Does anyone get GERD from using CPAP?

[Quackerville]

I have never suffered from acid reflux before, until trying to use a CPAP. Now every time I try to use my CPAP I wake up within an hour with quite painful GERD, even if I am careful not to eat before bed. I'm just wondering if anyone has had that and found a solution.

[ozij]

Yes.
CPAP can exacerbate reflux problems - and for some, silent (symptomless) GERD becomes symptomatic on CPAP

I knew I needed to take PPI's, but last year, at a time my pressure rose I had dramatic and frightening reflux. The tissues of my low esophageal sphincter had swollen, and it functioning worsened.

My solution - discussed with my doctor - consisted of:
Raising my very low dose of PPI fourfold (from 10mg to 40mg)
Doing my utmost to sleep only on my left side (avoid the right)
A temporary drop in pressure.
A year later my pressure is where it should be, my PPI dosage is one day of 10mg one day of 20 - more or less.

Search for GERD on the forum, you'll find many suggestion, including raising the head of the bed.

[Slinky]

Yup. And - Not yet.

And I do NOT suggest that you do what I "had" to do. I let it go so long w/o talking to sleep doctor or RRT and asking for help that I had no choice but to quit PAP therarpy entirely for about a month, maybe 6 weeks, just last year.

When I started back on PAP (I was on a bi-level) I started at IPAP 10, EPAP 5 and GRADUALLY (at least a week at each new setting - sometimes longer, as needed) built up towards the recommended pressure of IPAP 17, EPAP 13. I haven't made it there yet. I also was put on Dexilant for 8 weeks which also helped. I'm up to IPAP 16, EPAP 10, Pressure Support 4 and the GERD/reflux has started again. The last 3 nights I haven't used PAP at all and have just slept w/my 2L of 02. I was in to my family doctor today and given a script for the Dexilant again.

I should point out that I started on CPAP in Oct 06 and was 100% compliant from night one, except one night after a night in a motel after hitting a deer on the highway, and was switched to a bi-level in Mar 08 due to COPD and have been 99% compliant w/the bi-level until May or so of 10 and now again May of 11.

[Mary Z]

Very uncomfortable. You can try one of the OTC acid reflux medicines (zantac, tagamet, pepcid). If the OTC dose doesn't work you can look up the prescriptions doses on the Internet. And of course there's always perhaps the safer method of seeing your Doctor. Good luck. I used to have GERD before CPAP but after a while on the medicine it went away, or at least doesn't bother me anymore. I don't know how old you are, but my doc told me as we age we can develop "lazy sphincters" which allows stomach contents to rise into the throat. Oh yes, I think someone mentioned raising the head of the bed so you're sleeping on a slight incline. Good luck. CPAP can certainly exaccerbate the problem.

[Janknitz]

I have the opposite--terrible GERD, but NONE when the mask and machine are on my face.

In either case, it's a serious situation. Be sure to talk to your doctor.

Elevating the bed never helped me much, but it was even worse lying flat. Try not to eat or drink (even water causes my GERD!) within 3 hours of bedtime and watch for triggering foods (for me it's dairy products--I think the milk sugars, and I LOVE milk ).

Lowering the pressure temporarily might help. Also, be sure to get that tongue up on the roof of your mouth as aerophagia seems to make GERD worse and leakage into the mouth causes a good deal of aerophagia.

[Audge]

Hi Quakerville, I cannot speak to CPAP causing GERD because I have suffered from it for years. I am on 80mg daily of Nexium....but.....I had to see my doc today because of worsening chest pain after starting CPAP. He told me esophageal discomfort and irritation are not uncommon when first starting CPAP therapy. I have to take a PPI and have been for several years but I think there could be a corrolation to esphogeal irritation and beginning use of a CPAP.

Audge

[Sheriff Buford]

Folks was is "PPI"?

Sheriff

[archangle]

Folks was is "PPI"?

Sheriff

"was is"??? You need to get some sleep, sheriff.

PPI is Proton Pump Inhibitor, a type of drug that prevents your stomach from making acid.

As for GERD, I think I got it really bad when I had my CPAP machine set wrong and I was getting too low of a pressure. It went away like magic when I fixed my settings.

[Sheriff Buford]

Arch: thanks... I have GERD too. As for the english... er I from Texas... I speek grate english.....

[AMUW]

I have never suffered from acid reflux before, until trying to use a CPAP. Now every time I try to use my CPAP I wake up within an hour with quite painful GERD, even if I am careful not to eat before bed. I'm just wondering if anyone has had that and found a solution.

Having also had the problem, I looked into published literature connecting gastro-esophageal or laryngo-pharyngeal acid reflux, OSA, and CPAP. One needs to look at least at the 3-way connection; and other factors may contribute.
A few concepts many agree on:
- during inhalation / exhalation there are a lot of pressure variations along the upper airway; almost like using a plunger to unclog the kitchen drain, acidy liquids and gases can be sucked upwards (dr. Park says even into the nasal passage)
- the sphincter muscles in the esophagus play an important role
- there is an interplay between OSA and acid reflux
- the net effect of CPAP is to push the acid downward, so it is a beneficial effect
Beyond this, the experts disagree on whether OSA causes GERD, or the other way around, or a vicious circle under some circumstances ... or no connection at all. Could CPAP-associated nervous irritation play a role in increased stomach digestion?
I suspect that the doctor will suggest trying out the solutions already mentioned in the posts above. Note that raising the bed head may conflict with the suggestion to sleep more on one's side.
Have you compared using nasal pillows vs. the full face mask? There is just a possibility that more air going down the nasal passage may change the irritated locations? Also, I've switched to light dinners, longer than 4 hrs before bedtime, and little alcohol with dinner in the evening.