Dr ordered higher pressure for aegophagia?

[cgmichigan89]

I have been suffering from aegophagia since stating CPAP about 40 days ago. My Auto Pap was set at 5-14 and I was averaging 13.8 each night. Called my doctor and they now want my pressure to go up to 15.... this seems strange to me... thought I would be able to lower my pressure to help with it not increase it. Any advise?

[chunkyfrog]

They're trying to treat the apnea while assuming the aerophagia has gone away.
It often does, but not always; or not as quickly as hoped.
Search areophagia in the search window and start reading.
There are a lot of suggestions/solutions--hope something works.

[Pugsy]

Goes against what I have always read.
If you do need the higher pressures for events and the aerophagia is horrible you may need a Bilevel pressure machine. He may be thinking higher pressures to deal with the events since you are averaging near your max but it sure won't help the aerophagia unless the events are part of the problem which they of course could be.
Do you use EPR? Do you have the software to see what is going on or are you just looking at the LCD screen?
Has anyone considered a tighter range? Sometimes less variances in pressure help reduce the gas.

[cgmichigan89]

So my AHI is at 0.8... never goes above 1. So the apnea's are under control just fine.. I called to ask them about what I could do to help with the aegrophagia and the doctor wanted a download of my data. Once they saw my data they came back with increasing the pressure to 15 so that goes against everything I have read on this site about treating aegrophagia. I currently don't use EPR ... should I?

[Pugsy]

I currently don't use EPR ... should I?

I would if it were me. EPR at 3 will reduce your pressure 3 cm on exhale and it may help the aerophagia.
Won't notice it at 5 cm when you start up though because the lowest the machine will go is 4 cm. Watch the AHI but I think you have a lot of wiggle room there. Might as well give it a try. EPR is a comfort feature....might as well see if it will maybe add some comfort.

[cgmichigan89]

Great advise Pugsy...will try it out tonight! Thanks.

[GumbyCT]

So my AHI is at 0.8... never goes above 1. So the apnea's are under control just fine..

That is Great IF your leaks are under control and a fairly flat line on the software.

Keep in mind - while EPR is a comfort feature going to a 3 can cause your AHI to rise because it will reduce the pressure which can allow events to increase. The doc may have already considered this but then maybe NOT.

How is your doc making these changes? Via modem? via Card? Or via RT?

[cgmichigan89]

Doc is making changes via card

[Wulfman...]

I have been suffering from aegophagia since stating CPAP about 40 days ago. My Auto Pap was set at 5-14 and I was averaging 13.8 each night. Called my doctor and they now want my pressure to go up to 15.... this seems strange to me... thought I would be able to lower my pressure to help with it not increase it. Any advise?

Has the thought occurred to you that it might actually be the range of pressures that's contributing to your problem? (and high AHI numbers)

A significant number of people who experience "aerophagia" also have GERD (and there is also a "silent" version of GERD) which drives APAPs (in a range of pressure) crazy. There are quite a few examples of these stories in these forum pages.
In your sleep study, were they able to determine a fixed pressure for you? If so, I'd recommend trying it.

My suggestion would be to set your machine to CPAP mode at a pressure of like 10 cm. and see what happens. You may also want to try to experiment with the EPR settings......even turning it Off.


Den

[Randyp1234]

Has the thought occurred to you that it might actually be the range of pressures that's contributing to your problem? (and high AHI numbers)

OP said "So my AHI is at 0.8... never goes above 1. " Doesn't sound like high AHI numbers to me.

[Goofproof]

Maybe the doctors idea is that more pressure will open us your gut and relieve the backpressure, I don't concure. Jim

[Wulfman...]

Has the thought occurred to you that it might actually be the range of pressures that's contributing to your problem? (and high AHI numbers)

OP said "So my AHI is at 0.8... never goes above 1. " Doesn't sound like high AHI numbers to me.

Yeah, I think I misread one of those initial numbers (maybe the 13.8 one) as an AHI number instead of average pressure.
So, my bad on that one, but I still stand firm on my recommendations about the range of pressures exacerbating the problems.


Den

[Papit]

Maybe the doctors idea is that more pressure will open us your gut and relieve the backpressure, I don't concur. Jim

I don't either. My doc just LOWERED my fixed 8 cm H2O pressure to 7 because of burping. Am not sure if it occurs while I sleep, probably not or not much. It begins within minutes of arising in the morning and continues on and off throughout the day. BTW, I did a test during which I made intentional timed burps and discovered that the burps, a lot of them anyway, show up as bogus central apnea events on the graphs. Anyone care to see if my test results can be duplicated by them independently?

Incidentally, I do have chronic GERD with mild gastritis and observed irritation in the lower esophagus that has been treated for a couple years with Prevacid (now switching to Nexium to see if that will help). So there's a good chance that the burping in my case has little or nothing to do with the burping symptom.