Aerophagia only with Swift FX...

[Gourou]

Hi,

I am 28 year old man, with light sleep apnea. I am under CPAP treatment since about 3 years. I have been using Swift II mask since the beginning. It works good, not super but... It does the job! I have recently got the new Swift FX mask and I just felt in love with it! It's so comfortable, it's small it's awesome. The only big problem is that when I use it I am having very bad aerophagia. I wake up with my stomach full of air, I fart and burp alot and it hurts I don't want to resort going back to my Swift II, the FX one is so much more confortable I would like to be able to use it.

My machine is a REMstar Auto M Series. I have humidifier at 3, AFLEX at 3, and APAP pressure between 5 and 10. Pressure usually stays around 6.5. Without CPAP I have an AHI of about 13, with CPAP it's below 3.

I was wondering if anyone else got aerophagia with this specific mask?? I still can't understand why it's happening only with the Swift FX and not the Swift II since both are intra nasal masks. I know my mouth doesn't open when I sleep, so it's air being pushed directly into my stomach I guess?

I would be really happy if someone had an answer to this.

Thank you

Phil

[cobra4x4]

I have the same mask and love it also, but I don't have that issue and my pressure is at 7. I also used a Swift II before I got the Swift FX. I've made no changes to any settings when switching between the 2 masks.

Just a suggestion here ... maybe having Aflex set at 3 is way too much relief for such a low pressure, try turning it down for a night or 2. I'm not sure where you live but a setting of 3 on the humidifier also seems a bit high especially during the summer months. I've turned my humidifier off and just run it in passive mode (water in chamber, but not turned on), as fall rolls back in I'll turn it back on and adjust the setting upward slowly as the temperature drops.

[torontoCPAPguy]

Try farting. Helps me out a whole lot but my wife does not like it at all and the window blinds are taking one heck of a beating.

Seriously, I find it questionable that at those pressures your CPAP would be causing the problem, but it is certainly possible if your throat is opening up during sleep and you are swallowing air.

If the problem has not presented before like now, I might look to other causes, such as diet, sleep hygiene, etc. I know that I am diabetic and really need a snack before going to bed. If I eat 'regular table food' I have terrible stomache and intestinal gas as my wife and the window blinds can attest to. But if I eat a plain old banada, I take care of my blood sugar levels for the night and do not have gaseous nocturnal issues. Then there is the matter of timing. One needs to ensure that both the stomache and intestines are relatively empty by bedtime, especially of gas makers. This is MY experience anyway. It was awakening me at night and we tried medication and the whole nine yards. All it took was to have dinner at 6 p.m. or earlier and an evening snack (preferably just some leftover protein like bland chicken) around 9 p.m. or so and nothing after that. If I miss an evening snack I, as a last resort, have a simple banana or perhaps a banana in some plain low fat, sugar free, yoghurt, a little later but not right at bedtime.

Ah. This is a complex issue. Is it swallowing air? Is it air being forced into a less than solidly sealed stomache? Is it diet related? Is it both? Is it medication? Perservere and you shall overcome.

One other thing.. you have to learn NOT to be as polite as you used to be. Whatever gas you may have brewing down there needs to be gotten rid of before bedtime. So the expression "farting around" or as the Eskimos do "burping to show your delight" must be taken to heart, regardless of where or with whom you may be. If you must, excuse yourself and make sure that you are clear before hitting the sack. I realize that it is not as simple as all this, but I simply relate what seems to be improving things for me... either that or as posted by one of my fellow forum members, it is "a phase" that I am going through for whatever reason and it will (pardon the expression) pass.

All I know is that it is no fun, especially when it awakens you in the middle of the night. I am and have been adjusting my diet, eating habits, medicines (reduction of any sedatives is a must as is reduction of any pain meds that will loosen up your 'seals', and so on. I notice as of late some significant improvements and I leave the eating of things like fried onions to those that can tolerate them these days. Ditto beans and other legumes. I used to love barley soup and still do but I cannot tolerate it. As we grow older we are unable to process many foods that we learned to love as kids. I believe that it is all part of the formula to resolution of the issue.... and in any event will help.

[Gourou]

Thank you for answer torontoCPAPguy ...

The thing is, as I mentionned the problem doesn't happen when I use my Swift II... it's only with the Swift FX! Now I know you would say "Then why don't you use the Swift II" ? Well like everybody i don't like using a CPAP, but I would find it less bothering with the FX because it's much more confortable... if only i could solve that air swallowing problem

[torontoCPAPguy]

Thank you for answer torontoCPAPguy ...

The thing is, as I mentionned the problem doesn't happen when I use my Swift II... it's only with the Swift FX! Now I know you would say "Then why don't you use the Swift II" ? Well like everybody i don't like using a CPAP, but I would find it less bothering with the FX because it's much more confortable... if only i could solve that air swallowing problem

Are you certain that it is only with the one mask and not the other? As one with a scientific background that would lead me to believe that it is either that one mask has a better seal than the other (since they are similar mask types) or that it is simply coincidence... and I would tend to go with the latter as you would know pretty quickly if it was a seal issue.

In any event, I reiterate that I read about the problem many times on here and elsewhere, with all of the usual suggestions to resolve same and the one thing that I came away with is that the problem is NOT a simple one and EVERYTHING comes into play, even to the extent of a change in social habits (I am older and more polite now... I do not break wind). When you lay down the trapped gas that may be there will move along in a different manner and be trapped in different places where you are not desensitized to it - presto, an hour later you feel it sitting there and it wakes you up as it moves along slowly or presses on the stomache wall (sure it is not the small intestine walls?). A very complex issue that initially points to swallowing of air and the need for the use of minimum pressures in therapy (I'm there I think) but that in and of itself presents problems because you need a APAP and multiple titrations or the ability to read your own data, including SO2 and BP (which is going to wake you up for sure when that cup on your arm squeezes you).

Perservere and do not aim your sights solely at the swallowing of presented air spontaneously. Like I said, it could be sedatives you may be taking, pain meds, my wife even developed reflux taking a medication for arthritis before her knee replacement surgery and went so far as to have her innards 'scoped' from both ends due to severe reflux and gas. Turned out to be some arthritis meds with built in anti-inflamatory/pain meds that were loosening up things asides from arthritic targets. Stopped the med and wound up losing two other meds that she had to take to prevent the ancillary symptoms.

Good luck. You will get here.