Is Cpap causing my Stomach Distension??

[lauerj]

I`ve been using my cpap for over a year. I have grown to like the therapy. Over time, I have made minor air flow tweaks to optimize comfort. Over the past 6 mo or so, I have been experiencing severe bloating of the abdomen area. I have seen gastroenterologist and have had work ups such as colonoscopy & upper GI, ultrasound and blood work. Everything checked out ok. I`ve been put into the category of IBS.

My stomach discomfort has really started to effect my quality of life. The stomach distension in particular. My wife asked a simple question last night that I never really considered: Can my cpap be causing my stomach distension? Wow! I have been doing all these gastro tests and hit a brick wall. Now I have a new path to consider. I read a lot of google blogs from other cpap users that have the same symptoms as me. How can I find out for sure? Any advise would be greatly appreciated. I`m getting pretty desperate here!

[Pugsy]

What machine (model number off the bottom of the blower) are you using and at what pressure(s) and are you using the exhale relief feature?

Yes...the cpap could be the cause. It's fairly common.
See this
wiki/index.php/Aerophagia

Depending on your settings now...you may be able to get some relief with a little tweaking of the pressures.

[Wulfman...]

I`ve been using my cpap for over a year. I have grown to like the therapy. Over time, I have made minor air flow tweaks to optimize comfort. Over the past 6 mo or so, I have been experiencing severe bloating of the abdomen area. I have seen gastroenterologist and have had work ups such as colonoscopy & upper GI, ultrasound and blood work. Everything checked out ok. I`ve been put into the category of IBS.

My stomach discomfort has really started to effect my quality of life. The stomach distension in particular. My wife asked a simple question last night that I never really considered: Can my cpap be causing my stomach distension? Wow! I have been doing all these gastro tests and hit a brick wall. Now I have a new path to consider. I read a lot of google blogs from other cpap users that have the same symptoms as me. How can I find out for sure? Any advise would be greatly appreciated. I`m getting pretty desperate here!

Ingesting (swallowing) air during CPAP therapy is called "aerophagia" and is pretty common. Go up to the Search line and put that word in and you'll get lots to read. Many things can cause it or help it go away. Pressure settings (ranges or straight pressure), exhale relief and sleep position to name a few.

It MAY be linked to GERD in some cases or a weak LES.


Den

.

[lauerj]

Remstar Auto 560P. I`m currently using A Flex with 5 min ramp @ 7.5/then 8.0 minimum-10.0 max. I don`t see an exhale adjustment. Only A-Flex or C-Flex adjustment 1-3. Is that what controls the exhale? That is currently set @ 1. Should I crank that up to 3? I have a sleep number bed and have tried inclining my head position but that doesn`t seem to give me any relief. Thanks so much for your help!

[Pugsy]

Only A-Flex or C-Flex adjustment 1-3. Is that what controls the exhale?

CFlex and AFlex are Respironics terms for exhale relief. The most it can go to is 2 cm and that's with a setting of 3. Actually the amount of reduction is flow based meaning how forcefully you breathe. If you aren't a particularly forceful breather you may not even get that 2 cm relief that the setting of 3 offers.

AFlex is usually for when using auto mode. CFlex usually for when using fixed cpap mode.

I don't know if changing the setting to 3 will be enough to help with your symptoms but it is worth a try.

Your pressure settings aren't all that high (your small range with max of 10) so I don't know if there is much room for compromise with the pressures themselves. I depends on what the pressures are doing and what is needed to keep the airway open. I don't know if there is any wiggle room there.
Also, I don't know for sure that even reducing the pressures dramatically would even help all that much.

I do know that sometimes there is a very fine line where above so and so pressure the aerophagia is pretty bad and below that pressure it isn't bad at all.

Since you are having considerable discomfort I do think it is worth investigating to see if you could maybe find that fine line for you.

Final option is a bilevel pressure machine because the difference between inhale and exhale can be set higher than what you can get with regular cpap/apap.....but that's another machine and all that.

[Pugsy]

Question....do you have to use a full face mask because your nose simply won't let you be comfortable with nose only breathing?

[lauerj]

Thanks for the advise. I`m following through with my scheduled CT scan this afternoon so I know I covered all my bases. Would my upper GI have revealed an issue with the LES or not? I went ahead with the A-Flex adjustment tweak. If I do come to realize cpap is the culprit here, I don`t know what to do next? My immediate concern is how to get my stomach to deflate so I can feel normal again?

[Pugsy]

I don't know just how much an x-ray of the upper gi would show in terms of LES patency. If there was some gross elasticity issues it would show up but I don't know how bad is bad enough to show up. So in other words it might show something but the fact that it might not show much doesn't really mean a whole lot.
Something to discuss with your doctor.

If it is cpap that is the culprit there are still some things to try to help reduce the symptoms.
From maybe a slight reduction in pressure to a different machine to a combination of various tricks.

Do you use the software available to see exactly what your pressure does or doesn't do during the night?

[lauerj]

I have the sleep software loaded on my laptop, where it reads my memory card. Probably not the smartest thing to do.. but I have not used the cpap for the past 48 hours to see how my stomach feels? My stomach does feel a bit flatter but I woke up with kind of a sore throat (prob from snoring). I am going to use cpap tonight with the A-Flex adjust to 3, as you suggested. I did test it for a few minutes after making the tweak a few days ago and I could tell there was an increased exhaust plume, when I inhaled. Maybe that will help me? Are you a doctor or something? You`re pretty knowledgeable about this stuff! I appreciate your help. Keep the ideas coming!