CPAP CAUSING ACID REFLUX

[Guest]

Yes I was told that my reflux would get worse with the machine. I was told to try the machine. I have been on it for 4 days and last night I thought I was dieing. My reflux is worse then it has been in 10 years. I have it in my back...I need the machine but the reflux is going to kill me if I keep using the machine...

[ozij]

Hi there, Guest.
I had that bad last year: Rolled over in bed and was flooded in acid up to my nose - terrifying. I immediately contacted my PCP, who raised the amount of PPI I take dramatically - (I was on 10mg of generic Prilosec in the morining, and it was immediatel raised to 40 mgs) That gradually helped my irritated esophagal sphyncter heal and after about 4 months I gradually lowered the amount.

I suggest you also contact your sleep doc. immediately, and discuss the possibility of lowering your pressure somewhat, and then bringing it back up in small increments -- giving your esophagal sphyncter time to heal

Please register, and tell us some more about your therapy - the pressure you're on (and why) the type of machine and mask you use, etc.

Between us, we have the experience of many thousands of successful sleep hours with CPAP, if you know more, we may be able to give you tips that may make things easier for you.

Welcome to the forum
O.

[OutaSync]

I recently found out that it isn't normal to have the contents of your stomach end up in your mouth when you bend over to tie your shoe or hug a child. I thought that happened to everybody. I didn't even know I had GERD until the good people on this forum advised me to get it checked out.

[Janknitz]

Hopefully you are under medical care for the GERD--it's very important to get it treated. It's also important to use your CPAP. I have a few suggestions--some these already mentioned:

1. Raise the head of your bed.
2. Try to reduce the aerophagia--(keep your tongue on the roof of your mouth because that will reduce the air swallowed on CPAP, look up sleeping positions that will help, experiment with pressure relief during exhalation, and talk to your doctor about possibly backing down the pressure temporarily to get used to it).
3. Avoid eating at least 3 hours before bed.
4. A lot of people cite "acidic" or spicy foods as a problem with reflux, but in my experience it was actually sugars (especially lactose--I love a glass of milk in the evening) that made things the worst.
5. Take medications prescribed by your doctor like PPI's. But over-the-counter antacids like Tums have a rebound effect and actually INCREASE stomach acids a few hours after taking them.

I'm one of the lucky ones for whom CPAP actually stops the reflux--but these things worked well for me before CPAP.

[Mightily_Oats]

I started having this problem a few months ago all of a sudden. My physician said that it was a combination of aerophagia and my diabetes (and eating too late before bed, a snack that I was usually washing down with a glass of lemonade.) He told me to raise the head of my bed to create a slight angle and that seems to have done the trick, the problem went away. (I still have no idea why it started all of a sudden, though, as I've both been on the CPAP and had type 2 diabetes for several years and been eating this sort of snack at the same time for about a year beforehand.)

A little tip on raising the head of the bed: my bed frame actually has little wheels instead of legs so I couldn't just put it on blocks or they'd roll off. What I did is take two little scrap pieces of 2×4 lumber and two plastic caps from old medication bottles and used small wood screws to fix the caps to the top of the wooden blocks. The bed frame's wheels then sit in the middle of the plastic caps and so are unable to roll off of the blocks. (So far, at least.)

[Janknitz]

Bed, Bath, and Beyond sells bed risers that will accommodate wheels on the bedframe safely. They look really sturdy.

[Mightily_Oats]

Yeah, there are lots of prettier options I could've used if I was more inclined towards tastefulness. I have a couple of candle holders that are solid glass blocks with holes for the candles that I had considered using but I decided that I wanted to keep them for candles.

[Mr Bill]

best thing you can do is elevate the head of your bed, even if you only raise it 3" it will help.

Don't eat anything 2-3 hrs before bed, take a PecidComplete right before bed (nothing else works as good in my opinion, berry flavor is great).

Straight CPAP can be pretty aggressive with that condition.

Agreed! I sent this to all my friends back in August 2008.
This might change your life

I’ve been meaning to write about this for quite some time. My quality of life fundamentally changed on May 17 2008. That was the day I had one of those mentat moments and put together a bunch of disparate facts and knew it would work for me. So, to the story...

I caught a cold the Thursday before we went down to the FIBARK weekend in mid June of this year (2008). I was just miserable for two nights. But I brought a cot before the trip and propped it up just like my bed at home. I’m happy to say that by Monday morning at work my cold was gone and I had no cough, none, finito. Usually a cold would take a couple months to clear. Its some sort of personal record.

Summer of 2008, I got a letter from the my insurance provider that they wanted to a doctors visit to check on the status of my asthma before they would refill my next prescription. So, I let the RX run out and waited till the end of the summer for when I needed to get my blood tested for the thyroid levels before my annual physical in August 2008. So, at the physical, I mention the letter to the doc and he says I need to be off the meds to really know if the asthma is still going on. What a coincidence I say because I’ve been off them for a month. While I am getting examined, I mention that at the health fair this spring, the guy said I show no symptoms of asthma in the rebreather dohicky. So, he brings in the machine and they check and he says “right now you do not have asthma”. Well this is pretty cool. So what has made this happen in just a few short months?

OK, we are ready for the info that changed my life. My nephew Ian has started suffering from migraines and had gone to the hospital ER several times for the migraine shots. So, no caffeine for him so it could be kept in reserve for migraine onsets and they give my sister the big horse pain pills for when it got bad. He also suffered from sinusitis, shortness of breath, chest pains, and asthma like symptoms whenever he eats some foods and especially spicy foods. He has a high pain threshold, so he likes really hot foods like those fire cheetos. When he sneezes its like a snot hurricane. My sister finally decided to take him for a complete alergy workup. She called me May 17, 2008 to tell me that after putting the grids on Ian and inoculating him with everything under the sun, he has no allergies. The doctor opined that he might be suffering from Gastro Esophageal reflux disease (GERD).
http://en.wikipedia.org/wiki/Gastroesop ... ux_disease
He put him on an acid reducer and noted that GERD can be caused by an alignment and leakage problem where the esophagus joins the stomach. So, while sleeping, stomach acid attacks the esophagus and can cause all the symptoms Ian had been experiencing. He suggested that many people get the most relief by simply raising the head of their bed by six inches. He said propping up your head with pillows is ineffective compared with sloping the bed. Kathy called me at work is telling me this and I am having an epiphany. It so happens I had been suffering from one of those persistent cold coughs that had started on Ash Wednesday three months earlier.

Item: GERD is often associated with being overweight but I was not overweight when this asthma and coughing of mine started.

Item: My nephew is not at all overweight

Item: The doctor says the tendency for GERD runs in families regardless of weight, it can be a heritable structural problem

Item: I have had that little cough since high school days, whenever I got tired, and that has gotten worse over time

Item: My doctor once noted that I have an “excitable epithelium” to explain my problem with persistence of cold symptoms, especially chronic sinusitis that defies steroids.
http://en.wikipedia.org/wiki/Sinusitis
My sinuses are constantly partially blocked and I have put up with sinus drainage making me cough and constantly clear my throat for what seems like forever.

Item: While in Idaho, my doctor had put me on acid reducers and antibiotics because he said I had reflux disease caused by those acid producing bacteria. But it continued after the bacteria were dead.

Item: I had spent a bundle sleeping with a pulse oximiter one night in the 2006 trying to find out why I felt short of breath at night. Turned out my blood O2 was fine and I did not have sleep apneia.

Item: whenever I’m under prolonged stress, I get an acid stomach and its uncomfortable but I ignore it and its worst at night especially when sleeping on my stomach or left side. I prefer to sleep on my stomach and hate sleeping on my back.

Item: I get some relief during colds by propping myself up with pillows and sleeping half upright on my back.

Item: too numerous to mention but a million details of my past 20 years fused into this gestalt realization that I needed to go directly to a lumberyard after work.

So, after work, I went to Sutherland’s lumber supply and bought three 2” x 6” redwood construction studs about three feet long. I sorted them from their scrap pile out back for ninety cents a board. I went home and stacked them and slid them under the head of my bed frame and propped the head of my bed up six inches. You can hardly tell there is a slope. I coughed a bit as usual and then at bedtime crawled in and slept on my back wondering what the morning would bring.

The next morning, I just could not believe it!! My cough was gone, my sinuses were absolutely clear and dry, I could take the deepest possible breath and that tickle that forces me to cough was 90% gone. After a couple more nights, I’m happy to report it is 99% gone. I have been cough and throat clearing free now for over two months. My singing has become more clear especially in the high registers. I plan to have my doctor verify that my asthma symptoms: shortness of breath, etc are completely gone! I have not used an inhaler for more than six months. But, I will have to get something done about the acid stomach. It got really bad this spring because of the gas industry bringing huge numbers of samples and needing the results on really short notice. Its very stressful trying to get all that data out and have it all be good quality. However, I can report that despite the stress and the stomach acidity, I don’t have the cough, or the throat clearing, or sinusitis. I can still get an instant replay of the symptoms by drinking limeade and getting that tickle on the end of the esophagus.

I’m an experimental sort and I get tired of sleeping on my back. I keep trying one side or the other or the stomach. It only takes about fifteen minutes before my sinuses start getting stuffy and I can feel that tickle. I think its amazing that irritation of the esophagus can cause such an array of symptoms. I was tempted to title this “How six inches changed my life” but I was afraid most of you would delete it as spam. But hey, I know some of you have that cough or some of these symptoms. It cannot hurt to try raising the head of your bed six inches and you may be very pleasantly surprised.

Cheers to you all
Bill

P.S. In reading since, I have found out that its irritation of the vagus nerve which may be behind all this. The vagus nerve ennervates the stomach, lungs, heart, and sinuses among others. If you irritate the esophagus, the vagus nerve sends signals to the sinuses and you get action! How about that? I actually asked my sleep tech and doctor if irritation of the vagus nerve might be causing my breathing problems.

[Mightily_Oats]

Glad to hear that tilting the bed worked as well for you as it did for me, perhaps even better. Also, you kick ass for using the phrase "mentat moment".

[Slinky]

Six inches found my husband and I scrunched down at the foot of the bed every morning. Four inches worked great for us. Hubby just took some scrap 2 x 4, cut them into 4 inch blocks. Nailed 2 together to make a 4 x 4, put one of each of them under the box spring on the bed board supports and then put 1 of the 2 x 4 blocks about midway down each side of the bed to help support the box spring almost in the middle. Voila! Nice secure 4 inch raise to the head of the bed.

[UpChuck]

I've been on CPAP for about a week: 4 days with a nasal pillow and chin strap and 2 days with a mask. The past 2 nights with the mask I have experienced acid reflux symptoms that I did not experience with the nasal pillow. I was hoping to have better sleep with the mask and I believe I can, if I can resolve this burning esophagus sensation. Any thoughts on why I'd experience reflux with the mask and not the nasal pillow? All other conditions were the same. I don't have a history of acid reflux otherwise.

[Julie]

Hi - I suggest you start a new thread (just cut & paste) because you're at the tail end of a 3 yr old one and it may not get seen properly. And if you could give the complete name & model # of your machine and mask type (nasal or full face?) it would help.

[elessadil]

I have had very severe GERD for 20 years and I have been on various PPI's for most of the 20 years. I sleep on an 8" wedge, I'm careful what I eat, don't eat for 4 hours before bed, consume very little alcohol (it makes the GERD even worse). Most of the time it is under control, but it took quite a while and during that time I had days when I could hardly function because of the pain, even with meds. I also have asthma, which is probably related to the GERD, as well as a cough that rears its head after I eat, also because of GERD. I was diagnosed with Atrial Fibrillation 1.5 years ago. Recently found out I have a hiatal hernia and possible esophageal erosion. This causes pain in my chest and also causes esophageal spasms. I have to be careful not to eat anything too hot or too cold because it just hurts going down. If I eat anything hard like crackers etc then I have to chew them til they are mushy or they also hurt going down. Just been diagnosed with moderately severe OSA and I have only been on APAP for 1 week, but already I have noticed an improvement in the GERD and the chest pains. Hopefully the rest of it will improve with more time. I have been lucky so far and have not experienced aerophagia. I think sleeping with the wedge helps with that. Maybe I am one of the lucky ones for whom CPAP makes things better.

Definitely raise the head of your bed. 4" minimum a little more if it doesn't cause you to slide down the bottom of the bed. I find the wedge works best for me
Go see your Dr and talk to him about it. GERD needs to be treated. You may have had silent GERD and unfortunately for you it has reared its ugly head.
Don't eat for at least 3 hours before you go to bed. I found switching my big meal to lunch and having a light supper also helped. Watch your alcohol intake, it can exacerbate reflux.
You may have to experiment a bit with foods to find out which make it worse and try to avoid them as much as possible. What works for one person won't for another. Instead of eating
3 meals a day, try to eat 6 smaller meals. That way you always have something in your stomach for the acid to work on.
If you need to, try to lose some weight.

[TrishB]

Thank you to all for posting your thoughts -- especially the long post about acid reflux and asthma, cough, etc. I just starting using the cpap and have stopped because of acid reflux -- an issue I haven't had it years! A nutritionist has put me on a cleansing diet -- says that some foods can cause the tongue to swell, and that this is the first thing to try before a cpap. Will post my progress. And if there's a new list, I will hopefully find it and post there.

[derickso]

It is a common side effect for some people to get indigestion for a few months after starting. I too am suffering that. The technical term is aerophagia. It is due to gasping for breath. Nose pieces without the full mask are the major culprits, but it can happen with full mask. There are adjustments to the machine, that can minimize the problem, and I am being reassured that it will get better in a few months? For now, I am not a happy camper during the day - and probably no one who live around me is due to the very loud bleches