Trouble with air in stomach/gas

Caffy · Post by **Caffy** » Tue Apr 03, 2007 2:16 pm

Well... I called a resp. therapist which was no help
at all. Didn't know a lot about the C-flex. She said
I may have to go through another sleep study to see
if I need one of those other types of machines. I
am suppose to contact my doctor. My doctor is on a
2 month leave of absence. *sigh*

I really appreciate all those who responded - Thank You!

Linda3032 · Post by **Linda3032** » Tue Apr 03, 2007 2:23 pm

Since you doctor is unavailable for 2 months, then all the more reason to take matters into your own hands.

1. Do you know how to change the cflex settings? I still think you need to try different settings because some people have written that they get more aerophagia with cflex. I'm just saying to try it with cflex lower or off for a day or so.

2. Also, you can lower your pressure. Lower pressure might not stop all the apneas, but it should relieve the aerophagia. It's better to use a lower pressure than to be miserable and not use cpap at all.

If you need any help with either of the two suggestions above, just ask.

BTW -- are you renting your machine or have you bought it already?

Caffy · Post by **Caffy** » Tue Apr 03, 2007 2:29 pm

I will check out my directions and change the C-flex. What will
going without it do/change? I don't completely understand the C-Flex yet.

I don't think I can lower the pressure but I will check and see.

I have bought the machine. I actually bought it two years ago.
I tried using it a didn't succeed. (in the closet it went - shame on
me!) Finally took my stubborn backside in to be re-taught 2 weeks
ago so I could start using it.

Linda3032 · Post by **Linda3032** » Tue Apr 03, 2007 2:36 pm

You can change the pressure on your machine -- you don't need the doctors approval. It's your therapy.

Here's some info on c-flex:

How C-Flex Works
C-Flex tracks your breathing to lower the amount of pressure delivered at exhalation. With three C-Flex settings you have the ability to select the level of pressure relief that's right for you.

The amount of pressure relief delivered by the REMstar Auto with C-Flex is based on the patient's expiatory flow and the C-Flex setting. As you move through the settings, the amount of variable relief increases. This allows you to choose what you feel is the right level of pressure relief at exhalation -- which makes therapy more comfortable. And that makes long-term compliance easier to come by.

But some people don't use c-flex because it throws their natural exhale out of sync -- it's a personal preferance sorta thing.

Caffy · Post by **Caffy** » Tue Apr 03, 2007 2:45 pm

Thanks! You'll have to excuse my stupidness (is that a word? )
but will turning it off make it easier to exhale?

CollegeGirl · Post by **CollegeGirl** » Tue Apr 03, 2007 2:56 pm

Hi Cathy,

What Cflex does is sense how strongly you are breathing out, and lower the pressure for you to compensate for that. A setting of one lowers the pressure a little, two lowers it a little more, and three lowers your pressure the most. So turning Cflex UP (not off, as you just asked) makes it easier to exhale. Keep in mind, this is only on exhale. A higher Cflex setting can often help aerophagia. There are some people for whom the "timing" of Cflex feels unnatural, so you don't HAVE to use it if it makes you feel like you can't breathe properly. But most people like it quite a lot.

Your doctor is incorrect in saying you would need another sleep study to get an auto machine. An auto is still a CPAP machine, it's just an automatically-adjusting one. If you were considering a BiPap, that would be different, as some doctors do require seperate titration studies for BiPaps as they work differently than CPAP machines.

You CAN lower the pressure on your own machine (though doctors & DMEs often don't like this). If the aerophagia is only a little uncomfortable, I would just put up with it temporarily rather than lowering the pressure, because you would be trading a little discomfort for more apneas that are actually damaging your body. But if the aerophagia is so painful you can't use CPAP, then yes, I would consider lowering the pressure. Some treatment is still better than none.

Aerophagia is often actually caused by a damaged sphincter between the stomach and esophagus. When that sphincter is intact, it keeps air from getting into the stomach. When it is damaged, it allows air through. The damage to it is most often caused by GERD (reflux disease). Often, the damage can be repaired (and aerophagia eventually eliminated) by taking prescription drugs such as Nexium or Prilosec to help reverse the damage. Even if you think you don't have GERD, it can be "silent" - meaning you can be mostly asymptomatic and still have it. If I were you, here are the steps I would take, in order:

1) Try raising Cflex to 3 tonight. Use it on this setting for several days to see if it makes a difference. Cflex is only a comfort setting - using it will not negatively impact your treatment.

2) Talk to your doctor about being evaluated for GERD. If you already know you have it but are not taking medication for it, start the medication. It can take time for the damage to be repaired.

3) If neither of the above work, talk to your doctor about getting an auto. The doc will need to write a prescription specifically for "auto CPAP." For reasons you can give your doc to write the script (aerophagia is a good one), check out cpaptalk-articles/reasons-APAP.html . My personal favorite machine is the Respironics REMStar Auto. I like the "classic" model, but the Respironics REMStar M Series Auto is a good machine, too. The reason an auto helps with aerophagia for most people is that it allows you to stay at a lower pressure for most of the night. The lower the pressure, the less air gets into your stomach.

4) While you're waiting on the auto, if you absolutely can't stand to use CPAP because of the aerophagia, you can choose to lower your pressure temporarily. You do this by unplugging your machine, and then plugging it back in. While you're plugging it back in, hold the two gray arrow buttons down until the machine beeps. You'll be in the setup menu. You can raise your pressure from there. If you need more help in doing that, just post.

Good luck.

Linda3032 · Post by **Linda3032** » Tue Apr 03, 2007 3:07 pm

Caffy wrote:Thanks! You'll have to excuse my stupidness (is that a word? )
but will turning it off make it easier to exhale?

I think stupidness is a word - and if it's not it should be. I've been there many times.

The greatest exhale relief is a setting of 3. But as I said earlier, sometimes cflex messes up our natural exhale/inhale rhythm, which can cause aerophagia. That's why you need to test various settings for your own comfort zone.

Lowering your pressure isn't as desireable, but definitely better than pain or non-compliance.

Caffy · Post by **Caffy** » Tue Apr 03, 2007 3:09 pm

Collegegirl

Thank You so much... Great explanation. I will try this. I really think
the pressure is ok so will just try thr C-flex adjustment.

I do have GERDs and esophagus problems. This may be another
reason for my troubles. I take Aciphex for it.

Appreciate your time and suggestions.

Caffy · Post by **Caffy** » Tue Apr 03, 2007 3:11 pm

Thank You so much Linda. I think I'll leave the
pressure alone for now. It's set at 4/9

brackstone · Post by **brackstone** » Tue Apr 03, 2007 8:17 pm

Good Luck Caffy.

Just so you know I didn't need another sleep study done, I just told my doctor what I wanted and they hooked me up to an auto bi-pap and let me breath with it while I was awake and I felt the difference right there! He then wrote me the script for it and within a month I had my new machine.

track · Post by **track** » Wed Apr 04, 2007 10:18 am

have trouble with this from time to time as well, and find that it is (for me) almost entirely dependent on my sleep position. For instance, I have little trouble on my back, somewhat more when sleeping on my right side, and ALWAYS have trouble with this when sleeping on my left side.

That's been my experience exactly

Caffy · Post by **Caffy** » Thu Apr 05, 2007 2:43 pm

This is so frustrating. I think the C-Flex set on
3 helped a little but not enough. I can't even
get to sleep because the aerophagia starts within
5-10 minutes. I also have problems with my ears
plugging-up... and my mouth fills up with air at times,
I feel like a chipmunk.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, aerophagia

Sleepy-eyes · Post by **Sleepy-eyes** » Thu Apr 05, 2007 2:52 pm

Cathy,

I've been following your problem and have only commented once. But I've a question. I don't understand what you mean by your pressure is 4/9. You are on a CPAP machine and not an auto or APAP. How can you have a pressure of 4/9?

Caffy · Post by **Caffy** » Thu Apr 05, 2007 3:00 pm

I'm sorry, the pressure is set on 9 and the ramp on 4.

Linda3032 · Post by **Linda3032** » Thu Apr 05, 2007 3:12 pm

Cathy, I haven't re-read the thread, but obviously you have a problem which might only be solved with a Bi-Pap. Hopefully, you have made a doctors appointment for ASAP.

In the meantime, I think you should lower your 9 pressure. Go as low as you need to go to reduce the aerophagia. Anything (even 4 or 5) is better than being miserable or not using the machine at all.

Did you try turning the cflex off altogether? As weird as that sounds, some people say that helps.

Mask

Additional Comments: Strictly a side sleeper