Honeymoon is Over

[j_dow]

Well I have been on CPAP for 4 months and it has ended up a nightmare. I was so excited in the beginning. First time I had gotten a good nights sleep in years. I started out using the machine for 7-8 hours every night right off the bat and it was great. Then after about the first week I gradually started getting burning off and on in my chest. The next thing you know after about 2 months I end up with full blown raging acid reflux.
Tried all kinds of things ended up at the doctor and now I am addicted to PPI drugs that just make me feel bad. I'ts the worst 1st thing in the morning when I wake up and remove the mask. Whenever the acid starts to well up I start feeling sick. It varies around with food, PPI drugs, bending over you know the story. I feel like throwing the machine in the trash. My stomach was doing so well before, I was eating healthier and had absolutely no reflux problems this year. Now I feel that I have damaged myself for life and the only way out is surgery. I have worked a desk job for 25 years and it is getting very hard to show up every day and I should work another 10 years. I know, just need to buck up, I sure sound like a winer. Anyway here's my question: Will the use of any other type of machine AutoPap, BiPap, etc help with my situation. I think the problem is when I exhale my ResMed S8 starts to ramp down in pressure from 10 to 4. When I breath out initially it is creating to much pressure in the esophagus and pushing my weak LES valve open. Is this a good hypothesis? I talked to my local experts at the sleep clinic and they didn't seem to have any ideas and said only 1 other person they know of ever complained about CPAP making reflux worse. Am I that much in the minority? Part of their sales pitch when they handed me the machine is that it will improve and can even eliminate acid reflux. So why is my body reacting this way? I feel desperate, so any advice would be greatly appreciated.

[zorrro13]

Reflux or diabetes etc can hit you anytime and could just be a coincidence. How scared of surgery are you? try a totally vegetarian diet , no smokes, alcohol, sugar, coffee and preferably raw uncooked food. I personally could not do it but know a friend who has through desperation and apparently a life changing experience. Good luck

[Slinky]

... I started out using the machine for 7-8 hours every night right off the bat and it was great. Then after about the first week I gradually started getting burning off and on in my chest. The next thing you know after about 2 months I end up with full blown raging acid reflux.
Tried all kinds of things ended up at the doctor and now I am addicted to PPI drugs that just make me feel bad. I'ts the worst 1st thing in the morning when I wake up and remove the mask. ... My stomach was doing so well before, I was eating healthier and had absolutely no reflux problems this year. Now I feel that I have damaged myself for life and the only way out is surgery. ... Will the use of any other type of machine AutoPap, BiPap, etc help with my situation. I think the problem is when I exhale my ResMed S8 starts to ramp down in pressure from 10 to 4. When I breath out initially it is creating to much pressure in the esophagus and pushing my weak LES valve open. Is this a good hypothesis? I talked to my local experts at the sleep clinic and they didn't seem to have any ideas and said only 1 other person they know of ever complained about CPAP making reflux worse. Am I that much in the minority? ...

Well, first off, most likely the problem is "aerophagia" (air swallowing). And, no, aerophagia and/or reflux are not that uncommon as you've been led to believe. And, yes, often an autoPAP or a bi-level can eliminate the problem. It would have been best had you discussed this w/a medical professional sooner, and that medical professinal to have been aware of its possibility and changes that could be made.

There are at least 4 models of Resmed S8 CPAPs: Compact, Escape, Elite, AutoSet Vantage and, I think one or two other of the bi-level and/or SV type so it will help to refer to your Elite rather than to S8, assuming it is the Elite.

The Elite is a straight CPAP w/EPR and the Ramp feature. So I am assuming that your set pressure is 10 cms, that your Ramp is set to start at 4 cms and we have no idea if you have the EPR turned on and what it is set at.

At the very least, we need to know if you are using EPR and if so at what setting. 1 would give 1 cm of pressure relief on exhalation, 2 would give 2 cms of expiration pressure relief and 3 would give 3 cms of expiration pressure relief. So EPR set at 3 would have you at 7 cms of pressure during exhalation.

Your theory is most likely quite correct: too much pressure on the esophagus and LES. For the time being you might do well to sleep in a recliner w/your Elite and mask and the EPR set on 3 as well as the dietary and medication regimen. Have you raised the head of your bed 4"? (I found 6" to be too much, we ended up scrunched down to the foot of the bed during the night).

Given your current sleep medicine professional has little understanding of aerophagia and reflux/GERD you would do well to do some searches on "aerophagia" "reflux" "CPAP" (w/o the quotes) and gather the best information to provide to them. Especially, peer-reviewed medical journal abstracts and/or full articles from MedLine (PubMed).

http://www.ncbi.nlm.nih.gov/entrez/ is the URL I'm fairly sure from memory.

You are not necessarily at this point "doomed" to a lifetime of PPIs and/or LES surgery. But some changes need to be made and the sooner the better. Hopefully RestedGal or other of our forum members can direct you to posts in this forum regarding this issue w/better info than I have been able to provide.

[need_sum_sleep]

Finally something I can post on. Let me give my two, well, one and a half cents. I am an acid reflux sufferer siec the age of 17. I have tried ALL the over the counter drugs. And when I say ALL I mean ALL. I even went to Chinatown and got a remedy from an ancient "Potion Maker" Finding out what was in it made my stomach turn knots. And there is nothing worse than waking up and you cannot breathe, You have inhaled some acid into your trachea, by way of the esophagus. Now you are gasping and feeling like a heart attack is ensuing with a category 4 forest fire in your chest. Then the hour and a half of coughing up acid based flem.

Personally, as Slkiny has suggested, I have to sleep in a recliner. Gravity seems to help SOME. I have also been keen to ask the docs about different acid related medicines. Some DO have the symptoms of cramps, vomiting etc. There is no one cure all pill. Ask for a trail box, or sctript of diffierent types, until you find your match.

Understanding Acid Reflux (AKA GERD): Here is a Good video with info (abuot 5 mins long) http://www.healthcentral.com/acid-reflu ... 2-109.html

[oceanpearl]

Internist suggested that I elevate the head of the bed 2 to 4 inches.

[krousseau]

Try 30 degree elevation for the head of your bed for GERD or aerophagia-chances are that will take 4-6 inch blocks. Personally, I would slide out the bottom of the bed-so sleep in a recliner--doesn't eliminate the aerophagia but does help.

[Wulfman]

Go up to the Search function and search on "reflux". There will be 8 pages of threads to sort through. In other words, it's a very common problem.

One other thing that I don't believe was mentioned yet was to NOT eat within 3 - 4 hours of going to bed......along with watching what you eat.

Den

[IndyJudy]

I am a very new CPAP user and just had my second sleep test to set the pressure on my machine last night. I had NO idea the CPAP may irritate my acid reflux. When I get into a "reflux crisis" (as I call it), I cough, gag, and vomit for a 2-4 month time frame....until my reflux decides to calm down and the coughing stops. The lesson I have learned today from you folks---be sure to take two of my 'purple pills' a day, morning and night. Hopefully this will prevent any problems. I'll also look into the other machines. Thanks to those who post all this valuable information!