can aerophagia last all day, into late evening?

[msr0459]

I've been on cpap therapy since Oct. of this year. My pressure is currently on 8. Over the last week or so I've started to notice a slight "uneasy" feeling mainly just below the sternum area, accompanied with random burps with a slightly weird taste. These normally occur on an empty stomach.

I recently had my 2nd follow up with my sleep doc. I was discussing with him the fact that cpap really hasn't helped my level of sleepiness during the day, and that I still felt like crap most mornings. According to my ResMed software, my AHI's are usually very low, and yet I still feel horrible, which to me means I'm not getting any deep sleep. My doc was discussing perhaps too much stress can contribute to my issues, and that's when I told him about my recent abdominal/burping issues.

Well guess what, he immediately wants me to go see my GP to confirm what he thinks is going on,... GERD. He claims that reflux is what's waking me during the night, preventing me from getting my deep sleep, and that I may not even realize that's whats been going on, and of course want's me to go on PPI's to combat the reflux.

Well, I'm highly skeptical that this is my problem. I've been over the top about my fitness and nutrition for the better part of the last 30 years. I rarely eat processed foods, etc. and have NEVER had any reflux symptoms. The doc claims that it could have nothing to do with digestion, but that my LES could be weak and allowing the acids to come back up during the night. OK, perhaps this is the case. It just seems that if that's so, I would have had some other symptoms already, since I've had issues with sleep for nearly a decade at least, and I NEVER awaking during the night or morning with any kind of "throat soreness", which from what I understand is a symptom of night time reflux.

After researching on here and on the web, I've discovered that cpap can also bring on "aerophagia", which leads me to my subject question. Do you think that cpap could be CAUSING my recent symptoms? Can the stomach discomfort and burping caused by aerophagia last all day and into the evening? Would I notice these symptoms mainly on an empty stomach.

I also know of the side effects of taking PPI's and I REALLY don't want to go down that road. I think this is yet another case of a doc simply applying a "band aid" to the symptom, and not finding the root cause.

At this point I'm thinking that I need to stop cpap for a while to see if the stomach discomfort abates, as I feel its pretty coincidental that these symptoms started a couple of months after I started cpap, and NEVER before then. I'm also considering seeing a gastro doc and having him scope my esophagus to see if there is any preexisting damage from reflux, which I feel should be present if the doc is correct in saying that reflux has been wrecking my sleep all along.

Opinions please

[apneawho]

Don't stop CPAP to see if symptoms abate. The way you are describing the symptoms, I would agree with the doctor you may have GERD. The symptoms sound less like aerophagia. See the gastroenterologist.

[Perrybucsdad]

I get aerophagia from time to time, but normally it is all out of me within an hour of waking.

Our bodies change through time, and even if you are fit and eat well, it may be GERD. My 17 year old daughter who is a runner and eats extremely well will suffer from it from time to time. If it is, it's not the end of the world.

Also, have you analyze your sleep data to see if there is anything going on with your apnea? Maybe it's a combination of things (pressure not being adjusted correctly thus resulting in a higher than desired AHI) and that is why you still have the sleepiness. You have the S9 Elite, so you should be able to download the data yourself into something like Sleepyhead and analyze the data if you have not already.

Link to Sleepyhead: http://sourceforge.net/projects/sleepyhead/files/

John

[teknomom]

I was diagnosed with GERD years ago with no symptoms - they discovered it on an upper GI test. I was to the point of having pre-cancerous lesions, so the fact that you don't know you have it doesn't mean it's not there and dangerous. I have a problem with the LES that has nothing to do with diet, exercise or general health. Treatment can be as easy as taking an OTC medication every day. Please get it checked out - I'm so glad I did because the pre-cancerous lesions are now gone!

[LSAT]

Another vote for GERD. What you state as your symptoms definitely point to GERD. PPIs CAN cause side effects, but, there are several choices. If one doesn't agree with you there are others. The simplist way to determine what your problem is would be to go on PPIs for 2 weeks. You can get them OTC at your pharmacy.

ALSO...raise the head of your bed 4-6" by using blocks or bricks. That will help keep any acid down during the night. Don't eat within 3 hours of bedtime.

[NotSleepingBeauty]

msr0549 - I am in the same boat as you are. I get the same queasy, heartburny feeling right under the sternum. I already take Protonix for Acid Reflux have not had an episode in years. I did a Google search on "CPAP Heartburn" and found some good results. I spoke to my DME about it and she said that some GasX might do the trick, or even some Tums. I used a nasal mask for the 1st time last night (disaster) and had Aerophagia withing 5 minutes. I think this is different than that. Just my opinion. Let me know what you find out from your tests, I am curious to know.

Please keep using the CPAP and get the tests to confirm GERD or not. In the meantime, get some heartburn releif OTC.

[archangle]

Strangely enough, increasing my pressure a few points reduced my GERD like symptoms. Most people find it works the other way. I'm guessing that with a lower pressure, I'm still struggling with breathing a bit and that my effort to breathe moves my stomach acid or makes more of it.

[NotSleepingBeauty]

@archangle - That sounds about right. I also had pain in my abdomen, what felt like muscle pain, so maybe I am getting an AB workout in my sleep?

[avi123]

For ingested air I take Pepto Bismol successfully. If its GERD then one or two Prilosec tablets daily [ 20 mg PO BID] should help. Also, if a short- segment Barrett's Esophagus desease is involved. Do an upper Endoscopy, to find out.

[msr0459]

Thanks everyone for posting. I suppose since I've had NO OTHER symptoms over the years I find it very hard to believe that I have GERD, especially since I just started cpap therapy and now have these symptoms. I also had four days of what I believe to have been(the symptoms were identical) BPPV (a specific type of vertigo) after starting cpap therapy. Were they both coincidences?, perhaps,.. or maybe not. I also recognize that, for no reason at all, it could in fact be GERD,... stranger things have happened.

My main issue is that after much research on the subject, it seems that upwards of 80%(maybe more) of patients prescribed PPI's, actually have low stomach acid, NOT too much stomach acid, which is what the PPI's are for. So the treatment, while still providing some relief, is obviously the exact WRONG thing to do. The symptoms for both issues are identical. Couple that with the side effects of PPI drugs, i.e., malabsorptsion, an increase of bad bacteria in the stomach, SEVERE rebound upon stopping, .. and many more that I won't get into, and you can see why I'm reluctant to go the "drug" route.

I may indeed wind up going to a gastro doc, just to confirm whether or not I have esophageal damage. If my sleep doc is correct stating that I likely have GERD, and that is what has been preventing me from getting into a deep sleep, then I should have pre existing esophageal damage, due from nightime GERD, of which I was unaware.

I've also read that cpap can open the LES, allowing stomach acid back up the throat at night, thus CREATING gerd, thus preventing the cpap from helping me sleep.

So who knows, I've got some more experimenting to do to try and figure out if I'm producing too much, or too little stomach acid,... if in fact that is what's happening at all! It could also be the H. Pylori bacteria, of which I'm about to embark on trying to take care of naturally, just in case.

I keep you guys posted. Thanks again.

[SleepingUgly]

Research shows that CPAP helps GERD, even in the absence of OSA (yes, unbelievable!).

I'm usually a big fan of researching things on the internet, but in the case of GERD and low acid vs. high acid and ENT's opinions on GERD... I'm not. Although I'm not even sure that your premise that you would have esophageal damage in the presence of GERD is correct, I'd still recommend you go to a good gastroenterologist and get a professional opinion.

[NotSleepingBeauty]

Funny you mention BPPV. I have Meniere's and am waiting to see what the result of CPAP therapy will be. Whe I wore the nasal mask the pressure on my ears was too much. It's tolerable with the FFM, but I woke up a little wobbly this morning and I can ocassionaly feel like the bed is moving. It would be awful if CPAP aggrivated the Meniere's.

[Ticman]

This sounds like exactly what happened to me. This may sound silly but get some blocks of wood and raise the headboard of your bed about 4 inches or so. It might feel a little strange at first but it worked wonders for me and my wife. I had the exact pain you described for years until I raised the headboard. Heck, I travel with two 4x4 blocks of wood for hotel beds.

It will take a while before you'll see if it works or not but it's worth a try.

[msr0459]

Well I made an appointment today to go see a gastroenterologist next Thursday. They went ahead and booked the following Friday for me to have an endoscopy done (if the doc thinks it's necessary).

If the endoscopy doesn't show any damage(obviously I hope it doesn't!), I really don't know what to think. I mean, what if the cpap therapy is/could be working, except for the fact that the pressure is in fact keeping my LES open and causing the GERD symptoms, thus preventing me from getting deep sleep and obviously preventing the cpap from doing it's job. How can I tell if this is the case?

Also, since I'm so unfamiliar with GERD symptoms, what do you guys think it means if I ONLY have symptoms on an empty stomach? As I stated earlier, I eat impeccably, no processed foods, etc., and so I NEVER have any of the heartburn symptoms I read about, nor do I ever wake up with dry or soar throat, ..yet the last week or so I keep having these "burps" when my stomach is empty, or at least a while after my last meal. No real pain or anything, just the feeling that something isn't right.

Oh well, perhaps the gastro doc can shed some light. I only hope he is thorough and doesn't just "assume" I need the PPI's. I guess I'll take them if I absolutely have to, .. it's just that the long term effect of these drugs is something I'd reaaallly rather avoid.

Thanks all

[LSAT]

Thanks everyone for posting. I suppose since I've had NO OTHER symptoms over the years I find it very hard to believe that I have GERD, especially since I just started cpap therapy and now have these symptoms. I also had four days of what I believe to have been(the symptoms were identical) BPPV (a specific type of vertigo) after starting cpap therapy. Were they both coincidences?, perhaps,.. or maybe not. I also recognize that, for no reason at all, it could in fact be GERD,... stranger things have happened.

My main issue is that after much research on the subject, it seems that upwards of 80%(maybe more) of patients prescribed PPI's, actually have low stomach acid, NOT too much stomach acid, which is what the PPI's are for. So the treatment, while still providing some relief, is obviously the exact WRONG thing to do. The symptoms for both issues are identical. Couple that with the side effects of PPI drugs, i.e., malabsorptsion, an increase of bad bacteria in the stomach, SEVERE rebound upon stopping, .. and many more that I won't get into, and you can see why I'm reluctant to go the "drug" route.

I may indeed wind up going to a gastro doc, just to confirm whether or not I have esophageal damage. If my sleep doc is correct stating that I likely have GERD, and that is what has been preventing me from getting into a deep sleep, then I should have pre existing esophageal damage, due from nightime GERD, of which I was unaware.

I've also read that cpap can open the LES, allowing stomach acid back up the throat at night, thus CREATING gerd, thus preventing the cpap from helping me sleep.

So who knows, I've got some more experimenting to do to try and figure out if I'm producing too much, or too little stomach acid,... if in fact that is what's happening at all! It could also be the H. Pylori bacteria, of which I'm about to embark on trying to take care of naturally, just in case.

I keep you guys posted. Thanks again.

I believe that the opposite is true. With the air pressure from the CPAP blowing down your throat...it would keep the acid down where it belongs at night.