Aerophagia and use of BiLevel

[dsm]

Just posting this as an early observation.

1st, since taking up xPAP therapy and while using CPAP & APAP (both occasionally with CFlex), I have repeatedly been afflicted with aerophagia. I use a full face mask & was thinking this may contribute but all attempts to get by on nasal pillows & nasal masks have not worked & I nearly always fall back to my f/f mask.

The aerophagia would manifest itself in a number of ways 1stly by me repeatedly burping during the night & 2ndly with air being expelled regularly from a lower body orifice.

Last night was my 1st night trying a BiLevel (15cms Inhale & 8cms Exhale) & what a delight it was. The breathing out was such an easy thing to do compared with straight cpap & also with AUTO & with both using Cflex.

I had finally concluded that Cflex was a very nice aid but nothing I could do was preventing the aerophagia.

The 1st thing I can report about using the BiLevel was that I only recall burping once early in the night & now with the following day passing, none of the 'bass' burping is occurring either (bass being the deeper rendition of blowing air one usually expects from the other orifice ).

So the observation is that for me, it is a possibility that the aerophagia is caused by breathing out against pressure on the normal xPAP machines. With those machines the air seems to also find its way into my stomach. On BiLevel with the very low exhale pressure & very well controlled pressures, that is not happening. In fact I have been running mostly on 14-14.5cms until last night but with the introduction of the BiLevel I decided to up the cms to 15 (my titration recommendation). In the past I tended to get mask leaks as soon as I upped cms to the recommended 15.

I will report back in coming days if this pattern is confirmed as if so, then *one* answer to chronic aerophagia may well be a BiLevel.

Cheers

DSM

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, Titration, CPAP, Nasal Pillows, auto, APAP, aerophagia

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, Titration, CPAP, Nasal Pillows, auto, APAP, aerophagia

[rested gal]

Glad to hear bilevel relieves aerophagia for you, dsm. I had the opposite experience - autopap preventing it better for me:

Jul 28, 2005 subject: APAP vs. BiPAP for aerophagia

A wise Guest in that thread mentioned that bilevel helps prevent it for some, while autopap prevents it better for others. It's good that you found which type of machine offered you a solution, cause aerophagia sure ain't fun.

[dsm]

Hi RG,

Just as you must have been posting I was modifying my post to say *one* answer to aerophagia rather the the 'the' I had 1st written.

I keep reminding myself as I write that I can only speak for myself as there are so many times that we discover how the same situation can be quite different for others.

I will look thru the linked to thread. I am still in awe of your ability to point to a detailed topic of interest.

Cheers Doug

PS last night I also used an F&P HC150 & it is a great humidifier. I was always inspired to get one after reading one of your commentaries on it & as is so often the case - you were dead right.

D

[dsm]

RG,

I read the thread - very informative.

My understanding (a summary) is that depending on the cause of the aerophagia it can solved by either approach allowing that BiLevel should suits those who are afflicted with aerophagia when 'breathing out against pressure' and an AUTO can alleviate the problem for those who are afflicted with it via 'high inhale pressures' & thus benefit from the AUTOs average lower pressure range.

It seems to be a case of inhale casuality vs exhale casuality.

I think that encapsulates the core points ?.

Cheers Doug

[robert_zucker]

How can one tell whether inhale causality or exhale causality?

I have seen 2 sleep neurologists. One is adamant that bipap will achieve nothing in terms of reducing aerophagia, and the other is diametrically opposed.

[dsm]

How can one tell whether inhale causality or exhale causality?

I have seen 2 sleep neurologists. One is adamant that bipap will achieve nothing in terms of reducing aerophagia, and the other is diametrically opposed.

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, aerophagia

The only comment I can make is what it does for me & so with me now into my 3rd night on BiPap (after 5 months of CPAP, APAP & CFLEX modes & a variety of brands of machine), I am welcoming the difference. It was pronounced for me in that for the 1st time in months I actually increased the cms I run my machine at. It the past anytime I set it to 15 (or on AUto to just above that) I would get worse symptoms of aerophagia & lots of face mask squeaks & leaks.

Thus I am willing to make the following statements ...

- "Aerophagia can become a cause for being disheartened in xPAP therapy"
- "I am seeing a distinct difference in regard to symptoms of aerophagia at this time"
- "My symptoms appear to be related to breathing out as I have been able to increase my inhale cms without aerophagia returning"
- "If this stays as good as it is now, I will stay on BiPap"

I know that your remarks are hearsay and thus may vary just a little from the actual comments of the specialist opposing BiLevel as a possible way to alleviate aerophagia, but in principle, I believe the strength of us users experience and our remarks on what is actually occurring, carries some weight.

However I would enjoy discussing the issue with the person(s) just to understand why they believe what they do. There is always some new angle to see things from

Cheers

Doug

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, cflex, CPAP, auto, APAP, aerophagia