aerophagia

I havent had much of a wind problem since switching from cpap to apap. but in the last few weeks, i have had two terrible mornings, one meant i was 2 hours late in to work (and its not a flexible job so i am just lucky it was a nicer manager on), this morning I had to cancel my plans. Dont see anything in the data from the two nights, which look pretty much like all the other nights. Havent eaten late, or heavy food, or had a lot of fluids near bed time.
Currently I switch between a quattro fx (as it hurts the bridge of my nose after too long) and quattro mirage (as it hurts the inside of my nose after too long), maybe 4 nights on each. Both nights its been the mirage I've had on, but imagine thats just a coincidence. I spend most of my time on my left side, on two pillows - although might bring in another pillow to increase the incline.
I have lost a bit of weight, enough that I could get retested on the NHS - but i kind of figure if the pressure moves like it does, i still have apnoea anyway, although my average pressure has gone down with the weight loss.
Is it worth turning EPR up to 3?
Dont think lowering the starting pressure will help since I do spend most of my time above it - and dont look to go above 13 anyway. thoughts on lowering the max? Pretty keen to avoid any mornings like these - although maybe it has just been some random bad luck, given i've had no problems for so long?

zoomed in the first one cause I had a nap earlier in the day.



random night with no problems

Diamondminek wrote:I havent had much of a wind problem since switching from cpap to apap. but in the last few weeks, i have had two terrible mornings, one meant i was 2 hours late in to work (and its not a flexible job so i am just lucky it was a nicer manager on), this morning I had to cancel my plans. Dont see anything in the data from the two nights, which look pretty much like all the other nights.

Aerophagia is bummer.

The only immediate difference I can see between the random good night and the two bad ones is that on the two bad ones there's a bit of minor mouth breathing showing up in the leak line. Not enough to cause official Large Leaks, but maybe when you do a bit of mouth breathing, that somehow encourages the air to get into your stomach. But I'm grasping at straws here.

Currently I switch between a quattro fx (as it hurts the bridge of my nose after too long) and quattro mirage (as it hurts the inside of my nose after too long), maybe 4 nights on each. Both nights its been the mirage I've had on, but imagine thats just a coincidence.

Sounds like trying a third different mask might be worth considering.

I spend most of my time on my left side, on two pillows - although might bring in another pillow to increase the incline.

Finding a comfortable sleeping position is critical. The more restless you are during the night, the worse the aerophagia can be: Restlessness can trigger swallowing which triggers aerophagia which triggers more restlessness which triggers more swallowing which triggers more aerophagia, and so on and so forth.

Is it worth turning EPR up to 3?

Yes, it's worth trying an EPR = 3. If that makes the situation worse, it's also worth trying EPR = 1 or even EPR = off. Some people with aerophagia problems find a larger EPR useful. Others find a constant pressure useful. Experiement and see what leads to the least aerophagia in your case.

Dont think lowering the starting pressure will help since I do spend most of my time above it - and dont look to go above 13 anyway. thoughts on lowering the max?

I don't think lowering your starting ramp pressure or min pressure setting will help. Lowering the max to 13 is worth it, but probably won't do much of anything.

It's counterintuitive, but if your stomach can tolerate a bit more minimum pressure that may help in the long run since a higher min pressure should result in smaller pressure swings. But with aerophagia it can be hard to tolerate even a minor 1-2cm increase in min pressure. (As I'm finding out in my own need to increase my min EPAP from 4 to 6 cm.)

Thanks for breaking it down like that. I'm wondering if related to how I breath with the different masks, and the humidity, it's the xylimelts making the swallowing difference - my mouth doesn't get so dry with the mirage, so since I recently have been using two with it and been overly wet, maybe more saliva to swallow is leading to the issue. At any rate I switched to one xylimelt with the mirage and sticking to two with the quattro, and so far haven't had any more problems...so think I will leave it at that before adjusting anything else.