Cpap blows air into stomach

Hello. I'm new here.

After 9 years of successful (more or less) cpap treatment, I've stopped using cpap for the last 7 months because of cpap blowing air into my stomach, causing gas pains very quickly after turning it on. Does anyone have any suggestions? I'm going to give all my details below for context, but the main problem I'm focused on is how to get the cpap to stop blowing air into my stomach.

DIAGNOSES
327.23 Obstructive Sleep Apnea
327.15 Hypersomnia not due to substance or known physiological condition
RLS
Severe acid reflux
Hiatal Hernia
Severe Depression and Anxiety


HISTORY
2009 Sleep Study 1 (Diagnostic only. No cpap tried.)
DIAGNOSIS: Sleep Apnea (mostly hypopnea and no O2 desaturation).
PRESCRIPTION: cpap. Bought an Auto-Pap, since no titration was prescribed.
RESULTS: Within 3 days, using APAP brought my sleeping from 18 hours per day down to 12 hours per day, and much more functionality when awake.

2014 Sleep study 2: Diagnostic only. Did not qualify for a split night study. Doctor had hoped to determine optimal pressure setting.
DIAGNOSIS: Obstructive Sleep Apnea
PRESCRIPTION: Cpap
RESULTS: Continued using apap with auto-setting, with good results.

2017 Different Sleep Doc, different interpretation of same study. Looks at study but puts in his notes that the study showed that no sleep apnea was found. The study is full of contradictions, which I pointed out and he acknowledged. Still, when writing his notes, he didn't cross-reference the contradictory pages. In next appointment, I asked why his notes said I didn't have sleep apnea. He pointed out some numbers on my study. I asked then why he recommends a cpap for me. He said, "Oh, we try to get ev....lots of people on cpaps anyway because they help."
Complained of APAP blowing air into stomach: Doc recommended gas-x, which doesn't help enough. Then recommended a surgically implanted device that stimulates your tongue to keep out of the way.

2018 Stopped using APAP because:
APAP blows air into my stomach, causing gas pains, disturbing my sleep
APAP worsening reflux symptoms
Using a cough drop to anchor my tongue seems to help a lot
Haven't noticed increased fatigue since stopping
I have lost 40 lbs, but I'm only down to the weight I was the first time I was diagnosed. I'm still 50 lbs overweight.
Studied my sleep studies more closely and it looks like my RERA's are nothing compared to my Non-Specific (unknown cause) arousals. Sleep doc says I shouldn't focus on those, but admits he says that because they don't know what to do about them. He hopes the large number of non-specific arousals was just due to the strange environment of the sleep lab. Because I still sleep 10-12 hours per day and am debilitatingly exhausted, it makes sense to me that there is a high probability that I'm having those non-specific arousals at home too.


AROUSAL DATA
Arousals with Respiratory Events: 13
Arousals with LM Events: 58
Arousals with Snoring Events: 10
Non-Specific Arousals: 218
Total Arousals: 299
Arousal Index: 46

AHI
4.9

RESPIRATORY DATA
Lists various respiratory events, but zero RERAs, even though the arousal data says I had 13 "Arousals with Respiratory Events" in 6.5 hours of sleep.

EQUIPMENT
Resmed IPX1 (SN 23121706743) Autopap
Amara full face mask

PRESSURE
Auto-set. I've never had a set pressure. I don't qualify for a split night study to titrate a machine because my oxygen stats are not bad enough. So the docs say they can't adjust the pressure, even though they think it would help.

SOFTWARE
None. Not sure a machine as old as mine has it. I've always gone to the medical supply place for printed reports from the machine.

SUMMARY
Feel free to comment on any of this, but again, the main problem is the APAP blowing air into my stomach, causing painful gas. I would resume using it if this didn't happen.

It is a shame that most doctors know nothing about the settings. You don't need a titration to change the settings. You can download sleepyhead for free and post graphs of a typical night. We can help you dial in to better settings that will help with the air swallowing as well as better sleep apnea help. Using the machine wide open is a prescription for disaster. It's a wonder you have stuck it out this long at that setting.

Tell us more about your machine, mask, and settings. Download sleepyhead and post some graphs of a typical night, and you will get some useful advice.

welcome to the forum!

now, i KNOW you just listed your equipment in your post. this may seem redundant, but when you have time, please go to the control panel and list your equipment there. then it will show up at the bottom of each of your posts as mine does below.

you have an autoset machine, which is good. it means you can set your own pressures. and you CAN look at it to see what your pressure is.

i'm assuming the model listed will let you check your settings and even change them. but i may be wrong.(and often am!)

i'm thinking that your settings aren't set correctly and that maybe we can get that fixed for you so that you don't have to go through the gas pains any more.

someone with some knowledge and good advice will be along shortly to help you out.

good luck!

ETA: disregard, i see that your machine isn't current.

this is what i get for shooting off my mouth.

still, let's hope some knowledgeable person comes by with some advice.....

Welcome to the forum.

You got your machine in 2014???? A ResMed apap machine it sounds like..so probably either the S9 model or the AirSense 10 model. I forget just when the AirSense models replaced the S9 model.

Go here and see what your machine looks like to figure out if S9 or AirSense.
I got no where searching by the SN.
https://www.cpap.com/cpap-machines/apap ... e.php#:::2::::

Once you figure out which model (and hopefully not the S9 Escape Auto) we can better help you.
You can go here and request the provider/clinical manual which explains how you can get into the clinical menu setup area to see all your settings and make any changes to those settings if you wish. It's not hard at all.
https://www.apneaboard.com/adjust-cpap- ... tup-manual
Software is available that you can use to see what's going on in terms of where the pressure is going (as long as it is a full data machine and the Escape Auto is NOT full data which is why I hope you don't have it).
https://sleep.tnet.com/equipment

The air getting into the stomach and gut...common complaint and for some people a serious issue but there are some things that can be tried to help reduce the problem but we need to know what your settings are and where the machine wanted to go and how long it stayed at where ever it went. Sometimes just added more exhale relief is enough relief...sometimes a different machine is needed.
We call it aerophagia and there's been many, many discussions about it here on the forum.
wiki/index.php/Aerophagia

Hopefully you have a full data machine and can use available software to post images of a typical night and then someone can offer some ideas....that's assuming you want to try going back on the machine.
Here's some examples of what can be seen.
viewtopic/t158560/How-to-post-images-for-review.html

Finally...your exhaustion simply may not be from sleep apnea...you were barely diagnostic during the sleep study and maybe something else is causing the exhaustion and need to long hours of sleep.
Maybe it is those arousals that no one knows the cause of that is the problem...not everything unwanted can be fixed by cpap.

Do you take any medications of any kind? If so, what?
Any other health conditions that might impact your sleep quality and/or cause arousals.

When you were using the cpap...how many hours of real sleep were you getting and were those hours still highly fragmented for some reason or other? Arousals (that we may or may not remember all of them) will sure trash the normal sleep architecture that is needed for the restorative powers of sleep to work their magic.

So we can try to help depending on what you want to try to do.
Since there is a chance that sleep apnea might not be the sole culprit...also need to know about meds, sleep quality in general and other potential health issues. Got to get an idea as to the big picture and not just target the machine because often it's more than one thing combined that ends up being the culprit. That's why all the nosy questions about hours of sleep, fragmented sleep, meds, etc. Helps us get an idea what else might be a factor or not.

Pugsy wrote: ↑

Thu Jul 12, 2018 7:57 pm

Go here and see what your machine looks like to figure out if S9 or AirSense.

I have an S9 Autoset. I guess I won't be able to use external software. Thanks for the link to the manual, though!!

I've attached a spreadsheet comparing data from a few APAP reports and my most recent sleep study. It shows that my apnea isn't severe, but that the APAP was helping...until it was harming more than helping!

Thanks for the link to previous threads on Aerophogia. I will read them with interest.

Regarding sleep apnea not being the only cause of my exhaustion, I'm sure it's not! Thanks for offering to explore that with me. My over-all health is very complicated. I mentioned things about my over-all health just for context, but we should probably stick to sleep issues, since this is a CPAP forum.

POSSIBLE SOLUTIONS I'M CONSIDERING
Adjust pressure settings on APAP to see if that eliminates aerophogia.
Find a way to test the efficacy of my cough-drop tongue-stabilizing method. (An at-home sleep study, a video camera, or my APAP, if I can stand it.)
Find a better tongue stabilizing method.

You can use the available software with the S9 AutoSet....it's the S9 Escape Auto that doesn't offer much for the software to show.
Why can't you use the software? Computer problem???

Bigtonguehypopnea wrote: ↑

Thu Jul 12, 2018 10:16 pm

Thanks for offering to explore that with me. My over-all health is very complicated. I mentioned things about my over-all health just for context, but we should probably stick to sleep issues, since this is a CPAP forum.

Well suit yourself but it really ties our hands when trying to help someone and we don't have the whole picture.
Good luck to you.

Pugsy wrote: ↑

Thu Jul 12, 2018 10:38 pm

You can use the available software with the S9 AutoSet....it's the S9 Escape Auto that doesn't offer much for the software to show.
Why can't you use the software? Computer problem???

Oh, I guess I misread you. I thought I had the wrong machine. I have now downloaded Sleepyhead and will work with it tomorrow.

Pugsy wrote: ↑

Thu Jul 12, 2018 10:38 pm

Bigtonguehypopnea wrote: ↑

Thu Jul 12, 2018 10:16 pm

Thanks for offering to explore that with me. My over-all health is very complicated. I mentioned things about my over-all health just for context, but we should probably stick to sleep issues, since this is a CPAP forum.

Well suit yourself but it really ties our hands when trying to help someone and we don't have the whole picture.
I don't like doing a half assed job myself.

Well, alright. How kind of you to offer your time.

PRESCRIPTIONS
Wellbutrin for depression.
Methylphenidate (Ritalin) for Binge Eating Disorder. (I eat too much because I'm desperate for energy. Ritalin is prescribed for this because it has a side effect of decreasing appetite. For me, it also gives me energy so I don't need so much food.)
Pantoprozol for acid reflux.
Iron and D for deficiencies
Gas X

TESTED NEGATIVE FOR
Parasites
Hormone Imbalance
Genetic disorders
Other stuff I forget now. Had lots of tests over the years.

CHRONIC FATIGUE SYNDROME?
Had Mono at age 8. Debilitatingly tired ever since. Common story for CFS.
Have not been tested for viruses associated with Chronic Fatigue Syndrome (Haven't found a doc that believes in it.)
I do have post-exertional malaise like CFS patients.
Don't fit the diagnostic criteria because my fatigue is explainable by depression and anxiety/PTSD.
My mental health therapist suspects CFS because I'm usually in a good mood and just exhausted. But she's really clear on my severe anxiety and PTSD. And I'm usually in a good mood when I get to leave the house and be with people. I turn "on"..until I crash at home.
Unlike many CFS people, I can usually will myself to have energy when needed for short periods of time. But I do crash afterward.


GASTRO-INTESTINAL PROBLEMS EVERY DAY
Severe reflux and heartburn despite high dose antacids, long term.
Hiatal Hernia (diagnosed by endoscopy)
gas that keeps me awake at night even without the cpap
Stomach Aches
Constipation/Diarrhea

THE REFLUX-APNEA CONNECTION
I knew a guy who said he had 30 years in apnea research. He said it's closely connected with reflux. The acid makes the tissues raw and more likely to stick together when they touch.

THE REFLUX-ANXIETY CONNECTION
There is an interesting blending of my gastro pains and my anxiety pains. For years my biggest problem was chest pain. I would say I was "so tired it hurts". Sleep was the only thing that relived it. I was in bed for most of 6 years. Even brushed my teeth and urinated from bed most of the time. After being helped by CPAP, anti-depressants (which mainly made me less tired) and stimulants, I don't feel "so tired it physically hurts in my chest". The sensation became a little less complicated. After that, I started calling my chest pain "unbearable emotional pain".

Recently I read a book, "How Emotions Are Made". It explained that emotions are interpretations of biological responses to stimuli. Something happens, your body responds with fight or flight, etc, and your brain evaluates the environment and what's going on in the body and uses emotion to interpret the body sensations. It's similar to how my physical therapist explained new research on physical pain. Your nerves don't decide how much pain to produce based on how bad a wound is. Your brain tells your nerves how much pain to produce based on how important your brain thinks it is for you to pay attention to the wound. Therefore, if you're afraid of pain, your brain will instruct your nerves to produce more pain.

This recent revelation about how emotions take their ques from physical sensations has been a game-changer. Even though part of me wants to argue and say that emotions sure seem to generate physical sensations, which might also be true, what's important is that it has helped me to realize that when I'm upset with what seems to be "unbearable emotional pain", it's usually a horrible stomach ache or severe acid reflux. Once it was food poisoning. That's why it never worked for counselors to coach me about "ways of looking at things" to feel better. In my mind, I'd already be fine. But my body still hurt like hell. When I thought it was my emotions that hurt, it felt hopeless, like I just couldn't talk my body into knowing that everything was alright. I'd spend my time crying and writing and talking to try to "feel better". I'd go to therapy to figure out why my childhood trauma made it so that my body felt so much emotional pain even when my mind didn't.

Well, now, I can separate the physical from the emotional more easily and recognize my gastro symptoms. It feels for all the world like I'm unbearably upset about my latest worry or hurt. But i'm not. It's gastro symptoms that respond to treatment and diet changes (when I make them). My apparent emotional upset vanishes when my reflux goes away. I'm just still struggling daily. It's hard to make diet changes when I'm so tired all the time. And even for me, life gets busy sometimes. I'm overwhelmed by the slightest thing on my to-do list because it's so hard to do, and so unpredictable when I'll be at all able to do things. Very often, my only goal in a day is to sit upright for a few hours, and I very often fail at that. So you can see why I have reflux. I know a ton about diet. I just haven't gotten to the point of doing all the things I know I should do. Whatever I do, I feel like I'm also pushing a car at the same time. So have to choose very very carefully how to spend my limited energy. My basic needs for social contact and a sense of meaning compete with my need to prepare healthy food to get my gastro situation under control. But my housemate just died of esophageal bleeding, and I suspect I will too if I don't change my priorities. Given how much it hurts, I have little doubt that it will be the end of me if I don't fix it. My day-to-day challenge is to get ahead of my fatigue so that I feel well enough to do the things that make me feel well.

So that's why I'm looking at my health-to-do list, which brought me to the cpap issue. I don't THINK I'm more tired now that I'm not using it. My husband doesn't think I'm more tired without the cpap. (And he has no vested interest in me not using it. He uses a CPAP too.) But tiredness is hard to measure, especially when the bar is so low and my life is organized in such a way that I don't HAVE to function much at all.

I do really have concerns that my gastro symptoms are made worse by the CPAP, and it may not be worth it. However, it's important that I figure it out one way or another, if for no other reason than that I have a disability review coming up and I think it's probably a good thing if I'm compliant with all my prescribed treatments. I also just need to do anything I can to have more energy. I'm hopped up on stimulants, but still feel like a zombie most of the time. This project (this forum) snagged me today, but as soon as I get up from my wonderfully distracting computer I'll probably clutch my stomach and moan and stumble to bed, wishing I knew how to make my throat stop burning, because I know it will be worse in the morning.

So that's the scene.

I can see several issues that are probably related. For example, people who don't get enough sleep do tend to eat more in an effort to get energy. This is why weight gain is often caused by sleep apnea and not what is causing the sleep apnea.

Low iron is also a cause for lack of energy. And Iron supplements can cause constipation/diarrhea issues. (I know, you just can't win sometimes). I was diagnosed with low iron back in December when I was suddenly sleeping any chance I could, totally wasting my days off. I would sleep in late, eat some food, and then fall asleep watching tv. Wake up for some dinner and back to bed. Barely eating, barely moving. On work days, I would drag myself to work, feeling ehausted. I would fall asleep while my dinner was in the microwave after work. I finally decided that this was beyond normal and must be medical.

The chronic fatigue could be the result of the sleep apnea rather than an additional problem. So, it may improve with cpap treatment.

Acid reflux. I still have some during the day, but the night time events were horrible before cpap. I would wake up choking, gagging, often to the point of vomiting. I didn't learn until I started cpap that sometimes it is the result of sleep apnea. Basically, as your throat closes, and you gasp for air, you create a vacuum that eventually brings up the acid. I have never had a choking, gagging episode while using cpap.

Pugsy wrote: ↑

Thu Jul 12, 2018 7:57 pm

Finally...your exhaustion simply may not be from sleep apnea...you were barely diagnostic during the sleep study and maybe something else is causing the exhaustion and need to long hours of sleep.
Maybe it is those arousals that no one knows the cause of that is the problem...not everything unwanted can be fixed by cpap.

Do you take any medications of any kind? If so, what?
Any other health conditions that might impact your sleep quality and/or cause arousals.

When you were using the cpap...how many hours of real sleep were you getting and were those hours still highly fragmented for some reason or other? Arousals (that we may or may not remember all of them) will sure trash the normal sleep architecture that is needed for the restorative powers of sleep to work their magic.

So we can try to help depending on what you want to try to do.
Since there is a chance that sleep apnea might not be the sole culprit...also need to know about meds, sleep quality in general and other potential health issues. Got to get an idea as to the big picture and not just target the machine because often it's more than one thing combined that ends up being the culprit. That's why all the nosy questions about hours of sleep, fragmented sleep, meds, etc. Helps us get an idea what else might be a factor or not.

I see I didn't answer all of your questions.

SLEEP ISSUES

ANXIETY: I suspect that anxiety causes the huge number of non-specific arousals that show up on my sleep studies. I don't subjectively perceive fragmentation, but I do have semi-regular nightmares. PTSD stuff. So anxiety seems a likely culprit.

IDIOPATHIC INSOMNIA: My sleep doc says I have this. Can't sleep for fear of not getting enough sleep. I do have trouble falling asleep when I have to do something the next day, but that is rarely the case. Most often, I'm asleep before my 30 minute timer turns off my audio-book.

IRREGULAR SLEEP SCHEDULE: When I keep a sleep journal, I see that by far the biggest challenge in keeping a regular sleep schedule is gastro-intestinal pain that I can't sleep through. And of course, an irregular sleep schedule is no good.

Those arousals from limb movements alone would be quite disruptive to sleep. What is the status on your limb movements? Do you have restless shallow sleep? Keep in mind if those limb movement arousals and other arousals weren't present there's a possibility that having that much more sleep time would have allowed more apneas to manifest. I am pretty cynical regarding study results for one with both OSA and periodic limb movements. Always a chance neither disorder is fully appreciated. An underappreciated AHI due to arousals from other causes could mean your case of OSA is more severe than is known and you are making decisions about treatment with a false sense of security. I do hope working with others here will optimize your cpap treatment. It can be a balancing act getting a nice low AHI yet not triggering too much air in the belly. Some decide to accept a bit higher AHI to achieve sleep less disrupted by belly issues. I encourage you to make a valiant effort toward achieving a workable solution.

I can't possibly know your situation or the need for the meds you are on. I certainly wouldn't want anyone to read my skepticism and make any changes. I am admittedly jaded. I do want to throw out there that depression and sleep deprivation can cause similar symptoms and you wouldn't believe how many people on here have reported being given a pill instead of getting to the root cause of their issues. Now, if your depression affects your ability to function or compromises your emotional stability, that's a different story. But if you have any reason to suspect you were put on meds for depression when the core issue was sleep deprivation, talk to your prescribing doctor about it. My main reason for mentioning this is some meds can actually cause problems with limb movements. So hard to know that without a careful weaning to see if legs move less and sleep improves. Were your limb movements a problem before going on meds? If so, you can bypass that discussion.

Can't help but think if your sleep was healthier some of the other possible culprits you're looking at would fall by the wayside. Much of what you write reminds me of my condition when jumpy legs and untreated OSA were my lot. Good luck with things.

zoocrewphoto wrote: ↑

Fri Jul 13, 2018 1:05 am

I can see several issues that are probably related. For example, people who don't get enough sleep do tend to eat more in an effort to get energy. This is why weight gain is often caused by sleep apnea and not what is causing the sleep apnea.

Low iron is also a cause for lack of energy. And Iron supplements can cause constipation/diarrhea issues. (I know, you just can't win sometimes). I was diagnosed with low iron back in December when I was suddenly sleeping any chance I could, totally wasting my days off. I would sleep in late, eat some food, and then fall asleep watching tv. Wake up for some dinner and back to bed. Barely eating, barely moving. On work days, I would drag myself to work, feeling ehausted. I would fall asleep while my dinner was in the microwave after work. I finally decided that this was beyond normal and must be medical.

The chronic fatigue could be the result of the sleep apnea rather than an additional problem. So, it may improve with cpap treatment.

Acid reflux. I still have some during the day, but the night time events were horrible before cpap. I would wake up choking, gagging, often to the point of vomiting. I didn't learn until I started cpap that sometimes it is the result of sleep apnea. Basically, as your throat closes, and you gasp for air, you create a vacuum that eventually brings up the acid. I have never had a choking, gagging episode while using cpap.

That's fascinating! I had heard that acid reflux and sleep apnea make each other worse, but I hadn't thought of this reason.
CPAP didn't take away my fatigue for 9 years. But it reduced my fatigue quite a bit. Depression, anxiety, PTSD, and Sleep Apnea are certainly enough to wipe a person out, so I'm not attached to the idea of Chronic Fatigue Syndrome.

It sounds like you were VERY SLEEPY! That's interesting. It's hard to say if I would be more "sleepy" and taking naps if I had to work and couldn't sleep so long at night. I don't often nod off. I'm just super-exhausted. Sometimes in the brain, sometimes in the body, and sometimes both. Each day I wake up and find out what capacities I have that day, and then I try to find ways to be productive. Once in a blue moon I wake up and the "lights are on" and I feel normal. That's a happy day!

I didn't know that iron pills can cause constipation. Oh, bother.

kteague wrote: ↑

Fri Jul 13, 2018 2:15 am

Those arousals from limb movements alone would be quite disruptive to sleep. What is the status on your limb movements? Do you have restless shallow sleep? Keep in mind if those limb movement arousals and other arousals weren't present there's a possibility that having that much more sleep time would have allowed more apneas to manifest. I am pretty cynical regarding study results for one with both OSA and periodic limb movements. Always a chance neither disorder is fully appreciated. An underappreciated AHI due to arousals from other causes could mean your case of OSA is more severe than is known and you are making decisions about treatment with a false sense of security. I do hope working with others here will optimize your cpap treatment. It can be a balancing act getting a nice low AHI yet not triggering too much air in the belly. Some decide to accept a bit higher AHI to achieve sleep less disrupted by belly issues. I encourage you to make a valiant effort toward achieving a workable solution.

I can't possibly know your situation or the need for the meds you are on. I certainly wouldn't want anyone to read my skepticism and make any changes. I am admittedly jaded. I do want to throw out there that depression and sleep deprivation can cause similar symptoms and you wouldn't believe how many people on here have reported being given a pill instead of getting to the root cause of their issues. Now, if your depression affects your ability to function or compromises your emotional stability, that's a different story. But if you have any reason to suspect you were put on meds for depression when the core issue was sleep deprivation, talk to your prescribing doctor about it. My main reason for mentioning this is some meds can actually cause problems with limb movements. So hard to know that without a careful weaning to see if legs move less and sleep improves. Were your limb movements a problem before going on meds? If so, you can bypass that discussion.

Can't help but think if your sleep was healthier some of the other possible culprits you're looking at would fall by the wayside. Much of what you write reminds me of my condition when jumpy legs and untreated OSA were my lot. Good luck with things.

Thanks for your comments!

LIMB MOVEMENT STATUS: I think I have this taken care of. I'm not aware of many limb movements any more. I take a supplement for it and do stretches every night. I should have mentioned that before. So many details! As much as I still struggle with energy, I'm MUCH better since fixing the leg thing. That was CRAZY. It sounds like you can relate!

ANTI-DEPRESSANTS: My RLS/PLMs did begin when I took an SSRI anti-depressant, and they reduced but remained when I got off it. I do believe that I need the Wellbutrin antidepressant because I got on CPAP first, and the Wellbutrin was a big improvement after that. But I'm not sure it does anything for my mood. Mostly my energy. So, it's still possible that completely resolving my sleep issues would resolve my so-called depression. Getting on disability and not having to be in terror about how to survive was the best anti-depressant. From Social Security's point of view, my disability is depression and anxiety. I'm not inclined to argue. I resisted those diagnoses and meds for YEARS. But now, I don't care. The energy that Wellbutrin and Methylphenidate give me, and the peace of mind that my little disability check gives me, make life worth living. I do get better and better with time. If I get to the point where I feel well, then I will try to get off those things. But I did resist meds for so long that I feel pretty familiar with how I am with and without them, and I don't think they are causing any negative side effects. It's impossible to be sure, but I don't think so. I'm not sure if I would have "depression" if I wasn't disabled from exhaustion, which can be depressing! But my anxiety has shown up more and more clearly as I've felt better in other ways and my anxiety has become my limiting factor in a lot of things. Sometimes I wonder if it is caused by meds. But I see the threads of it throughout my life, and I have clear PTSD symptoms from childhood crap. Most of us have pretty severe childhood trauma, unfortunately. But mine was a little extra-specially traumatic. So, it all adds up to me.

You make an interesting point about how if other things weren't fragmenting my sleep, my OSA might have had more chances to manifest, so maybe it's worse than the study shows. Hmmm....

Thank you for taking the time to give me the bigger picture.....and as I suspected it's a complicated bigger picture.
Lots of stuff going on that can feed off each other and make the situation more difficult to isolate which came first type of thing.

But how do we eat an elephant....one small bite at a time so let's start with your primary complaint that brought you here and work on it and see if we get lucky or not in helping you feel better and sleep better.

Insomnia is an ugly beast and often difficult to manage. I wish RobySue was still here and active because her experience in that area is so much better than mine. I mention it along with the aeropahgia issues because there is some thought that arousals themselves can feed the aerophagia monster. She had a rather in depth discussion about that possibility with a sleep tech that used to be here on the forum because she suffered from aerophagia and insomnia. Later when I have time I will try to find that thread and point you to it so you can see what was said. She was quite active at one time on the forum so I will have a lot of threads to sort through...don't think I saved that one because she was here and able to point people to it herself.
You might start by reading her entire blog if you haven't already.
http://adventures-in-hosehead-land.blog ... er_19.html

Without seeing any actual software reports as to what your machine actually wants to do and hearing about what happened in terms of the aerophagia and sleep quality it's really hard to get any sort of idea where to start in terms of machine settings so I think if it were me I would back way up and take small baby steps. Gotta start somewhere and I don't know how much help 7 month old data will give us anyway. Once you get SleepyHead up and running...there's not going to be much detailed data available because of the way the S9 overwrites the detailed data after 7/30 days. It doesn't keep everything but maybe there will be something still available on the SD card we can look at. So download the SD card to SleepyHead BEFORE you use the machine again. Once you use the machine again all the old detailed graphs will be written over and no longer available.

I am still looking for a specific thread but while looking I came across some stuff from RobySue that I think is worth reading.
So look in these threads for anything that RobySue wrote.

viewtopic.php?f=1&t=104831&p=989765&hil ... ng#p989765

viewtopic.php?f=1&t=104877&p=990372&hil ... ng#p990372

viewtopic.php?f=1&t=96469&p=893356&hili ... ng#p893356

Please remember in a lot of her threads she talks about using a bilevel machine...and while yours isn't...we can make it work like a limited bilevel by playing with EPR. More on that later.

viewtopic.php?f=1&t=79258&p=721170&hili ... ng#p721170

and finally I found it...where she asked deltadave for clarification and the discussion she had with him.
He's a sleep tech...and a good one. Runs a sleep lab in a large hospital on the east coast. Scroll up to the top and start reading.
viewtopic.php?f=1&t=71790&p=661822&hili ... ng#p661822

Your meds have some side effect potentially that could also be a factor. How much of a factor or even if a factor is unknown but the potential is there. Especially the Wellbutrin....google "SSRIs and sleep".
IMHO I think how they might mess with sleep is affect the arousal threshold level that some people have. Makes it lower so that they tend to awaken/arouse more easily from the least little thing. They feed the sleep maintenance insomnia monster sometimes.
Now I am not advocating changing medications...just explaining how they could maybe be a factor in the overall bigger and more complicated picture.

Right now targeting the aerophagia monster and the insomnia monster since they are sort of tied together....but with main focus on the aerophagia monster for right now since that is really what brought you here in the first place.
It's the easier of the 2 monsters to try to deal with anyway.

See if you can get me one good detailed report off the machine that last week you used it 7 months ago.
In this format
viewtopic/t158560/How-to-post-images-for-review.html
Once you use the machine again or change any settings that old detailed data will be unavailable....if it is even available now.

If not available..Plan B...start with modest settings and make use of EPR and see what happens.