Need advice please: Abdomen fills with air

[JHS2013]

I need help from you PLEASE. My husband was diagnosed with apnea. He used the machine faithfuly for several weeks. Then suddenly it started filling up his abdomen and chest with air, very painful and uncomfortable. We went to see our apnea doctor. On the phone the nurse said she never heard of this happening. I googled it and saw that several people had reported the condition. So I made an appt and we went in thinking they would change the mask or something. The doctor asst said take mylanta before bed that will stop it otherwise nothing can be done because its caused by him breathing that way. ????? So we go home. He tries the mylanta for several nights, every night he blows up. So now he refuses to use it. I can hear him stop breathing in his sleep so I am very worried. Please help!!

[Somnolence]

I don't have a good recommendation for you... It sounds like the doctor recommended mylanta to curb acid reflux which might be forcing a sphincter muscle open. Does your husband normally have issues with acid? How about burping, prior to CPAP?

Eliminating caffeine helped reduce my air swallowing quite a bit.

[Sir NoddinOff]

Search for 'aerophagia' on this site, then read what others have experienced with this abdomen swelling problem, then note some of their various cures. There are literally hundreds of threads on this very common complaint, especially with newbies. I hope you and your husband find an easy solution... most everybody does sooner or later. Side note: A sleep doctor or their staff who haven't heard of of aerophagia are to be viewed with caution, should the OPs report be correct.

What worked for me was initially taping my mouth shut, then a year later I transitioned to a chinstrap... either one provides results and each has its challenges.

[JHS2013]

Thank you so much.....I did not know that term so now I can research it. Thanks for taking the time to explain!

[chunkyfrog]

My aerophagia went away within a couple of weeks, thanks to a nice feature on my CPAP machine.
My machine has EPR, (expiratory pressure relief) where the pressure drops up to 3 cm while I exhale,
If an even lower exhale pressure is needed, then your doctor would need to prescribe a bilevel, or bipap machine.
Hang in there. Sometimes it goes away, but there are solutions. Good luck.

[hyperlexis]

Watch this re cpap bloating (aerophagia) -- it will help him.

https://www.youtube.com/watch?v=-65JWNBttnE

[ddk]

Side note: A sleep doctor or their staff who haven't heard of of aerophagia are to be viewed with caution, should the OPs report be correct.

Yeah, I'd definitely be switching doctors after that.

What worked for me was initially taping my mouth shut, then a year later I transitioned to a chinstrap... either one provides results and each has its challenges.

I found the opposite. Chinstrap or tape caused worse aerophagia.

[ReadyforRest]

Yes, good old aerophagia. Isn't it pleasant?

Another way to prevent it is to use this technique. Tell your husband to lock his tongue up against the roof of his mouth and keep it there all night. The tongue should be adhered against the upper palate, with the tip of the tongue near the upper teeth. This keeps the air pointed in the right direction, which is down the windpipe into the lungs and not into the stomach.

Also, in conjunction with this technique, get him to keep his mouth closed, so that no air can escape through it, and there is less chance of him swallowing it into his stomach. There are many ways to do it, tape the mouth closed, use a chin strap, use patches that adhere to the skin and push the mouth closed "pug" style.

And make sure that after he has his mask in place and the machine turned on, he doesn't talk or open his mouth. I find that opening my mouth while the air is blowing in will instantly cause the air to fill up my stomach ... immediate aerophagia. Some people are less sensitive and can talk, etc, without any problems, but others aren't so lucky. For the first few weeks of treatment, I had terrible gas, bloating, and burping. Once I got the mouth closed, the tongue locked against the upper palate, and the chin strap sorted, it went away and I haven't had it since. I hope you find what works for him.

[caffeinatedcfo]

In addition to the tongue/mouth closed technique above, you can also have him do the following in the morning ...

Before getting out of bed:

1. Lie flat on back and raise one knee toward chest and hold for 10 secs
2. Switch legs and repeat
3. Repeat 1 & 2 three times
4. Lastly, raise both knees to chest together & hold
5. With both knees raised to chest, gently roll from side to side (you do not need to go all the way to each side)
6. Do #5 for 20-30 secs

This gently pushes rogue air pockets through the intestines and may - no gaurantee - may provide some relief. It worked for me in the beginning.

[chunkyfrog]

--and now you know how to fuel a Dutch oven.

[caffeinatedcfo]

--and now you know how to fuel a Dutch oven.

+1

[SleepyCPAP]

Hi JHS2013,

I feel for your husband, and for you as you see it discourage him from his treatment.

The advice others have given is great, but I didn't see something which makes a difference for me: I have learned that certain body positions lead to air in the belly, and so I avoid those positions, or have used pillows to put myself in a comfortable posture.

I have also found that a very slight difference in pressure can make things better or worse. Even half a cm pressure reduction made a difference in relief for me, but didn't mess up my therapy. Perhaps he'd get permission to try that.

--SleepyCPAP

[kitfox]

I use a full face mask and have had this problem for a long time. I turned the pressure down on the machine and it went away, but I felt like I was suffocating.

The only advice I can give is to roll over onto your stomach...for me, this prevents buildup and expels and buildup of air.

Or, work to find what caused this so it can be cured.

[sawinglogz]

I share the concern about the sleep doctor whose nurse had never heard of this.

The most common term for it, as you've seen here, is "aerophagia". However, some people feel this is too narrow (and inaccurate) a term and can cause medical professionals to underestimate its significance; such people prefer the term "gastric insufflation". Gastric insufflation (caused by ventilators) is well understood to be potentially dangerous, whereas some cases of aerophagia are minor and aren't the result of a ventilator.

That said, here are three things to try:

1) Sleep on your left side. Someone here suggested that, and it did indeed seem to help. Conversely, I noticed it was worse when I slept on my right side. I don't sleep completely on my side, but rather slightly angled (pillow behind my back).

2) Tuck your chin, if comfortable and possible. My ENT suggested that. I haven't noticed a major difference one way or the other, but it apparently helps some people, so it might be worth a try.

3) Use a chin strap. I've found that if my jaw and tongue relax and drop while I sleep, I tend to swallow some air. As others have suggested, keeping your tongue up can help, and an easy way to start is to use a chin strap to keep your jaw up too.

What kind of mask does your husband use?

[SleepingUgly]

I never found a solution to aerophagia. I can tell you what makes it worse, though:

Higher pressures
Sleeping on my back
Arousals--when you wake up, you tend to swallow air, so relatedly:
Leaks