aerophagia

[onecoknower]

How do you know if you have it? What are the symptoms? How is it alleviated?

[Sleepy-eyes]

The first two questions are easy to answer.

Aerophagia is the swallowing of air................much like we used to do when we were kids and wanted to belch to make our friends laugh. ("we", that is if you were a boy.) You know you have it if you feel the air filling up that pocket just inside your chest where "we" used to store air so we could be obnoxious. You feel pressure in your chest and when that pocket becomes filled to a point where it feels as if you are bursting, you can feel it gurgling down into your stomach..............where eventually it will make you feel bloated like a Macy's Day Parade Balloon. How is it alleviated? I only wish I knew!!!!!!! I just spent the most horrible 4+ hours experiencing it. Finally gave up and took my mask off. I wish one of the local experts in this therapy would tell us both the answer to that one!

[air]

As about cpap causing aerophagia, i have noticed the following:

How do you know if you have it?

2 ways -that i know of-
1 is that you realise you are suddenly swallowing big air - feels strange and wakes you up if it happens just when you fall asleep
2 is that you get air little by little in the stomach and wake up burping, with stomach and everything below filled with air

What are the symptoms?

can range from just embarrassing to very painful.

How is it alleviated?

I read a lot about it and it seems there is not a simple answer.
In seems to depend on the exact cause, and that would be a weak LES or other stomach issues, like acid problems and gerd.

In my case, the following seem to have helped a lot:
1. took care of my acid probs by using an acid blocker
2. i avoid eating 2 hours before bed time
3. i avoid working on a chair or otherwise bending my stomach before bed time
4. raised the bed head about 5cm off the floor
5. experimenting with sleeping positions (havent completed that yet)
6. i lowered the max pressure for a while in order to let the body adjust to the pressure and so i was able to sleep more. now i'm raising it back up (doc has agreed to that)
7. lowered cflex to 1

of all the above, the most important are 1 and 2, meaning that i will get extreme aerophagia if i miss 1 or 2.

There are lots of other things that might help, like different sleeping pillows, room temperature, humidifier settings and others, but i'm not sure since i havent yet tested all that and anyway they should be of way less relevance than the 1 and 2 above.

Please note that thats my case... we are all different

Edit: corrected typo's

[Born Tired]

I almost stopped therapy because the aerophagia was so bad. Would wake up around 2AM with severe abdominal pain and have to remove the mask.
Tried propping up with pillows--woke up all through the night with air bubbling up my throat.
Tried various postions--didn't seem to help.
Tried cflex vs no cflex--couldn't really tell a difference.
Was urged to get an Autopap (which I see you already have) so I would only have pressure as high as I needed. That helped a lot.
My titrated pressure is 7 (which I know is really low compared to most) but I still had pretty bad aerophagia whenever the pressure would hit 7 (which was not very often). So now I have my pressure range from 5-6 (still have slight aerophagia, but now I am very compliant (and my AHI is veritually the same as when I had the range 5-8 ). I have discussed this with my doc and she agrees that it is better to be able to use the machine all night on a slightly lower pressure than to wake up throughout the night with severe aerophagia.
And I feel much better than I ever used to pre-autopap.
Different things work for different people, but the lower pressure is what works for me. If other things don't work for you, it might be good to talk with your doc to see if you could try a lower pressure at least for a while to see if that helps.
Sure hope you can find what works for you!
Esther
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[cpapjack]

I was experiencing bad aerophagia a few months into my therapy, which started in May 2006. I was able to convince my Dr. to switch me to an APAP for this and other reasons. That seemed to do the trick up until about 2-3 months ago. It came back and it came back with a venegance. I was able to get my Dr. to switch me to a BiPAP for this reason and no more aerophagia. Keep in mind though, everyone is different.

Jack

[Sleepy-eyes]

So far I've not heard a "solution". All I'm hearing (and they are valid statements) is "this is what I did and it worked for me". I sure wish somehow there could be a black and white answer. Frustrating. The discomfort can be awful, sometimes.

[JimW]

Chris - I also had pretty bad (wake-me-up-at-1:30AM-with-pain) aerophagia on starting out. Based on what I had read here, I talked with the RT and the sleep lab, and now have an autopap. I had been on CPAP at 14 cm; am now at 6-20 cm per the sleep doc's prescription; numbers have been pretty good so far, and the aerophagia is nearly absent, although I did notice a bit on awakening this morning. While you may not see a "solution" here, I count at least three people in this thread (including myself) who have been helped by the overall lower pressures afforded by autopap as opposed to straight CPAP, and one other who was helped for a while by this and then took the additional step to a BIPAP. If your problem with aerophagia continues, you may want to consider an autopap as one possible solution.

[Sleepy-eyes]

Thanks, Jim. I'll keep that in mind. Though I do have a problem in that the VA is my health care provider and I don't think they offer anything but the machine I have. We'll see though.