aerophagia & APAP?

[echo]

Hi folks - quick question -- does using APAP (vs. CPAP) make aerophagia more likely?

I'm still experimenting with settings - so instead of a straight CPAP of 10.5, last night I tried APAP with min=10.0, max=12, initial=10.5

On straight CPAP I'm still getting a few central apnea's here and there but also a lot of hypopnea's & flow limitations, so I'm trying to find a way to catch both.

On APAP 7-10 and 8-10 and CPAP 10.5 I didn't get any aerophagia, but now with the APAP 10-12 I felt like a bloated fish as I was falling asleep (no ramp)... uuuurgh. Which is really weird cause the pressure was exactly the same, that is, 10.5, but it felt different. Maybe it was psychosomatic or ...???

Just wondering if APAP makes aerophagia more likely? What I read in the collective wisdom seems to indicate that APAP can help with aerophagia... me confused!

[roster]

........

On APAP 7-10 and 8-10 and CPAP 10.5 I didn't get any aerophagia, but now with the APAP 10-12 I felt like a bloated fish as I was falling asleep ......

Your explanation indicates so far you only get gassed at the highest pressure setting you have tried. Higher pressure makes gassing more likely.

[OutaSync]

I didn't have aproblem with aerophagia until I switched to APAP. I very rarely have pain, mostly it's discomfort with a lot of gas. I didn't know I had GERD, either, until I had the endoscopy, as recommended by the good people here.

B

[echo]

Rooster - I wasn't getting the aerophagia at the straight CPAP setting of 10.5, which I've been on over two weeks.

Outasynch - yeah thanks for the reminder. I did get a referral from my GP but just haven't made the phone call yet (exams and holidays coming up, eek). My dad had esophagael cancer (never smoked) so I did get one endoscopy but that's been like 7 years now. I'm definintely overdue for another one.

How do they actually diagnose GERD ?? I SHOULD know this, and can probably google it quite easily, but I'm being very lazy and actually it didn't even occur to me until now - i was just thinking of the endoscopy re: cancer... doh. I probably DO have GERD. sigh.

[Babette]

Dang, don't make me fish that letter out of the trash.... I can, though. I got a letter from my insurance telling me they wouldn't pay for my GERD medicine anymore, because it's only supposed to be used for a short time, like 90 days. Whatever. I never believed I HAD GERD anyway. But the letter tells me how to get it diagnosed.

Seriously, if you don't get a better reply, I'll fish it out for you.

BTW, apparently it's only this one class of drugs they don't like you to take more than 90 days - proton pump? I think I'm taking generic Protonix. But not anymore!

LOL,
B.

[roster]

Rooster - I wasn't getting the aerophagia at the straight CPAP setting of 10.5, which I've been on over two weeks.

.....

That was my point. So it could be that 10.5 is not enough pressure to break the seal in one or both esophogeal sphincters and push air into the stomach.

But you say you are getting it at APAP 10-12. So likely this setting at time pumps the pressure above 10.5 and reaches a pressure that will open up the sphincters.

[Babette]

Okay, while I wait for the copier technician to finish up, here's some links I trolled on diagnosing GERD:

http://www.cpmc.org/services/gi/services/gerd.html

http://heartburn.about.com/cs/treatment ... segerd.htm

http://heartburn.about.com/b/2003/08/15 ... e-gerd.htm

http://www.healthcentral.com/acid-reflu ... 7-145.html

http://www.ehow.com/how_2047865_diagnose-gerd.html

http://www.diagnose-me.com/cond/C374158.html

And, that guy who wants $20 to cure your apnea? I think he might be behind this, too.....

http://www.refluxremedy.com/

LOL,
Babs

[echo]

No worries babs I'll talk to the GI specialist about it anyway and google it as backup

The thing that kills me, totally sucks, is that my dad took GERD meds for YEARS.. his GP never referred him to a GI specialist.. his OWN DAD was a doctor.... yet he got bloody fkipping cancer from all the acid eating away at his esophagus..... ONE endoscopy, just ONE endoscopy in all those years would have caught the stupid thing before it turned cancerous. He took prilosec and all sorts of proton pump inhibitors and other stuff, and exactly as you say, they should NOT be used for more than 90 days. I'm sure there's a reason for that!!!

I have also thought (since I do like some of the alternative medicine stuff) that the whole GERD thing is not due to TOO MUCH acid, but rather lack of balance in the GI tract -- and espeially TOO LITTLE acid... which creates too much bile (was that it?) and THAT's what actually causing the damage.

When I did meal separations - eating fats and carbs at different meals - my acid reflux went away. It mostly has not come back, the only time it comes back is if I eat too many carbs and too many fats in the same meal. But possibly I still have GERD when I'm sleeping? Who knows. But I do need to get that endoscopy ASAP...

Edit: cool, when I hit submit, it warned me that a new post had been made in the meantime, and asked if i wanted to review my post first. TOO COOL
So thanks for the links, dear Babette the Bad , I''ll read up on them this weekend. Yeah, I gave up on the $20 guy. He never sent me the Koala.

[OutaSync]

I had a bunch of swallow x-ray tests and you could see the liquid going down my throat, to my stomach and then back up when I laid down. Wierd to watch.

Bev

[RafterRattler]

So now that I know what aerophagia is (found out in the chat room tonight!), I'll respond to the original post - with my experience.

I've been suffering with severe morning gas and cramps for MONTHS, as well as other intestinal issues. My doc thinks I have IBS. I ended up getting a colonoscopy after a bunch of medication didn't help. Nothing. Having gotten used to it, I didn't give it a second thought until tonight. Since I started using my new machine (APAP), I haven't had the gas in the morning. My old machine was a CPAP at 13....I have the APAP set to 10/15, and the 95th ptile averages 12.4...

So for me at least, it looks like APAP may have actually improved the situation!
Mike

[OldLincoln]

Since I started using my new machine (APAP), I haven't had the gas in the morning. My old machine was a CPAP at 13....I have the APAP set to 10/15, and the 95th ptile averages 12.4... So for me at least, it looks like APAP may have actually improved the situation! Mike

The thing is as rooster pointed out that you have a threshold pressure at which the sphincter gives way and air flows through. Prior to that, I don't think you will have any slip in by.

Contrary to many others, I don't hang my hat on any of the 90% numbers. If you get detailed numbers look at the actual minutes at the pressures and you can probably draw a line at your threshold. In my case, the auto would jump up to clear an event and back down in less than a minute. The painful bloat is gone and only a 'normal' morning amount remains.

[echo]

Thanks for all the suggestions and feedback.

I had a second horrible night on APAP. I just can't seem to stand having the IFL1 on. The durn thing goes up and down all night and I wake up every time. Aerophagia didn't seem to be an issue last night, strange. Maybe the pressures were jumping up as I was falling asleep, the first night.
I don't want to keep torturing myself so I'm going back to straight CPAP

[SleepyDragon]

I have a hiatus hernia and experience abdominal gas constantly since starting CPAP six weeks ago. I'm scheduled to see my sleep doc on Wednesday and I plan to discuss this with him. Most everyone I've talked to so far have only had "sucks to be you" comments, since there appears to be little that can be done. Experimenting on my own I've discovered that I get less gas if I sleep on my back (only a little, actually.) If I sleep on my side (my normal position) I get painfully distended in just a couple of hours. Fortunately it does not take long to start passing it. Its a lot like the gas you get during a colonoscopy.

On the plus side, my night time acid reflux has not bothered me at all since I've been on CPAP. Mabe the pressure keeps it down?

P.S. - Before anyone suggests I switch to BiPAP or APAP mode, my VPAP III was locked in CPAP mode on the Dr's order. He has a low opinion of new patients tweaking their own therapy.

[Poppy]

I'm so glad to read all of this. I've been using a cpap for a little over a year and wasn't aware of a forum until now. It's been a year of challenges: I'm on my 3rd mask design and my 3rd pap machine. Didn't use my cpap with cflex for the last two months because I could not stand the bloating anymore. I was told I'd adjust, but I never did. Just got an apap a week ago, so far with mixed results. Some nights I take on a lot of air, one night was particularly bad, but other nights it doesn't seem like I do at all. I have GERD and IBS and IC, too, so there are many reasons I wake up repeatedly all night long. My mantra: nighttime is not my friend. I hope that will change someday. I look forward to getting more ideas from this forum and to sharing what little I know.
Poppy

[echo]

Hi poppy - welcome to the forum!

I suggest a new mantra: xPAP is my friend and I will sleep better at nights

Amazing what a little power of suggestion will do. Don't fight against it, try to go with the flow. Soooo zen eh? But I totally know what you mean, I always dreaded going to bed, probably because my subconscience knew I would be suffocated once I fell asleep!

I'm sorry you've had a rough year, but I hope you find that this forum is great and full of wonderful people ready to try to help you with all your problems! And we love success stories So stick around...

Hopefuly the APAP will work better for you. There's a post on APAP & aerophagia in "Our wisdom" -- I'd suggest starting there and reading up all that you can... our-collective-cpap-wisdom/CPAP-hose-aerophagia.html
Aerophagia is definitely not fun, and not something "you get used to"!!!

Even though you're not a newbie anymore, some of those posts may give you some new ideas. Also don't be afraid to post and ask for suggestions! And I hope you'll share your experience with other newbies

Welcome!