Aerophagia poses catch-22 dilemma

Successful treatment of my complex sleep apnea has been been frustrated by unresolved aerophagia issues spanning over many years and I don't know where to turn for answers. Simply put, I have a long history of interrupted sleep due to aerophagia, particularly occasional hiccups, while asleep. Under a sleep doctor's supervision, I have adjusted the pressures downward, even to the lowest setting on my Resmed S9, without much improvement. Out of frustration, I will try sleeping without the machine, which, although sometimes successful, more often results in sleep interruptions from the complex apnea. This routine of on-again off-again with the machine happens most nights. Some nights I sleep better due to shear exhaustion or from a little help from a sleep supplement containing phenibut.

An ENT exam ruled out anatomical problems and I have tried using chin straps and monitoring nasal mask leaks.

My doctor believes my aerophagia might be caused by periodic limb movement, which he says elicits a reflexive swallow response. I tend to disagree as I experience the aerophagia even when I am still in a conscious state, and neither I nor my wife have ever noticed any leg jerks with me. (Interestingly, my wife does have plm and I am sometimes awakened by her leg movements). The doctor's protocol calls for increasing ferritin blood levels through supplementation and taking low-dose Parkinson's medication.which has made a difference for other patients. I might add that the sleep study recorded increased "leg movement". However, I believe what was recorded was nerve twitching from benign fasciculations in my calves, a condition I have had for several decades. Fasciculations are not noticeable to the extent that they should wake me up.

Nevertheless, I did try following the doctor's orders regarding the Parkinson's meds for a week but with no results. He wants me to up the dose. If that doesn't work, he wants me to try one or more other meds, until I find one that works. My intuition tells me I am going down the wrong path for the reasons just given.

We seem to be at a stalemate. The whole thing is frustrating and complicated. I am concerned about the negative implications for my health from this and need to find a solution.

Has anyone else had this problem? Any suggestions are appreciated.

Thanks for reading.

Curious to ask if you've ever had an endoscopy? Or tried taking small amts before bed of either something uncomplicated like a small TUMS, or possibly even Beano (if only to see the effects)?

Julie wrote:Curious to ask if you've ever had an endoscopy? Or tried taking small amts before bed of either something uncomplicated like a small TUMS, or possibly even Beano (if only to see the effects)?

Thanks for your reply. Your suggestion of taking calcium carbonate or charcoal tablets sounds novel.

It sounds like your larger question has to do with acid reflux. I have had an endoscopy and an esophogoscopy. Nothing with the latter. Throat redness and granulomas, however. I'm pretty sure I have silent reflux. I have been following Jamie Koufman's reflux diet and have slowly recovered from months of throat irritation. I had also broached the subject of a possible correlation between acid reflux, a weakened esophageal sphincter and the aerophagia problem to my sleep doctor. I have a real concern that the cpap machine pressure is either causing or exacerbating a weak sphincter and causing the hiccuping while I sleep.

Another area I am wondering about is anxiety's role in sleep apnea (and reflux for that matter). Anxiety can cause shallow breathing (hypopnias), and I've wondered if treating anxiety might indirectly address complex sleep apnea. There is also some auyervedic approaches to treating shallow breathing which I have not pursued.

The occurrence and frequency of hiccuping varies. Some weeks I have very little. That is why I wonder if there are other factors, such as anxiety, that are playing a role here.

Hiccups does go with GERD. Have you tried raising the head end of your bed on 5" blocks of some kind - apparently it really helps, and seems a little less daunting than dealing with Ayurvedas .

Julie wrote:Hiccups does go with GERD. Have you tried raising the head end of your bed on 5" blocks of some kind - apparently it really helps, and seems a little less daunting than dealing with Ayurvedas .

I have tried raising bed at about 4", but it didn't make a noticeable difference. BTW, I don not hiccup at all in my waking state.