Cpap blows air into stomach

[Bigtonguehypopnea]

you mentioned taking time of of cpap to take care of something else. all to the well and good, but when you get back on it and try the changes mentioned here, could you report back here on this thread?

it'll make it easier for the people helping you to keep track of things.

good luck!

I'd be happy to!

[Bigtonguehypopnea]

As I'm compiling my CPAP health to-do list, I realize I have another question.

The CPAP makes my nose really dry. I use oil to lubricate it. My nurse practitioner told me emphatically not to use any food oils because the cpap can blow air and the oil up into places where bacteria have potential access to the brain. Any food substance gives bacteria food to eat. Sounds unlikely, but I did hear of a friend of a friend dying of an infection where something "got up into her brain".

Anybody know anything about this? What do you use in your nose? I've seen some products, but I hate petroleum based stuff. Petroleum based lip balm makes my lips peel and get dryer than before. Any thoughts?

[Pugsy]

Have you ever looked at Lansinoh lanolin ointment/cream? We often advise its use when people have issues with nasal pillows causing problems with the nostrils. It's not harmful to humans or the silicone and breast feeding mom's use it on their nipples so apparently safe enough for a baby.

I used to use it a lot until the nostrils got more used to the nasal pillows.
Not so much now. Mainly for the dryness I now I use a high humidity setting along with frequent use of Simply Saline nasal spray.

[Bigtonguehypopnea]

Have you ever looked at Lansinoh lanolin ointment/cream?

It looks perfect. Thank you so much!!!

[Bigtonguehypopnea]

Another thing you might try is probiotics.

Thanks again for your suggestions. I'm so much better today. I was really getting worried. My throat, chest AND stomach were burning like crazy, day and night, for 3 days. Not good. I went to the store and did some grocery shopping to get me moving around. I spent $120 on every type of digestive thing and took them all. Then I drank a whole bunch of unsweetened kefir, ate half a bunch of parsley, stayed up another few hours until I felt less full, slept mostly upright. Woke up feeling better. Phew! Probiotics and enzymes are expensive, but it's cheaper than hospital bills! Just wanted to let you know you made a HUGE difference.

[Bigtonguehypopnea]

you mentioned taking time of of cpap to take care of something else. all to the well and good, but when you get back on it and try the changes mentioned here, could you report back here on this thread?

it'll make it easier for the people helping you to keep track of things.

good luck!

Minimum of 5
EPR at 3 full time
Max of 12

UPDATE: I had a successful night back on the CPAP!

PROBLEM
Air in stomach / gas pains from CPAP. Rapid onset (60 minutes) of gas pain too intense to sleep through. Worse with existing reflux or gas, which are chronic even without the CPAP. I have a hiatal hernia. Have not used CPAP in 7 months for the above reasons.


CHANGES MADE
--EPR from 0 to 3, full time.
--Max from 20 to 12
--Traded cough drop for licorice bark for reflux reasons. That means I was still prone to swallowing all night because I had something in my mouth. But at least it was soothing instead of possibly aggravating my burning esophagus. The machine can tend to worsen the feeling of reflux burning if it's already bad, so I wanted to sooth it. I also think that sucking on something keeps my tongue reflexively suctioned to the roof of my mouth all night, keeping it out of my airway.
--Avoided wearing the mask when only half asleep. Didn't put it on until ready to go to sleep. Took it off as soon as I woke up, even though I stayed in bed and slept restlessly for another 2.5 hours. I wouldn't have taken it off except that I did feel some slight gas bubbles in my ribs already.
--Avoided swallowing with air blowing. As I was falling asleep, if I wanted to swallow, I'd move my mouth to break the mask seal so that I could (hopefully) swallow without swallowing so much air.
--Last meal over 3 hours before bed.
--Strict reflux diet.
--Improved timing of reflux meds.


RESULTS
--Machine didn't get up to a 12 anyway. Only went up to 9.52
--Felt slight pressure in stomach while falling asleep.
--Felt very mild gas bubbles in lower ribs and slight fullness upon awakening 7.25 hours later, unlike gas sensationsI get without cpap. But nothing I'd particularly notice if I weren't looking for it.
--Feel over-all more well rested than without the cpap. (At least speaking for the last two weeks, in which I have been struggling a lot with fatigue.)

Screen Shot 2018-07-16 at 10.12.40 AM.png (571.9 KiB) Viewed 23688 times

[zonker]

you mentioned taking time of of cpap to take care of something else. all to the well and good, but when you get back on it and try the changes mentioned here, could you report back here on this thread?

it'll make it easier for the people helping you to keep track of things.

good luck!

Minimum of 5
EPR at 3 full time
Max of 12

UPDATE: I had a successful night back on the CPAP!

PROBLEM
Air in stomach / gas pains from CPAP. Rapid onset (60 minutes) of gas pain too intense to sleep through. Worse with existing reflux or gas, which are chronic even without the CPAP. I have a hiatal hernia. Have not used CPAP in 7 months for the above reasons.


CHANGES MADE
--EPR from 0 to 3, full time.
--Max from 20 to 12
--Traded cough drop for licorice bark for reflux reasons. That means I was still prone to swallowing all night because I had something in my mouth. But at least it was soothing instead of possibly aggravating my burning esophagus. The machine can tend to worsen the feeling of reflux burning if it's already bad, so I wanted to sooth it. I also think that sucking on something keeps my tongue reflexively suctioned to the roof of my mouth all night, keeping it out of my airway.
--Avoided wearing the mask when only half asleep. Didn't put it on until ready to go to sleep. Took it off as soon as I woke up, even though I stayed in bed and slept restlessly for another 2.5 hours. I wouldn't have taken it off except that I did feel some slight gas bubbles in my ribs already.
--Avoided swallowing with air blowing. As I was falling asleep, if I wanted to swallow, I'd move my mouth to break the mask seal so that I could (hopefully) swallow without swallowing so much air.
--Last meal over 3 hours before bed.
--Strict reflux diet.
--Improved timing of reflux meds.


RESULTS
--Machine didn't get up to a 12 anyway. Only went up to 9.52
--Felt slight pressure in stomach while falling asleep.
--Felt very mild gas bubbles in lower ribs and slight fullness upon awakening 7.25 hours later, unlike gas sensationsI get without cpap. But nothing I'd particularly notice if I weren't looking for it.
--Feel over-all more well rested than without the cpap. (At least speaking for the last two weeks, in which I have been struggling a lot with fatigue.)

Screen Shot 2018-07-16 at 10.12.40 AM.png

hokie smokes! good job, BTH!! yeah and don't even worry about it only making it to 9.52 max. i'd say leave as is and get some sleep. as pugsy has said before, we don't sleep the same way every night and who knows, you may need that higher top end pressure some night.

good luck!

[Cpapian]

The first step is always the hardest to make. Congratulations.

[Bigtonguehypopnea]

UPDATE: 2nd night, only used CPAP for 30 minutes. Laid awake, didn't swallow, and felt air and painful gas bubbles fill up my stomach, to the point where it would interfere with my sleep.

Doctor ordered an endoscopy to look at my hiatal hernia and sphincter and do a test where they leave a thing in the esophagus that measures acid levels over time. He thinks my persistent esophageal reflux pain could be a symptom of Gastroparisis, a relaxing of the sphincter into the stomach, or a tightening of the sphincter from the stomach into the intestine. I think the CPAP seeming to blow air directly into my stomach (rather than me just swallowing air) may be an indication of a weak or open sphincter into the stomach, so I'm glad I'm getting this test. The doctor is also testing for an ulcer, or irritable bowel syndrome.

I am going to keep trying CPAP every night and making notes on my experience. I will post another update here in a few weeks, after my GI and Sleep Specialist appointments and tests.

Pugsy, THANK YOU SO MUCH for all your help! It's a whole new world for me now that I know about the software, and that I can change my own cpap settings. I really appreciate your time and thoughtful consideration.

[Pugsy]

Glad to help in any small way that I can. Sometimes just having control and some options available helps the mind which in turn helps the body. Gives us hope that there is some light at the end of the tunnel.
Good luck on the endoscopy....I had one and that's how I found out I had a hiatal hernia and probably explains my persistent GERD issues (that and the fact that I don't always stay on the "prevent GERD" diet " I am not a good patient in that regard.
I wouldn't be surprised if you found out that the LES is a bit damaged and thus might be a sometimes factor in allowing the air to get into the stomach. Maybe sometimes it's just more inflamed than other times for whatever reason.

[Bigtonguehypopnea]

After studying my sleep studies more closely, I talked to Doc about getting off PAP, and even calling my OSA diagnosis "resolved" in my medical record. Interesting conversation.

BACKGROUND

2008 Sleep Study: AHI 3.5 RDI 19.3 Prescribed PAP for the RDI and my excessive daytime fatigue. I was happy that the doctor didn't go by the book (AHI must = 5) but made a good argument for me to have PAP. IT WAS LIFE CHANGING!

2013 Sleep Study: AHI 4.9 RDI 4.9 Notice that the problem for which I was prescribed PAP has now been resolved. However, they rounded 4.9 up to 5 and diagnosed me with OSA. Because OSA is so mild, doctor recommended a dental device and positioning before CPAP. But I was already on CPAP, so just continued. I was happy that doctor didn't go by the book, but rounded up to 5. I was afraid they'd take my beloved PAP away!

2017 PAP started causing me major problems with gas too painful to sleep through, so I quit using it. Haven't noticed any difference in daytime fatigue. (My husband didn't notice me getting more fatigued either. In the past, the no-cpap difference was huge.)

2018 Started it up again for 5 days. Didn't notice a difference in daytime fatigue. Still had some problem with gas, but I'm sure I could work with it. I'm also concerned about PAP irritating my already acid-drenched esophagus, so I'm reluctant to use it until I get some reflux issues managed. AEROPHAGIA UPDATE: Took off the APAP 1 out of 5 nights due to moderate gas building up. I think lowering the EPR was successful. I also think something else has changed, because in the past, the pressure was going way up, but now it only went up to 9.5, so of course I'm not getting as bad a problem with air in stomach. Unfortunately, I did something wrong and didn't capture data from the other 4 nights of my 5 night experiment. (I probably had the SD card write protected by accident.)

2018 Lost 45lbs since last study. My AHI is probably even better than 4.9 now.

INTERESTING CONVERSATION WITH DOCTOR

Doc says PAP would still benefit me if I can tolerate it. But if I can't tolerate it, given my numbers, I can safely quit PAP if I want to. He's so sure of that, he doesn't need me to get another sleep study. But...

If I'm not going to be on PAP, then I want my diagnosis of OSA marked as "resolved" on my medical records. I don't want to be "non-compliant" if my situation is reviewed by the DMV, or insurance, or Social Security Disability. (This is perhaps one of those things that I worry about more than necessary. But I like to dot all my i's and cross all my t's.)

The doctor didn't say it in so many words, but the message I got was that once you get an OSA diagnosis, it's hard to remove it because even though the official cut-off for a qualifying AHI is 5, an AHI of, say, 4 isn't that statistically different. Therefore, a PAP machine is still beneficial to someone with an AHI of 4. If a PAP is still theoretically beneficial, then the standard of practice is to keep the prescription (and therefore the diagnosis) active. I can see how marking an OSA patient as no longer having OSA might be a bit of a liability for them. But in the end, he consulted with his superior and said that if I got another study, and the AHI is below 5 (that probably means below 4.5, if they round up), then they could mark the diagnosis as resolved. So we scheduled another sleep study.

NON-SPECIFIC MICRO-AROUSALS
I'm happy about getting a new sleep study in part because I'm still concerned about my very high "non-specific arousals". (34 per hour) My doctors don't know what to do about them, so they say not to focus on them. They say it was probably the strange environment that made me sleep a little lighter, and that some micro-arousals are natural between sleep cycles. But, if I'm on disability for how fatigued I am (currently officially attributed to depression), then why wouldn't I be concerned about 34 unexplained micro-arousals per hour? More importantly, if arousals are the main reason that having OSA makes you tired during the day,(aren't they?) and they prescribe me a PAP because of 4.9 arousals per hour, and they give me medication to resolve 8.9 limb movement arousals per hour, why wouldn't they be concerned about 34 unexplained arousals per hour? I mean, I get it. They don't know what to do. But I'm going to keep searching for answers. So, it will be good to get an updated sleep study to see where I'm at with that.

[Bigtonguehypopnea]

UPDATE:

New sleep study results (I did anchor my tongue with a piece of natural licorice bark, and I am 40lbs lighter than last study.)

AHI: 2 (Down from 4.9)
Non-specific arousals: 23 (Down from 218)

My RDI during REM sleep (of 40 minutes) is 12. That would be concerning, except that I happened to get unusually congested that night.

QUESTION:

Do you think I should be concerned about an RDI of 12 for 40 minutes of REM?
(The RDI is comprised of an REM-AHI of 6 and a REM-RERAI of 6)