Abdominal pain with CPAP?

matthew76 · Post by **matthew76** » Fri May 23, 2008 10:09 am

Ok, some nights I am now getting better sleep. But at the start of sleep, restless legs often keep me up for a while, and by mid-morning, I'm waking up with abdominal pain/discomfort. It feels like my insides are pulled in a way, yet it also feels like bad gas buildup. It seems I have to go to the bathroom right or soon after after waking up - sometimes twice. Could CPAP be causing this discomfort? It seems to be worse on nights I sleep more.

Also, it seems the longer I stay in bed, the foggier, sleepier, and generally worse I feel the whole day. What could be causing that?

tomjax · Post by **tomjax** » Fri May 23, 2008 10:49 am

do a search on aerophagia on the forum.

there are about 12 million posts on this subject.

Quick answwer- it is a swallowing of air and usually is self resolving.

some may need a pressure adjustment, but I would give it a few days.

It is not Gas in the typical sense and all the anti gas products are worthless,.

Julie · Post by **Julie** » Fri May 23, 2008 11:10 am

Hi, I'm not sure that in this case aerophagia is the problem, it could be fluid build-up and for that I would definitely see the doctor (the restless legs and bathroom breaks are tip-offs) as the problem is potentially serious (though not related to Cpap).

NightHawkeye · Post by **NightHawkeye** » Fri May 23, 2008 11:18 am

Yep, sounds like aerophagia, all right. It rarely resolves by itself. The only two solutions which can offer immediate relief are APAP therapy and Bi-level (BiPAP) therapy. My recommendation to you is to contact your physician's office as soon as possible and let them know the pain you are in and that the therapy is not working. With that information they should be able to order a change in machine for you.

matthew76 wrote:Also, it seems the longer I stay in bed, the foggier, sleepier, and generally worse I feel the whole day. What could be causing that?

It sounds kinda like your CPAP pressure is not quite right. Pressure requirements can vary somewhat from night to night, so the pressure need now may be somewhat higher than you needed during your titration.

Folks here can offer further recommendations if you'll tell us some additional information, matthew76, such as your current pressure and what kind of mask you are using. Do you by any chance have "dry mouth" at any time during the night or when you wake up in the morning?

Regards,
Bill

matthew76 · Post by **matthew76** » Fri May 23, 2008 11:37 am

It seems I keep that gas feeling the whole day, unfortunately, and feel a need to go a lot. I get unfinished bowels. I had some of this before CPAP, but it seems worse now. I got my pressure lowered to 9; would raising it to 11 again make things worse? I'm trying to figure out if this is IBS as I MAY have CFS (I'm not sure,) from the CPAP, or something else.

Perhaps only my doctor would know what to do, but I can't get an appointment until next week, and I see my sleep doctor in June.

My dry mouth isn't as bad as before; I try to avoid drinking overnight as I get frequent urination, too.

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matthew76 · Post by **matthew76** » Fri May 23, 2008 11:42 am

BTW, I've been getting the abdominal pain with both the full face mask and nasal mask.

pjwalman · Post by **pjwalman** » Fri May 23, 2008 11:56 am

I am not discounting what the previous posting said about it possibly not being aerophagia, but for some the aerophagia does last through the day (speaking unfortunately from personal experience). Mine was much worse when I was on straight CPAP, no ebbing of the pressure, to the point of being literally doubled over in pain. It did get better when I went to APAP, I think because sometimes my guts were getting a break from the blast but maybe because APAP seemed to lower my events and kept me from gulping so much air to compensate for them.

My latest theory, FWIW (which is probably not much, because I'm still new and trying to figure this out still) is that the more events I have during the night, the worse the aerophagia and the longer it lasts throughout the day. So if that theory has any weight to it at all, then getting your numbers down might help with it, and letting the learned people on this forum know what equipment you're using, what pressure you were titrated at, what pressure you're using would definitely give them some clues to what changes you might want to discuss with your doctor at your appointment in June.

In the meantime, if you have a wedge pillow, you might want to try it...or at least raise your head a little bit. Some have suggested playing around with the humidity settings. On really bad days, you could try Gas-X or Phazym, something like that, but no guarantees it will work. Typical butt up in the air position sometimes helps some of the air to exit , and I've even tried rolling around on my exercise ball and then just letting the bottom half hang over it while I rest my head on my arms on the floor. May sound silly, but if you're miserable, then anything is worth trying. Right?

Good luck!! You may be one of those lucky people that just adapts eventually and "outgrows" it, so you can hope for that.

Peggy

NightHawkeye · Post by **NightHawkeye** » Fri May 23, 2008 12:02 pm

matthew76 wrote:It seems I keep that gas feeling the whole day, unfortunately, and feel a need to go a lot.

Yep, you may as well enjoy it, cuz ya ain't gonna stop it ... .

matthew76 wrote:I got my pressure lowered to 9; would raising it to 11 again make things worse?

Probably make the aerophagia worse, but might help your apnea treatment so that the rest of you feels better (just not your bowels ).

matthew76 wrote:I'm trying to figure out if this is IBS as I MAY have CFS (I'm not sure,) from the CPAP, or something else.

I vote for the simple stuff we hear a lot of around here. At least give that a try first. My recommendation is APAP, or possibly even Bi-level (BiPAP), but your physician will make that call for you.

matthew76 wrote:My dry mouth isn't as bad as before; I try to avoid drinking overnight as I get frequent urination, too.

Dry mouth is an indication of mouth-breathing. I'd bet that you're doing that, matthew76. Frequent urination is a classic symptom of sleep apnea. I think most folks here have gone through that. I know I sure did.

Here's what I'd suggest to minimize your discomfort until you can change your machine:
1) Go back to the full-face-mask - try to minimize leaks for effective therapy.
2) Get the gas out - move around, massage your belly, whatever it takes. Lower your pressure though if it's just intolerable. Partial therapy is better than no therapy, and you need to be able to tolerate CPAP therapy. Your life depends upon it.

Regards,
Bill

matthew76 · Post by **matthew76** » Fri May 23, 2008 12:02 pm

You know, it could be related to events. Because I had stomach problems when my apnea seemed to really take off after a virus I got in November of last year. More sleep = more events and pain while waking up? It's something I'll ask about. My CPAP has a digital display, but right now it is not data capable.

matthew76 · Post by **matthew76** » Fri May 23, 2008 12:06 pm

Thanks for your informative post, NightHawkeye. It makes me feel better thinking that this might be what my discomfort is all about. Eating sometimes adds to the gas, and I even urinate a lot during the day (might be related to my nervous system always being active due to my not feeling well yet.) I'll try all of your suggestions.

matthew76 · Post by **matthew76** » Fri May 23, 2008 10:31 pm

Well, at this point I'll be back on the boards after my appointments. My GP is not much older than me (only in her 30s,) and I hope she's not a bit too sure of herself. But my hope is that she and my sleep doctor will eventually sort out the physical from the mental.

BTW, my GP thinks the stomach stuff is anxiety, but it does seem to be more than that. Will discuss it with her.

NightHawkeye · Post by **NightHawkeye** » Sat May 24, 2008 5:50 am

matthew76 wrote:Well, at this point I'll be back on the boards after my appointments. My GP is not much older than me (only in her 30s,) and I hope she's not a bit too sure of herself. But my hope is that she and my sleep doctor will eventually sort out the physical from the mental.

Trust, but verify. That's my recommendation. Many postings of really stupid/careless/lazy and negligent docs show up here. They fail to make a proper diagnosis or they refuse to provide appropriate treatment. It boggles the mind, really.

Read other accounts of aerophagia here and you'll find that a large percentage of CPAP users suffer from it and have effects similar to yours. Do a forum search on "gas", "flatulence", and/or "aerophagia" and you'll find thousands of posts. Symptoms run from minor to major. Folks have tried many different remedies. The only ones which consistently work are APAP and Bi-level.

matthew76 wrote:BTW, my GP thinks the stomach stuff is anxiety, but it does seem to be more than that.

It is more than that. It is the presence of considerable quantities of pressurized air introduced into your digestive tract by your CPAP machine. Evidently, your doc doesn't know much about sleep apnea.

Tell her you're suffering from "gastric insufflation". That's the correct medical terminology for what many of us experience rather than aerophagia. That should get her attention as it can be a serious condition. Take a look at a discussion about gastric insufflation in the following thread:
viewtopic.php?p=261953

Regards,
Bill