Those who have overcome aerophagia...how did you do it?

[SleepingUgly]

Please briefly state what methods helped you overcome aerophagia (e.g., not eating within 3 hours of bedtime, use of EPR/Cflex, pillow wedge, bilevel, straight CPAP vs. APAP, narrow vs. wide min-max pressure range on APAP, etc., etc.).

[nanwilson]

SU
It just went away after a month or so...
Do not eat or drink after 8pm
Bed at 10pm
Pressure 10 to 13 on my m-series and straight 11 on my F&P 604
Humidity at 1 on both
Can't think of anything else I do that would help.
Cheers
Nan

[VA3AEQ]

Time...I had it for about 2 weeks. It was terrible. I felt absolutely full for 4 hours after waking. I had air leaking our both directions as well. It eventually went away. It does come back from time to time though. It really sucks.

[Lizistired]

I backed my pressure off and haven't been back there since. I think it's about finding a happy medium. I didn't try to tough it out. My auto is showing I'm headed there though, so I'll let you know.

[robysue]

The three biggest things that have helped me tame the aerophagia and get it down to something I can handle on a daily basis are:

• Use of a Bi-PAP. The old S9 AutoSet seemed to aggravate the aerophagia no matter what adjustments were made to my therapy.
• Lower pressure than my original titrated pressure of 9cm. Two retitrations led to a reduction in pressure to IPAP=7, EPAP=4. And I had NO problems with aerophagia at those pressures. Unfortunately, the titration night was a "good" one as far as the apnea was concerned, and at home, the AHI and snoring were bouncing all around, sometimes the AHI was as low as 0.5, but sometimes it was as high as 4.8, with no rhyme nor reason that I could determine. Sane thing with the VSI: On good nights for snoring, the VSI would be less than 5 or 10; on bad ones, the VSI could top 100. And there was no correlation between how high the AHI was and how high the snoring was; they seemed to bounce around independent of each other. So the PA authorized a switch to BiPAP Auto running in a very tight mode: Min EPAP = 4, Max IPAP = 8.
• Zero tolerance for nasal congestion. For me, nasal congestion is a real culprit in driving my EPAP pressure up without any real OSA-based need for bumping up the EPAP. And when the pressures hit and stay at the max of 8/6, my tummy is the first thing to protest. Fortunately adding Flonase to the daily regime of a 1/2 zyrtec and a neti pot seems to keep my nose almost completely free of congestion due to seasonal allergies. Which in turn keeps the EPAP pressure at 4cm for anywhere between 50 and 75% of the night on a regular basis with occasional nights of having my 90% EPAP = 4. And yet when the OSA starts to act up, the EPAP can rise just enough to pretty consistently keep my AHI below 2.5 and usually below 2.0 while minimizing my discomfort due to aerophagia.

In addition to the three critical things listed above, I also:

• Try not to eat for several hours before bedtime.
• Limit spicy stuff at supper.
• Absolutely no caffeine after 10AM.
• Avoid alcohol with supper unless it's a very special occasion. Then I limit it to one drink.

[Bright Choice]

Use of a Bi-PAP.The old S9 AutoSet seemed to aggravate the aerophagia no matter what adjustments were made to my therapy.

Hmm... Now that sounds like a good idea!

[Lee Lee]

Not eating for 2 to 3 hours before bedtime.
Sleeping with bed elevated 4 inches (at least)
Taking acid reducing meds.
Most importantly, time...it took a few months, but totally gone now.
Hang in there.
Lee Ann

[SleepingUgly]

So just sticking at the pressure and waiting it out might alleviate it?

[Pad A Cheek]

SleepingUgly,

I overcame it by tilting my chin away from my chest. I was trying to think about how to inprove the airway and thought about old fashioned First Aid Mouth to Mouth Respiration. One of the first things you do is to tilt the head back. I do not sleep on my back but I figured I would try tilting my chin out as I slept on my side. I have a tendancy to tuck my chin under when I curl up, so I tried to stop that and the aerophagia went away for me. That was a long time ago now, but that is how I stopped it and it never came back.
I hope this helps some for those who are suffering with this, it can be pretty painful.

Karen

[sister]

SleepingUgly,

I overcame it by tilting my chin away from my chest. I was trying to think about how to inprove the airway and thought about old fashioned First Aid Mouth to Mouth Respiration. One of the first things you do is to tilt the head back. I do not sleep on my back but I figured I would try tilting my chin out as I slept on my side. I have a tendancy to tuck my chin under when I curl up, so I tried to stop that and the aerophagia went away for me. That was a long time ago now, but that is how I stopped it and it never came back.
I hope this helps some for those who are suffering with this, it can be pretty painful.

Karen

Thanks Karen,
I too have a tendancy to tuck my chin under when I curl up so I am going to try this! I have it so bad and it is painful. I mentioned it to my dr. and he acted like nobody had it, or they didn't
complain.
Please pray that it goes away for me also.
GOD BLESS YOU!

[Pad A Cheek]

Sister,
I certainly do pray that it goes away for you. I would love to hear if this method helps anyone else.

Karen

[fadedgirl]

I only ever had severe aerophagia when using ResMed machines. When I switched back to Respironics, I was fine.

I have experimented with this a few times the past year. I'd get the S9 out and think: it can't be the machine, it was probably some other factor, just try it again. The curiosity gets the best of me. But it is the difference in the machines, of that I now have no doubt.

I cannot say if it would go away were I to continue using the S9 for a couple of weeks. It was so bloody painful that the longest I could stand to do it for was 3-4 nights (and even then I'd only make it a few hours and have to go the rest of the night sans cpap). Then I would give up and go back to my beloved Respironics and sleep pain-free and think: I really need to just get rid of that S9.

I have had it happen a couple of times with my Respironics, but only very slight and not-at-all painful instances of it. These happened only when I was sleeping on my right side. I typically always sleep on my left side or my back.

[newhosehead]

This is really a painful problem. I had it bad when my doctor raised my pressure from 10 to 14 in the beginning stages of my treatment. After two nights of it, I backed it down to 12 and everything was fine, along with my results.

Jeanette

[robysue]

SleepingUgly,

I overcame it by tilting my chin away from my chest. ....
Karen

Thanks Karen,
I too have a tendancy to tuck my chin under when I curl up so I am going to try this! I have it so bad and it is painful. I mentioned it to my dr. and he acted like nobody had it, or they didn't
complain.
Please pray that it goes away for me also.
GOD BLESS YOU!

SU,

Yes try a change in chin position. But like many things concerning xPAP, "best chin position for avoiding aerophagia" is something to tweak. For me, shortly after the aerophagia first developed, I started sleeping with my chin tilted up and away from my chest because (at the time)---partly because someone likely suggested it here and partly because it seemed like it caused fewer problems with my mask getting pushed around. My neck didn't like it much, but I couldn't figure out what to do with the mask AND my reasoning on the aerophagia was much like Karen's---that position should keep the airway more open.

Unlike Karen, my poor body had the opposite reaction and the aerophagia was worse in that position and again at the suggestion of someone here, I went back to working on finding a way to sleep curled into my "robin nest" position with my chin titled down. For me the chin down position seems to result in less aerophagia.

So all I'm saying is that chin position is like the humidity setting: Try both and figure out which one works best for you.

Best of luck in dealing with the aerophagia.

And re that doc: Just another example of how the sleep docs themselves just don't get it when it comes to the real reasons why the dropout rates for CPAP therapy stubbornly remain so high in spite of the fact that CPAP works so well in bringing those all important AHI numbers down to less than 5. Sorry you have to deal with such an insensitive doc.

[SleepingUgly]

I only ever had severe aerophagia when using ResMed machines. When I switched back to Respironics, I was fine.

Same exact settings? Were you using C-flex/C-flex+ or EPR?