Newbie on CPAP experiencing occasional night time reflux!

I have been diagnosed for severe OSA in October 2006, it took a while to get used to CPAP therapy. Before my diagnosis, I did not suffer from night time reflux. I've been experiencing these symptoms occasionally for about 1-2 months. My doctor has prescribed 40mg of pantoprazole (Protonix) once a day but it does not help when I go to sleep. I take Gaviscon and Gas-X to relieve the bloating at night, that I seem to get when I use my CPAP machine. I have taken ranitidine 150mg 2x/day (Zantac) but it did not work for me. My mother was diagnosed with OSA about 10 years ago, and takes omeprazole (Prilosec) to treat her ulcer. I asked her if she experiences acid reflux at night, she says that the omeprazole is working for her. I will be seeing my doctor in the next couple of weeks, I think I would be a candidate for an endoscopy to find what is causing the occasional night time reflux. I seem to tolerate the reflux on the Resmed Auto CPAP better compared to my regular CPAP machine that I first used since my diagnosis. The Resmed Auto machine is on loan from my DME supplier, I'm waiting for approval for a new Auto CPAP machine from Ontario Assistive Devices (Ontario Health Insurance Plan - OHIP) here in my province, which can take a while, hopefully within a month or two. My sleep lab doctor recently prescribed that I should get a new Auto CPAP machine. I will return the Respironics Sleep Easy CPAP machine to my DME that I used after my sleep study.

I also struggle with a mood disorder called cyclothymia (a milder form of bipolar disorder) which my symptoms last a couple of days and my moods fluctuate (depression and hypomania).
Could the CPAP therapy and my mood swings be aggravating my symptoms of acid reflux?
Since my CPAP therapy, I've been sleeping a lot better than before, I used to get night time panic attacks, I now know that my severe sleep apneas were not helping me, I was so exausted and sleep deprived for so many years!

I will be researching on this site which new model of Auto CPAP machine that I should choose to relieve acid reflux or GERD. My DME has a limited selection. They have some Resmed and more Respironics Auto CPAP models, I think she mentioned that they have the new Respironics M-Series and the Resmed S8 Autoset.

While you're searching for machines, go up to the Search function and search on "GERD" and "reflux" as there have been many, many discussions about those conditions.

Den

That's interesting, Cycloman2005. I was using a Remstar M Series for the first 1.5 years I was on CPAP therapy and I had problems with reflux at night. I was taking prilosec every day but it just wasn't cutting the mustard (no pun intended) at night.

I decided I wanted to switch to an APAP about 3 or four months ago and get a Resmed S8 Autoset II. I hadn't really thought about it until I read your post, but I haven't had reflux since then. I don't know that the change in devices had anything to do with it, but I can't explain it any other way.

Now I have something to mull over while my good friend Capt. Morgan and I go sailing tonight.

Re reflux and machines. When I used my Remstar Auto (pre M) & used C-Flex on a high setting, I would get aerophagia and that seemed to also aggravate my GERD (I take 1 small tablet called Pariet for GERD). If I turned C-Flex right off the aerophagia all but went away. I later switched to a Bilevel (a PB330 Knightstar) & aerophagia became a non issue & GERD tended to behave.

With the S8 & EPR, the EPR if in use acts like a bilevel. I haven't had any noticeable aerophagia using my Vantage & EPR.

I would imagine there is a tie up between aerophagia & GERD.

Also
GERD can & often does cause acid to find its way into the back of the throat & even nose. This is because of how we might sleep. When that happens we wake with phlegm in the back of the throat (the body tries to protect the tissue from the acid).

That reflux can be a trigger for nasal congestion & thus UARS

DSM

Thank you all for your prompt replies and responses, what a great forum!

dsm you have a good point...I was suspecting that the Remstar Auto (pre M) with no C-Flex, that I'm currently using has older technology, could be causing some aerophagia and aggravating GERD and reflux symptoms. I have it on loan from my DME, I will be asking for a bi-level function w/my new APAP, the sleep clinic doctor prescribed an APAP, but I did mention to him that I was having bloating and reflux issues with the Remstar Auto. The Respironics Sleep Easy CPAP that I will be returning to my DME, made my condition worse because of the constant high pressure of 16 cm H2o.
I will discuss the GERD and reflux symptoms with my doctor next week to get some type of control, so I don't have to wake up in the middle of the night and get some decent sleep. I have lots of catching up to do after being so sleep-deprived for many years!

Hello Cycloman2005, I have been lucky in that after starting Cpap my reflux has been less often. I was getting to where at times I would not wake up fast enough and would get some in my lungs. I take Nexium and Cytotec and it helps some. It is like the Cpap keeps the acid down where it belongs .
Don

I have had severe GERD that was made worse by nerve damage from my MS- i have taken Pantoprazole for several years and even then every now and then it would get worse and i would have to take double doses for a while. Since starting to use Vpap i have not had a problem with Gerd- my pressures are quite high and it seems to be enough to "prevent the reflux from occuring, i still need to take the medication as i already have barrets esophagus and a diverticulum in the wall of the esophagus. I have read that quite a few here have found that cpap makes things worse and i have sort of assumed that it is people who are troubled with aerophagia who are likely to have problems- the air that is swallowed or pushed into the gut attempts to get out again and pushes some stomach contents with it. Don't know if some of the old standards for gerd may help. things like avoiding eating and drinking late in the evening etc so that there are fewer stomach contents

http://www.sciencedaily.com/releases/20 ... 080008.htm

"These are patients without significant heartburn symptoms, who are experiencing acid reflux during sleep," explained William C. Orr, Ph.D. of Lynn Health Science Institute in Oklahoma City, OK. "'Silent reflux' may be the cause of sleep disturbances in patients with unexplained sleep disorders."

"All patients with sleep apnea should be evaluated for gastroesophageal reflux," said J. Barry O'Connor, M.D., of Duke University Medical Center, one of the investigators.