Severe aerophagia

[Sunpoppy]

Okay, so this is my first question on this site. I have been browsing around for a few days and love the info I have gathered! Two nights ago I started using a Resmed Elite with a Pilairo nasal pillow. I have only been able to use for around two-three hours per night due to extreme aerophagia. (This is so bad ((on a pressure of 6!)) that two years ago I gave up on cpap therapy altogether...have a much better Dr. this time around and a more "I WILL do this." attitude.) After a new sleep study I am now on a pressure of 10.

I have seen on this site where a bpap or an apap has worked for reducing this problem in some people. My question is what would be the easiest/fasted route for switching? I am assuming I will need a script for the different machine?

Seven years after my initial diagnosis, pillar implants and jaw realignment surgery am REALLY ready for a decent nights sleep!

[kaiasgram]

Hi Sunpoppy -- Using your EPR feature can help, it helped quite a bit with reducing my aerophagia. You don't need an APAP just for that, your Elite has that feature too. Post back here if you need more info on EPR. How you position your head and neck in bed can make a difference too and then there's the old tongue-on-the-roof-of-the-mouth technique which helps keep therapy air going down your airway and away from your mouth where you can start swallowing it. There are tips for how to practice this technique if you do a search. I'd try all these things before concluding that a different machine is needed (they're more expensive ).

[Sunpoppy]

Thank You, Kaiasgran!

Let the research on my machines features begin!

[Pugsy]

Use your EPR feature set at 3...that reduces the pressure on exhale by 3 cm and makes it sort of work like a bilevel machine. You will get 10 cm on inhale and 7 on exhale. The advantage to a bilevel machine you can increase the difference between inhale and exhale greater than 3.
Use the software available to evaluate the effectiveness of your 10 cm pressure with the EPR reduction to 7 cm.
See if you really need that much pressure or an maybe skate by with a little less.
If your software reports don't show effective therapy with these settings and you are still having bad aeropahagia then you can make a good case for needing a bilevel machine so that you can use the pressures you need with pressure support that will hopefully not cause so much aerophagia.

Yes, you will need a new RX to be able to buy a bilevel machine using your insurance or to purchase out of pocket online.
There is the secondary market available if you have the funds to purchase that way. Sometimes some really good deals can be found. That's how I ended up on bilevel. So just an idea to put on the back burner.

Do you have the software so you can see your reports now?
I have SleepyHead links in my signature line.

You can use ResScan...link in Uncle Bob's signature line memberlist.php?mode=viewprofile&u=38643

Tutorial on how to use ResScan
http://montfordhouse.com/cpap/resscan_tutorial/

[hopingitworks]

As I said to you in a previous thread I am still a newbie but I believe I read somewhere that the ResMed Elite was not a data capable machine. Hopefully someone will clear that up if I am mistaken. Most of the people on the forum want a data capable machine to see how their therapy is going.

I use nasal pillows and had to resort to using Micropore tape over my mouth to prevent the air going into my nose from going out my mouth. But for me it wasn't aerophagia, my leaks were simply too large. It may help as well. The wife was also happy not to hear the wind coming out of my mouth in the middle of the night. Only problem now is that she is suggesting I put the tape over my mouth a little earlier each night...lol!

There are different techniques in applying the tape and different kids of tape as well. Let us know how your search goes. Post back with any questions.

[kaiasgram]

As I said to you in a previous thread I am still a newbie but I believe I read somewhere that the ResMed Elite was not a data capable machine. Hopefully someone will clear that up if I am mistaken.

The S9 Elite is a data capable machine, it's the Escape that is not.

[Sunpoppy]

Thank you, pugsy for the links to the software. I have planned on getting something but haven't gotten around to it yet. Will do that now.

I can't find how to access the EPR feature on my machine.....is there a trick to this or am I just so tired I am not seeing it?

[Sunpoppy]

Hmmm.....is there an app for my iPad? I use it almost to exclusion of my PC...I'm gonna check that out!

Guess I'm just thinking out loud at this point...

[kaiasgram]

I can't find how to access the EPR feature on my machine.....is there a trick to this or am I just so tired I am not seeing it?

It's in the clinician menu -- do you know to access it? http://www.cpaplibrary.com/machine-education

[Sunpoppy]

I can't find how to access the EPR feature on my machine.....is there a trick to this or am I just so tired I am not seeing it?

It's in the clinician menu -- do you know to access it? http://www.cpaplibrary.com/machine-education

Yes! I finally figured it out! TY, kaiasgram. It was set to OFF so I switched it to 3. I sure hope this helps me tonight!

[Pugsy]

It was set to OFF so I switched it to 3. I sure hope this helps me tonight!

EPR set to 3 should help with the aerophagia. Now cross your fingers that the reduction doesn't let a bunch of events sneak past the defenses. That's why I suggested the software for sure. For some people the reduction in pressure during exhale allows more events to occur. Not everyone though...so maybe you will be lucky.
Will cross that bridge if needed. Right now most important thing is get you some good sleep without blowing you up like a puffer fish.

[CowFish]

I don't see how lowering the exhale pressure will make much of a difference. It's on inhale when most of the pressure leaks into the stomach.

[2 B Sleeping Soundly]

How you position your head and neck in bed can make a difference too and then there's the old tongue-on-the-roof-of-the-mouth technique which helps keep therapy air going down your airway and away from your mouth where you can start swallowing it. There are tips for how to practice this technique if you do a search.

Sunpoppy,
This is what kaiasgram was talking about when she was referring to the tongue technique, at least this is how I do it. I learned this from posts here on the forum (please search the forum for tongue technique if my description is confusing). You put the tip of your tongue at the back of your upper teeth (where the teeth and the roof of your mouth meet), push the remaining part of your tongue upward toward the roof of your mouth. Then with your tongue in this position swallow any saliva/air that may be between your tongue and the roof of your mouth (I kind of suck backwards like I using a straw, but I don't open my mouth or lips). What you want is a slight suction to develop which will keep your tongue in this position while you sleep. Unfortunately this technique does not work for everyone, but you might still want to try it if you haven't before.

I hope this (or something else) can help your with your Aerophagia and get you on to better therapy and sleep!

John

[kaiasgram]

You're welcome Sunpoppy and thanks 2B for the explanation -- you said it better than I could.

[Pugsy]

I don't see how lowering the exhale pressure will make much of a difference. It's on inhale when most of the pressure leaks into the stomach.

It lessens the amount of time spent at the higher pressure on inhale and thus hopefully lessens the chance of air sneaking into the stomach or at least lessens the amount of air getting into the stomach.

Roughly half the night is spent inhaling and the other half exhaling. That means half the night at a lower pressure which might be enough to prevent massive aerophagia symptoms.