Aerophagia Questions

NightHawkeye · Post by **NightHawkeye** » Thu Feb 16, 2006 12:06 pm

OK, now that I'm sleeping with pressures that the APAP is keeping mostly above 7 cm, I'm dealing with aerophagia again.

I've read postings that it gets better, but I'm not sure what that means. Does it get better in the sense that the aerophagia quits happening, or in the sense that you just kinda get used to it?

Regards,
Bill

yardbird · Post by **yardbird** » Thu Feb 16, 2006 1:08 pm

What's your c-flex setting set at? I had 2 nights of aerophagia. One was not so bad. The other was nasty. I dropped my c-flex by one and the aerophagia stopped completely. Hasn't happened since.

NightHawkeye · Post by **NightHawkeye** » Thu Feb 16, 2006 1:14 pm

I'm Flex free. . Aerophagia is not the reason I turned the Flex OFF, but it is OFF.

Regards,
Bill

yardbird · Post by **yardbird** » Thu Feb 16, 2006 1:30 pm

y'know how you start to wake up and you're nowhere near awake but you're not quite asleep either? I was able to hold that condition for a few minutes. And when I did I realized that I was getting a little gulp of air at the tail end of exhalation. Like in between breathing out and starting to breathe back IN again... there was this little slurp of air. The REMstar auto apparently was increasing pressure as I finished exhaling. I had c-flex on 3. I dropped it to 2 and that solved it. I can only surmise it had something to do with the pressure difference and timing.

Now... if you're NOT using c-flex, you're breathing against the flow full force each time. Granted a pressure of 7 isn't all that high relative to what some others are using, but mine is only 8 so... we're not all THAT much different in pressure. If you have that brief timing thing when switching exhale to inhale (or the other way around) you may be getting that same kind of phenomena (did I spell that right?).

You might want to try experimenting with the c-flex. One notch at a time. Just a thought.

NightHawkeye · Post by **NightHawkeye** » Thu Feb 16, 2006 1:47 pm

I know what you're referring to, Yardbird. I did experiment with C-flex, went through the entire range and decided to just turn it OFF. For me, that was the right decision.

While I was playing with C-flex though, I was aware of the effect you're referring to, as I could kinda tell when air was being pumped into my stomach.

I'm not really surprised to be experiencing aerophagia. I've had some amount of reflux for years (although mostly under control via diet), and my father had to have hiatal hernia surgery years ago, so I'd guess that my LES (lower esophageal sphincter) is not sealing real well. (Kinda like some of the CPAP masks. )

Regards,
Bill

yardbird · Post by **yardbird** » Thu Feb 16, 2006 1:50 pm

wanna learn to play didgeridoo?

I hear it helps. hehehe.

pokey · Post by **pokey** » Thu Feb 16, 2006 2:26 pm

Night...had the same problems w/ reflux and air. Bought a bed wedge (4 inch high, not 7") for about $27. Reflux is 100% gone.......air problem 50-75% improved. Its all about the angles. You can test if it will work for you in the following way. At bedtime, use one pillow under your shoulder and 2 under your head. That will give you the sloping angle you need. Picture your stomach as a bottle with the cap off. When you lay it on it side with the cap off the liquid comes out (reflux). Tilt it up just a bit and and the liquid stays in the bottle. Give it a try.....good luck

NightHawkeye · Post by **NightHawkeye** » Thu Feb 16, 2006 2:37 pm

Thanks Pokey,

I've been sleeping with three pillows under my head, but hadn't thought about wedging the shoulder up. I'll give that a try.

Regards,
Bill

Linda3032 · Post by **Linda3032** » Thu Feb 16, 2006 2:43 pm

So have to tried using the acid reflux medicine?. Some work better than others, you can try the over-the-counter, or prescription. I use Nexium and have no problems.

NightHawkeye · Post by **NightHawkeye** » Thu Feb 16, 2006 2:56 pm

Yes, Linda. The sleep doc prescribed Protonix for me. I didn't really expect much from it, because I had no success with Prilosec and some of the others in the past. Fortunately, I had the reflux under control most of the time in the past via diet.

To my surprise, Protonix has actually been working for me. I like it better than the very strict diet approach. To my disappointment, taking Protonix didn't affect AHI at all. Don't have any great expectation that it'll help with the aerophagia either, but at this point I can afford to give it time.

Regards,
Bill

pokey · Post by **pokey** » Thu Feb 16, 2006 3:05 pm

Night......re the pillows.......the ones under you head just bend your neck, you can use 10 and it wont help. Just take one of those and put it flat under your shoulders (same direction as your other pillows) and leave the 2 under your head and your good to go.

DSM-guest · Post by **DSM-guest** » Thu Feb 16, 2006 3:27 pm

To add my 0.2c - self has classic set of symptoms - reflux and OSA.

Prior to starting xPAP doc prescribed 1 daily tablet of 'Pariet'. That has been my daily dose for almost a year now & reflux is abated while I take them. No side effects that I am aware of. Leave off for 2 days & I can feel the symptoms returning.

Having tamed the reflux - began xPAP. At first I didn't seem to be afflicted with serious aerophagia. The initial problem was trying to use an Activa mask & keep my mouth under control. I have always had & can't do without, my Respironics Premier chinstrap. Symptoms were 'mouth pops' & mouth leaks. Tried tape for a while. Gave that up after damaging lips & after trials of so many types of tape. So switched to Ultra Mirage f/f. Mask & learned to live with it. But at 15 & above cms I was always battling leaks & squeaks.

Also, upon switching to f/f mask the incidence of aerophagia rose markedly. It was also impacted by the level of Cflex setting. I was becoming quite despondent with the aerophagia. Not nice.

Anyway, trying to deal with a separate issue - early & late sleep cycle centrals I switched to a BiLevel with Timed control. That has quite clearly resolved the particular centrals that were occurring *and* for me on my settings of 15/8 the aerophagia all but vanished. A big bonus.

In the past week I have done one other big change - switched to nasal pillows full time & dropped the f/f mask - no mouth pops - & just the rare minor mouth leak (caused me to do the chinstrap up a fraction tighter).

Also - I switched to another BiLevel just to try it out (no timed control on this one) & after a few nights on this machine wife says - "you are stopping breathing again just as you are starting to sleep" - that confirms yet again the early late cycle centrals problem. I again asked her was she aware of this when I was using the PB330 BiLevel with timed control - she said "no, as when you do stop the machines seems to very quickly get you breathing again".

But I will persist with the current machine for a few more nights as it it interesting the way this machines seems so much smoother at transitioning from Epap to Ipap when I use the nasal pillows mask. It is a bit noisy (Tranquility BiLevel 1700). Inside it has a biggish aluminium fan housing and a biggish motor. That seems to make it a bit heavy but the electronics are very complete even if not the latest state-of-the art chips as in the RemStar AUTO. It has a pressure sensor at the exit and the two air tube 'flow sensor' config now common in all the better xPAP machines.

One additional xPAP observation is that I have dropped cms to 13/8 as with nasal pillows I don't seem to need as much pressure (my subjective opinion).

So in summary

Aerophagia - for me it went when I went BiLevel.

Cheers

DSM

Linda3032 · Post by **Linda3032** » Thu Feb 16, 2006 3:34 pm

So have to tried using the acid reflux medicine?. Some work better than others, you can try the over-the-counter, or prescription. I use Nexium and have no problems.

NightHawkeye · Post by **NightHawkeye** » Fri Feb 17, 2006 5:39 pm

pokey wrote:At bedtime, use one pillow under your shoulder and 2 under your head. That will give you the sloping angle you need.

Well, Pokey, I'm not sure I did quite what you suggested, since I slept on my side, but I did put a pillow under my shoulder and aerophagia wasn't too much of a problem last night. Your comment about angles really got me thinking about sleep position and I tried to stay stretched out all night too. Must have helped.

Regards,
Bill

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