Newbie getting aerophagia when using CPAP

[Sir NoddinOff]

For me and for quite a few others it went away or greatly reduced after a couple of weeks. I think the upper esophageal splinter just gets stronger, tho I can't prove that. Your boyfriend can take Gas X or other OTC meds to help reduce the discomfort. He should avoid foods that are going to add to the gas problem like beans, raw cauliflower and broccoli, plus hot and overly spicy foods. Also, he can try sleeping in different positions. On my back I get very little aerophagia, on my left side it's mild, on my right it worse.

Somebody will undoubtedly post and say he has to get to a doctor right away because he has GERD. Before you panic and run out the door to the nearest doc, search for the phrase 'GERD' on this site and find out what the exact symptoms of GERD are. I am not a doctor and my opinions are not meant to replace a doctor's advice.

Corrected, thanks chunkyfrog

[chunkyfrog]

Please forgive the correction, but I believe it is GERD--Gastro-Esophageal Reflux Disease.
(Just so mystiohmy can look it up)

[Sir NoddinOff]

Re-reading the part of your post about a possible faulty humidifier on the : PR System One REMStar 60 Series Auto CPAP. I have an older machine and the heating element barely gets warm. This is because on this model of the PR System One, in an attempt to defeat dreaded 'rainout' (or the condensation of water in the tube and mask), they placed sensors in the device to measure room temp and humidity. IMO, all this did was just cool things down to the point of uselessness. Even on the humidity setting of 5, my tank barely gets warm. On the older machines there are ways to use the older humidifier settings (ie. much warmer) ... search for S1 + classic + humidifier. Follow Pugsy's threads and you can't go wrong! I think the Sys 60 actually comes with heated tubing or maybe it's optional? Oh yeah, I see it on you equipment profile, you should be set.

[kaiasgram]

You didn't say what CPAP machine your bf has -- some have features to reduce the pressure slightly on exhalation (on the ResMed S9 APAP it's called EPR, or expiratory pressure relief, and similar features go by other names on other machines). This feature drops the pressure slightly when you exhale and takes it right back up to the necessary pressure when you start to inhale again. This makes breathing feel more natural and comfortable without compromising the CPAP therapy. I found when I turned this feature on my machine it significantly reduced my aerophagia. I was trying to breathe out against the incoming air pressure and was getting 'overloaded' with too much air coming in. I also learned on this forum to practice keeping my tongue up on the roof of my mouth during sleep because it seals off access to your digestive tract and keeps the air moving into your airway. I'm a newbie myself, but these tips have helped me a lot and have kept me trying to deal with CPAP therapy.

[kaiasgram]

Sorry, in my sleep apnea-induced brain fog I missed that you had your machine info at the bottom of your post. I imagine others who use that machine could tell you whether it has the exhalation relief feature. Since it's an auto CPAP I would hope so. Or you could go to the manufacturer's website where they list the specifications/features of each of their machines. Once I saw that my ResMed machine had the feature I then scoured the internet for good tutorials and videos, and was finally able to find good info on how to enable it on my machine.

[CatButler]

I'll post what has worked for me, YMMV.

My Auto CPAP was increased to a range of 10 to 16. The API was better but the areophagia changed from just annoying to very uncomfortable bloating. After a month on the new settings, the API (around 2.5) and 95 percentile pressure value (around 12.5) was good enough that the Sleep MD felt good dropping the setting to 9 to 14. That has made a big difference and the areophagia is back to just slightly gasier than normal. It looks like your machine is an Auto, so hopefully it is running that way. I would have the doc take a look at your data. Maybe dropping the low end a bit could help. Exercising (a mix of weights and cardio) made a big difference in getting the API and 95 percentile pressure down.

[Pugsy]

Aerophagia to the point of pain or discomfort is of course unwanted and not using the machine until things get "fixed" is also unwanted.
For some people the air goes down the airway and diverts into the esophagus and the LES (lower esophageal sphincter) does not close adequately and lets the air enter the digestive system. Been there myself and not fun but fortunately not an every night occurrence.

Best thing is to alert the doctor and bring it to his attention first.
Sometimes just a minor pressure reduction will still allow acceptable therapy and not cause aerophagia to be a problem.....sometimes a different machine is needed.
There is exhale relief on the PR S1 machines but the reduction in pressure is minimal and based on breathing flow and not a real pressure drop but playing around with the Flex exhale relief settings is one thing that can be done.
Also...what are the pressure settings? Do you have the software to evaluate how high the pressure is going?
Leaks? If mask leaks the PR S1 machines will try to fix the leaks with more pressure and more pressure means more force going against the LES and greater chance for air entering the digestive system.

Send me a private message and I will give you some information about the only software available right now to evaluate the therapy in better detail. The information on the LCD screen on the machine is pretty much useless.
Did you find the provider/clinical manual which tells how to get to the clinical setup to see what the pressure settings are?
If not you can request it here http://www.apneaboard.com/adjust-cpap-p ... tup-manual

GERD may or may not be a factor. People with a history of GERD may have some LES damage but it is not a given.
I do have a history of GERD as well as a small hiatal hernia and I can count the times I have had bad aerophagia on one hand during the past 3 years. It is something to think about though but fixing the GERD (if present) doesn't fix the aerophagia because they are likely not tied hand in hand. It is the pressure that is being used that needs to be fixed but you don't want to reduce the pressure without evaluating the therapy results....too little pressure can let apnea events happen but there may be some room for reduction without an increase in events.
Best to keep the doctor in the loop though....if things are really bad and the machine just won't be used then perhaps a bilevel machine will offer the relief that is needed.