bloating

My wife and I use CPAPs so familiar with the process but recently our son, a big guy, went in for tests and eventally fit for full face masket. During the over night test and fitting for a CPAP he awakened with abdominal pain from air in his stomach. So far no one has given his an explanation and he is hesitant to use the CPAP. What do you think happened? Is it just breathing through his mouth. I've done that but did not get air in my abdomon. What is happening. Thanks. Bloated Son

Aerophagia. Air swallowing. Not unusual in the milder form for a few when first starting out. Usually resolves itself in a short time. We seem to unconsciously learn to adjust and prevent it during our sleep. Another few do have some real problems w/it and there have been some suggested methods of avoiding or stopping it but ... I'm not all that familiar w/the "fixes" for it. Try a search in the forum here on aerophagia or on air swallowing and you should find the posts w/the "answers".

I'm no doctor, but I've experienced extreme abdominal pain a few times with various types of "cpap" machines. The kind of pain that makes you turn the machine off and get that mask off. I can understand your son's reluctance to have that happen again.

As Slinky said, the word "aerophagia" means to eat or swallow air. However, there's another way this kind of bloating can happen (imho) besides literally swallowing the air.

If a person has a weak or damaged lower esophageal sphincter muscle (the "LES") I think it's very possible for cpap air to get pushed into the stomach inadvertently because the LES doesn't close properly. People with years of untreated OSA are very likely to have acid reflux disease due to the nightly battle to get air. The heaving struggle of abdomen compresses the stomach and can force acid up. Nightly acid baths can damage the LES and the entire esophagus.

I agree with a doctor who wrote that he thought EVERYONE who was diagnosed with OSA should be checked for GERD (gastro-esophageal reflux disease... acid reflux disease.) A person can even have "Silent GERD" that has none of the usual symptoms of heartburn.

If your son has ever been diagnosed with acid reflux disease and it's not been well-treated, he could possibly have a weakened LES.

As for doing something to prevent a reoccurence of the painful bloating he had on the study night.... he might want to ask the doctor if his cpap machine can be set at a pressure considerably lower than what the doctor might be planning to prescribe for him. There is less chance of air getting pushed into the stomach at lower pressures.

I'm a big believer in "some treatment is better than none." I know the kind of pain your son is talking about. As much as I understand about the need to use CPAP, I'd have to quit myself if I had that kind of pain from it every night. Maybe it won't happen to him again, but if it does, then I would definitely turn the pressure down, and down, and down until I found a pressure I could use without that happening. Then I'd raise the pressure one cm each week, hoping that I could slowly work it up to therapeutic pressure without aerophagia happening again.

People who have not had that happen to a painful degree might not understand why a person who really, really wanted to use cpap to treat their OSA simply could not do it...because of the extreme pain aerophagia can cause in some cases.

It's not just from breathing through the mouth, although that might make accidentally swallowing air happen more easily. It can also be from the sheer force of air actually getting pushed past the anatomical gates, so to speak. If it continues for your son, and reducing the prescribed pressure doesn't help regardless of how low the pressure is set....I'd definitely pursue getting GERD checked. If he has an extremely damaged LES, there is a surgical procedure called Nissen fundoplication that can repair it.

Good luck to him!

Sometimes I wish I could reach through the monitor and give RG a big old hug.

I think I may have the exact problem you describe, but I had a hard time communicating it with my doctor. I am going to ask to be evaluated for GERD on my next visit. I have a weird thing that happens when I exercise. I must be swallowing air into my stomach due to a damaged LES like you describe. When I do aerobic activity I have to burp almost constantly and it is sometimes hard to do. If you ever had the feeling of needing to burp and couldn't, you know how discomforting that can be. Try exercising while that happens.