Aerophagia?

[jerryfudd]

Hey all! Not been around for a while as I've been busy, moved house and stuff!

I thought I'd see if anyone had any suggestions, recently I've had really bad gas/burping - which from reading seems to be aerophagia, I had tried before to lower my max pressure to combat this, but it doesn't seem to have made a difference. Past week I've had it really bad a few days, and it lasts pretty much all day. I manage to sleep okay though.

My AHI is still pretty much always below 3.

I guess my question is should I do this...

1 - lower the min pressure to say 6.
2 - lower the max pressure to stop the air.
3 - should I change the EPR.

I have a new mask, same model as before - provided kindly by the NHS as they said I can have a new one each year, and that's helped with leaks.

screenshot-20210219-184740.png (97.37 KiB) Viewed 1288 times

[Julie]

Yes. lower the min... but just try 1 at a time which may be enough. And play with the EPR.

[zonker]

minimum pressure, as julie says.

and i agree with her on one change at a time so you know which change eliminated it.

let us know what works, won't you?

good luck!

[Pugsy]

I vote for lowering the minimum first. Though I have my doubts as to how much success that will offer because your machine wants to stay up 11 ish IPAP for a good chunk of the night so the machine is essentially setting a new minimum anyway for at least most of the night.

You are already using 3 EPR...lowering EPR is likely to increase the overall average pressure which will feed the aerophagia monsters so I don't see playing with EPR as helping much. If you could go higher with EPR that would be the better choice but of course you can't.

If it was me I would do a twofer....reduce minimum to 6 and then reduce the max to 10 and see what happens. The machine will likely want to go higher but as long as it being restricted doesn't allow too many events to materialize then it might be an acceptable compromise. We have to weigh which is worse...letting a few apnea events slip past the defenses or the physical problems aerophagia cause. Sometimes we just have to make compromises because feeling like crap all day from belly issues isn't a viable way to live.

[jimbud]

I do not see how lowering the minimum is going to help you with areophagia.
You are starting at 8cm and bumping 12cm within 10 or 20 minutes.
If you lower to 7cm you will just go right back to bumping 12cm aprox. as soon.

One can limit the max pressure sometimes and help.
You just have to find a happy spot where the areophagia and AHI are tolerable for you.

Maybe someone has a better idea and will help us out.

Good luck.

JPB

I see Pugsy beat me to it. She knows best.

[jerryfudd]

Thanks all, will give it a go tonight.

I am not sure if it’s worse when I sleep in different positions too.

Since we moved I’ve been sleeping on my back more as the bed now makes side sleeping harder, whereas before I’d probably always sleep on my side for a chunk of the night, not all night though.

[Dog Slobber]

I don't agree with lowering the minimum.

Yes to lowering the maximum, and perhaps even increasing your minimum.

For me, when I was relatively new, I had some aerophagia problems. It seems whenever my pressure spend much time over 13cm, I had Aerophagia issues. I kept my maximum capped.

But then when I started optimizing my therapy, and increasing my minimum, my pressure line flattened out and rarely would my machine even approach 13cm let alone go beyond it.

Sometimes increasing your minimum, will result in higher pressure peaks and those higher pressure peaks can be beyond your threshold for keeping the air from going down the wrong tube.

I would:

1. Lower my maximum, until I found the threshold for triggering my aerophagia
2. Start increasing my minimum to see if that reduced the pressure peaks
3. When my Aerophagia es under control, slowly start increasing my maximum pressure (the Zonker protocol)

This one is definitely a YMMV though.

[Dog Slobber]

Went back and found the period, where I started increasing my minimum:

Minimum_pressure_reduces_higher_pressure.png (26.9 KiB) Viewed 1249 times

You can clearly see how when my minimum pressure was lower (on the left) the machine was always hitting the maximum (which I had to cap because of Aerophagia).

But then as started increasing my minimum, the machine rarely needed to approach my maximum.

I now have my machine's maximum wide open. I'm not sure if I still experience Aerophagia anymore, because my machine rarely approaches the threshold where it would trigger it.

[Pugsy]

then as started increasing my minimum, the machine rarely needed to approach my maximum.

I have seen this happen quite often....get the minimum up to a more optimal setting and the machine simply doesn't go up nearly as high as it used to go.
Sometimes with a really remarkable difference and especially true when the machine essentially goes up and stays up and for all practical purposes establishes a new minimum on its own.

One of the most remarkable situation was someone new to therapy and she was using not quite wide open but close and the machine spent a lot of time up around 18 or 19...so the machine was setting it's own new minimum anyway BUT the pressure was causing really bad aerophagia....and she really, really need the higher pressures to keep the apnea events under any semblance of control.
So we did try more minimum but not a lot more in hopes that we would get lucky and in her situation we did...minimum of 8 gave excellent apnea prevention and the machine never went above 12.

In the situation here...I doubt reducing the minimum will do much because he never spends much time at the low setting anyway but for some people it's the EPAP that is the aerophagia trigger so it doesn't hurt to lower it a little and see.
And he doesn't really need more minimum to deal with apnea events...so there is room to reduce it and not let a lot of events happen.

[zonker]

you know, looking this over, i realized the poster's situation is not the same as what i went through. for one thing, his aerophagia is a recent "gift" and not something he's struggled with. for me, it was a key element in getting my ahi down to a reasonable level.

also, when i came up with "the zonker protocol (as ds puts it), i never lowered my maximum. i have pretty much left the maximum at 20 ever since i came to the forum. iirc, that was the consensus at the time; i.e. leave the max alone even if it never went there.

now, with that in mind, i never paid any attention to the maximum after that. the only time it became a thing for me was this last fall when i kept increasing my minimum until i essentially had a fixed pressure cpap at 20 and 20. so i don't remember where my pressure was going at the time i started trying to quell the aerophagia.

all *I* did was go back to the minimum that i could remember doing BEFORE my aerophagia hit. i then did the .2 increments to eventually vanquish it.

so my experience doesn't seem to match the original poster's at all.

[Architect]

Sorry to read your experiencing arophagia, from my experience, although uncomfortable, I left my pressures alone allowing my body to adjust, to each pressure adjustment, which took several days. What helped during this process is a product called Charcocaps, even when I felt fine I continued taking for an extra week or two, haven't had arophagia in years, max pressure 21,. Wish you well.

[mojowrkn]

No amount of money is worth the discomfort of aerophagia. Practically ruined my life, I dont understand why people put up with such a faulty "therapy". Ive quit CPAP and am much happier, dont listen to the cassandras around here. It is all the fault of CPAP and is a vicious cycle.

[zonker]

No amount of money is worth the discomfort of aerophagia. Practically ruined my life, I dont understand why people put up with such a faulty "therapy". Ive quit CPAP and am much happier, dont listen to the cassandras around here. It is all the fault of CPAP and is a vicious cycle.

seriously?

you created an account just to post this nonsense??

i'm passably familiar with the concept of troll( though i truly don't get it.), but this takes the cake.



pugsy?

please keep an eye on this.

[mojowrkn]

Not trolling at all. Ive been doing a ton of research since I started my CPAP journey, and ive yet to meet anyone that CPAP just works for....not one. All my friends have a story of a family member who suffered with it and quit. All I see here are stories of suffering, relapse and hassles.

Personally I find it very, very unnatural and believe its damaged my lungs (athlete) im seeing a specialist next week. Th misery from aerophagia was crippling and I dont use that word lightly.

What I do see around here is a culture of deflection and denial. So just trying to add some truthiness.

Best-J

[Pugsy]

Not trolling at all. Ive been doing a ton of research since I started my CPAP journey, and ive yet to meet anyone that CPAP just works for....not one. All my friends have a story of a family member who suffered with it and quit. All I see here are stories of suffering, relapse and hassles.

Personally I find it very, very unnatural and believe its damaged my lungs (athlete) im seeing a specialist next week. Th misery from aerophagia was crippling and I dont use that word lightly.

What I do see around here is a culture of deflection and denial. So just trying to add some truthiness.

Best-J

Well now you know of at least one person that cpap works for...me...and a whole lot of others here besides me.
Believe what you want but cpap can't damage normal lungs...it can't even blow up a balloon at 20 cm pressure.

Don't assume that your "truth" is everyone elses' truth. You are way up the DeNial River and without a paddle and you don't really want to make it work because of your own "truths". There are ways to deal with aerophagia BTW. It's not a death sentence. It is miserable...I grant you that but it is fixable if someone really wants to fix it.

What I see here....you want to rain on everyone elses' parade with your own negativity...and it's actually uncalled for and people will call you out on it.
Just because you believe something as the gospel...doesn't make it the gospel.
Get over yourself and move on...this is a cpap help forum...if you don't want to make it work then don't bother posting your garbage here.

Have a nice day.