develop almost anywhere, most are in the abdominal area. This includes hiatal hernias — also known as diaphragmatic hernias — which form at the opening in your diaphragm where your food pipe joins your stomach.  Most small hiatal hernias don't cause any problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn and chest pain. Self-care measures or medications can usually alleviate these symptoms, although very large hiatal hernias sometimes need surgical repair."

Another innocuous-sounding (but painful) condition is called  "taco tear".  If you ate something rough like a taco chip you could have lacerated your esophagus which would also have resulted in severe pain.  The relationship between the hiatal hernia and the CPAP-caused gas has been noted before in this forum and a number of us have experienced it.  As the stomach flap is weakened by the hernia the gas is more easily "pumped" into the stomach.  The interesting thing about this is that the increased pressure can also help prevent acid reflux as the acid is forced to stay in the stomach.  Thus you may have had a hiatal hernia for some time and didn't realize it.

As to your question about when to go to a sleep specialist, I would love to hear the answer.  It seems the doctors can prescribe the CPAP machines and then just turn folks loose without any further assistance.  Anyone have a good answer?

I have had the same problems with stomach bloating and gas. I also have a Hiatal Hernia. I started out a year ago with a CPAP, then went to a BI-PAP, and now I am on BI-PAP S/T. My inhale pressure is set on 22. I have to tighten the mask to where it causes me much discomfort to keep it from leaking. I haven't gained any weight, but my waist size has increased 3 inches, because of the air that is always trapped in my abdomen.

I have been experiencing severe aerophagia now tih my BI-PAP turned up from 10 to 12.  I use the GEL nasal mask from Respironics.  The main cause is that I have to tape my nouth shut to keep the air from rushing out as I nod off to sleep (my idea).  My doctor's don't like the idea of the tape but I cannot fall asleep at all with the air coming out of my mouth.

I cannot tolerate the full face asi t leaks bad and I have severe TMJ that triggers tremendous pain and headahces if the mask presses on my jaw.  When I tape my mouth shut, the air cannot escape and it then goes into my stomache and makes me burp until I learned to swallow the burp (air).  I can feel the air rumble into my stomache and after about the eighth time (each burp arrives about every 30 seconds), the burping subsides, the Ambien CR kicks in and I fall asleep.  I awaken a few time during the night with huge bloating, gas, etc. and go through the process again and try to sleep.  In the mornig, my stoche feels like irt is going to burst and I have trmendous gas and discomfort problems for a good part of th day.  Each night, I go through this again.   I I ramp up, it helps but I often feel as though I am suffocating and either rip the mask off or wake up with it off my face and those old apnea symptoms are present.

I am going on the AUTO to see if it will help.  Any ideas would be helpful.............

The links and suggestions in this thread are the ticket -- positional changes, higher setting of exhalation relief on your PAP, gas-x or similar product, and maybe an auto titrating machine.  For some it takes only a little experimentation, for others it takes a LOT... just when you think you've tried it all you think of something else and that's the one.  Don't give up, keep thinking about ways to change the relationship between your head and your neck, which in turn changes the relationship between your airway and your esophagus.  A small variation on something you've already tried might be the one that works.  You CAN find it, just keep looking, and combine with the other suggestions if necessary.

Blessings,
--pseudonym

Hi Everyone,
I have been on the Resmed Auto APAP with the Swift II Nasal Pillow with chin strap and the humidifier and I still get horrible air in my stomach. I've tried adjusting the head of my bed, changing pillows (I usually use a special neck pillow), no pillow and still get it. Not as bad but some days it's horrible. I've been using the machine now for almost two months and I still wake up tired but now I've got a bad stomach and a sore back and neck. I would really like to know what I can do besides what I'm doing. I'm going to try no pillow tonight with the bed flat and see if that helps. My setting is at 5 - 20 and I usually have an average of 10. Thanks for all your help and suggestions, the technician was of no help at all. Hopefully, if this doesn't resolve, the doctor will be able to help me when I see him.
Mary