Aerophagia on Bilevel

[Posey]

Last night I met the monster. I am using a Quattro FX and a bilevel @ 12/8. I had read on this forum to take GasX and it helped. Thank God for all you who post! But I need to know how to avoid it. I woke up my cheeks puffing out, tried to control that and started having chest pain. I recognized what it was and got up-trying to belch and took 2 of the GasX pills. After sitting up a while it eased enough to sleep w/o the machine.
The RT at the DME was no help- at all. The doc is off today

I have a small hiatal hernia & GERD so I take Prilosec every day. I have some allergy problems and took a Benedryl last night plus I am on two different nasal sprays. I wondered if post nasal drip was contributing -but don't feel stuffy today. Just tired and mildly queasy & achy and tired & also tired. I am almost at 2 weeks of CPAP and still not finding the right pressures to stop the apneas. I figured there would be adjustments but this is bad. Thanks for any ideas you may have.

[Pugsy]

What did your report look like with the 12/8 pressures? I know you went from 8/4 to 12/8.

[Posey]

Not great. I went to an AHI of 9.3 from 12.8 from 16.5 though & was willing to keep at it as old64mb had said it might take some time. I have had no major leaks but last night things really went sour.I had several CA & OA in the couple hours I had the mask on.
I feel like I have gotten worse since I started therapy rather than better. The 1st few days looked OK then I felt bad & checked the SD card and found AHI number had increased over time. I tweaked the settings- not much and not much difference either. Using 12/8 was looked like it was possibly working as the AHI headed back down and then the aerophagia. Sigh... wish all this was easier.

[Pugsy]

Is it possible that some of that AHI of 9.3 from last night was awake events being scored?
What was the breakdown? How much of that AHI was clear airway (centrals)? Did they all cluster around a time when you might have been having the aerophagia issues and been awake or semi awake?

[SleepDepraved2]

I found when I had the bilevel that I had some measure of aerophagia until the pressure was lowered somewhat. When it was the highest it was the worst, then they lowered it a bit and it improved. After a while, I got more used to it. The air would move through, though, even though it wasn't distending my stomach as badly, it was still there. I found that sleeping on my right side made it worse and if I was constipated, that would make it worse too. Then I trialed the auto bipap and had no aerophagia at all. When I went back to my usual machine, it took 1-1/2 hours to distend my stomach again, waking me up with horrible cramping, so I got up and turned the pressure down myself. I turned the machine down to the median pressure on the auto bipap.

Now I'm on an auto CPAP and have no problems with aerophagia. My medical history is a lot like yours, reflux with Prilosec, hiatal hernia. Now I'm off the Prilosec, the hernia is not bothering me, and my treatment is working nicely. Keep complaining about the aerophagia to your sleep doctor and tell them you think you are a good candidate for an auto bipap or cpap.

[JohnBFisher]

Posey, I just added a reply to one of your other posts. I'll do what I can to wade through your posts. I suspect you might need to adjust some of the settings to get your unit to act more as a BiLevel (BiPAP) than as an ASV unit. Due to other commitments it may take me a few hours to put together a more detailed response. But you are not being ignored. I know it's frustrating. Hang in there!

[CatherineF]

Now I'm on an auto CPAP and have no problems with aerophagia. My medical history is a lot like yours, reflux with Prilosec, hiatal hernia. Now I'm off the Prilosec, the hernia is not bothering me, and my treatment is working nicely. Keep complaining about the aerophagia to your sleep doctor and tell them you think you are a good candidate for an auto bipap or cpap.

Can I ask you how you are keeping your GERD under control without drugs? I have hiatal hernia (small) and GERD and a lot of problems with aerophagia. Without reflux medicines I feel those stomach contents backing up my throat and I have heartburn also.

[archangle]

I find that increasing my minimum APAP pressure seems to relieve GERD like symptoms. At a lower pressure, I don't show any apneas, but I get GERD type symptoms.

My best guess is at lower pressure, I'm still struggling a bit to inhale and get some more reflux.

[SleepDepraved2]

Now I'm on an auto CPAP and have no problems with aerophagia. My medical history is a lot like yours, reflux with Prilosec, hiatal hernia. Now I'm off the Prilosec, the hernia is not bothering me, and my treatment is working nicely. Keep complaining about the aerophagia to your sleep doctor and tell them you think you are a good candidate for an auto bipap or cpap.

Can I ask you how you are keeping your GERD under control without drugs? I have hiatal hernia (small) and GERD and a lot of problems with aerophagia. Without reflux medicines I feel those stomach contents backing up my throat and I have heartburn also.

I still have a little problem with heartburn now and then, but it's usually caused by specific foods. My insurance will not pay for omeprazole anymore, but I can buy it over the counter. So I take a bit of omeprazole 20 minutes before a meal with foods I know will cause problems and I haven't had too much heartburn. I also learned I can't chew gum. That kicks it up worse than anything. The CPAP takes care of the rest.

As for the hiatal hernia, when it starts to bother me I have my chiropractor put it back in place. I also use an exercise I found online.

Drink about a glass of either room temperature or slightly warm water when you get out of bed first thing in the morning. (No coffee, no tea, no juice, no cold water, just warm water.)

Then, while standing, bring your arms straight out from your sides and bend your elbows so that your hands are touching your chest. Then stand up on your toes as high as possible and DROP down onto your heels, rather like a weightlifter's squat! You should force a pretty good jolt. Drop down like this 10 times in a row. Then, while standing with your arms up, pant short quick breaths for about 15 seconds. That's it.

The warm water acts like a weight in the stomach. Warm water doesn't cause the stomach to cramp, but instead it relaxes it. Spreading your arms stretches the diaphragm and opens up that hole in the back. Dropping down on your heels jerks the stomach out of the hole, and the panting tightens up the diaphragm muscle to close the hole.

You need to do this exercise every day - not just until everything feels normal. This will also strengthen the area, and make the hiatal hernia less likely to come back.