Acid Reflux and cpap pressure

[Axxel]

Has anyone had acid reflux affect how much pressure they need?

In 08 when I was diagnosed with osa, my pressure was 9. In 2009, after years of acid reflux and GERD, I began prevacid. No more acid reflux. Scarring and inflammation in throat from years of acid damage begins to heal. Then, cpap pressure does not feel strong enough to open airways.

Did my soft tissues in airways harden or stiffen up once I started prevacid and now I need more cpap pressure?

I cannot afford any sleep studies at the moment. I am going to try increasing the pressure and see if I can sleep better.

I am going to set it at 10. How many nights would it take to determine if thats what I need? At what point would I try it at 11?

Also, last time I did sleep study in 2010, I tested as mild and they didnt even use cpap on me. However, I think I need it. I just cannot sleep still. Being that my last test did not require cpap, will my insurance still supply me with cpap supplies? I also have a new insurance provider as of 2011. I want a new cpap. Mine is 3 years old and I want one that displays data such as leaks and AHI. I wonder if my Dr writes a prescription for a unit, if my new insurance will cover it.

[Mary Z]

Axxel, I don't know the answer to your question, but it seems since acid reflux affects the esophagus and not the airway that your pressure needs would not increase with healing. However, since you have not had a sleep test for a while your pressure needs may have increased. You could certainly try increasing the pressure a bit and see if that helps. Personally, I would give each increase a week to determine if it's helpful. Do you feel worse than before? Maybe the pressure feels less strong because f the healing and does not need adjustment.
Do you have a machine that tells you leak, AHI, and AI? These numbers would be valuable in determining the effectiveness of your therapy. Please take a moment and fill out your equipment details (text, please) and we will be better able to help you.
Keep us posted.

[Axxel]

Axxel, I don't know the answer to your question, but it seems since acid reflux affects the esophagus and not the airway that your pressure needs would not increase with healing. However, since you have not had a sleep test for a while your pressure needs may have increased. You could certainly try increasing the pressure a bit and see if that helps. Personally, I would give each increase a week to determine if it's helpful. Do you feel worse than before? Maybe the pressure feels less strong because f the healing and does not need adjustment.
Do you have a machine that tells you leak, AHI, and AI? These numbers would be valuable in determining the effectiveness of your therapy. Please take a moment and fill out your equipment details (text, please) and we will be better able to help you.
Keep us posted.

Actually had a sleep study in dec 2010. Because of weight loss, osa tested as mild during that study and they did not use cpap. However, I wake up every 2 hours on the dot. Strange thing is, this 2 hr wake up time didnt begin until the weight loss. When osa was severe, I was still able to sleep 4 or 5 hours straight.

Fact is, I never became cpap compliant. I now want to try again though and like I said, the pressure doesnt feel as strong as before and also, even when I do use cpap, I still wake up in 2 hours on the dot. Frustrated. Thus, I think I need to try and increase the pressure.

My machine is Respironics M series model 1051085. Like I said, I never became compliant and used cpap much. When I have, I like the phillips easylife nasal mask. Very comfortable.

Thanks!

[Mary Z]

Axxel, insomnia and OSA may have a connection, but I doubt that has an influence on your 2 hour wake up pattern. SInce your last sleep study showed you didn't need CPAP why are you trying it again now? To increase your sleep time? Until you're totally compliant with CPAP it will be impossible to gauge the results. You need to use the machine all night, every night and naps. Then start asking these other questions. 100% compliance is one of the biggest keys to success with therapy. I certainly would not recommend any pressure changes until you do your part and use the machine.
The machine info you gave us does not help, we need the full name of the machine, not a model number. On the control panel you will find instructions about entering your machine information. Please do this in text. Going to the trouble to input this information is one way we can determine how serious you are about getting help. The information you gave does not tell us if the machine is data capable. Does it give AHI? LeaK?
I cannot state strongly enough that success with therapy depends on you using the machine all night every night. If you have problems doing that, please ask for help on the forum.
Good luck, Axxel

[LSAT]

Unless you can monitor your nightly AHI, you are shooting in the dark. You said your 2010 sleep study did not recommend a CPAP because your OSA was mild, but you refer to a period when your OSA was severe???

[Axxel]

Axxel, insomnia and OSA may have a connection, but I doubt that has an influence on your 2 hour wake up pattern. SInce your last sleep study showed you didn't need CPAP why are you trying it again now? To increase your sleep time? Until you're totally compliant with CPAP it will be impossible to gauge the results. You need to use the machine all night, every night and naps. Then start asking these other questions. 100% compliance is one of the biggest keys to success with therapy. I certainly would not recommend any pressure changes until you do your part and use the machine.
The machine info you gave us does not help, we need the full name of the machine, not a model number. On the control panel you will find instructions about entering your machine information. Please do this in text. Going to the trouble to input this information is one way we can determine how serious you are about getting help. The information you gave does not tell us if the machine is data capable. Does it give AHI? LeaK?
I cannot state strongly enough that success with therapy depends on you using the machine all night every night. If you have problems doing that, please ask for help on the forum.
Good luck, Axxel

I want to try again because when I wear my pulse oximeter, it shows desats and events. Basal of 95 and desats to 89. Thus, I believe I need cpap and is probably why I wake up every 2 hours. But, like I said, even when I use it, I still wake up. So I would like to try raising the pressure.

Sorry, the only info I know about the cpap machine is what it says on my unit. It says respironics remstar m series and the model number I gave you. I would enter into text, but, thats all I know about it.

[Axxel]

Unless you can monitor your nightly AHI, you are shooting in the dark. You said your 2010 sleep study did not recommend a CPAP because your OSA was mild, but you refer to a period when your OSA was severe???

My first sleep study in 08 was severe. I lost weight. Retested in Dec 2010 and was then mild. However, I still wake up every 2 hours. I have desats and events according to pulse ox. Basal of 95 and desat to 89. I believe I still need cpap

[Axxel]

Axxel, I don't know the answer to your question, but it seems since acid reflux affects the esophagus and not the airway that your pressure needs would not increase with healing. However, since you have not had a sleep test for a while your pressure needs may have increased. You could certainly try increasing the pressure a bit and see if that helps. Personally, I would give each increase a week to determine if it's helpful. Do you feel worse than before? Maybe the pressure feels less strong because f the healing and does not need adjustment.
Do you have a machine that tells you leak, AHI, and AI? These numbers would be valuable in determining the effectiveness of your therapy. Please take a moment and fill out your equipment details (text, please) and we will be better able to help you.
Keep us posted.

I filled out the equipment details to the closest match to my machine on the list. The m series ds100 might be mine. My machine only says respironics remstar m series cpap. It only has 2 of the blue led lit buttons on the front rather than 3 buttons on other units. I believe I have the most basic cpap there is. Are you aware of this cpap as able to show ahi and leaks?
Thanks so much

[Janknitz]

Doesn't look to me that the machine Axxel has is data capable. So, it's not going to be easy with that machine.

Axxel, if you want your new insurance to pay for a new machine and supplies, it MAY require a new sleep test and you'll have to meet their requirements for coverage. BUT, the only way to find out is to CALL the insurance company and ask--nobody here knows your insurance and what they will or will not pay for. So, if you don't want to work with your current machine, that's got to be your first step. ASK your insurance company.

Be sure to find out what your deductibles and co-pays are for a sleep study and CPAP equipment and supplies if you qualify. As the year winds down you may want to time everything to minimize your co-payments, even if it means waiting until the next calendar or fiscal year so you don't pay two deductibles.

If you want to continue working with the machine you have meanwhile, you should understand that without data all is guesswork. Your oximeter can certainly help, though. First, are your desats occurring at 2 hour intervals with your wakeups? If so, that's a good indicator that apneas may be causing the wakeups. If you are not desaturating when those wakeups occur, it may or may not be related to apneas--difficult to say. Second, as you change pressures, your oximeter can help you see if you're on the right track or you're causing more problems with the change. If you increase pressure and see MORE desats or worse desats, then obviously, the change was not for the better.

IF you decide to make changes to your therapy, make only one change at a time and leave it for a few days, so you can see what effect the change really has. Make sure you have a well-fitting, clean mask--if it's old it may be time for a new one. Once you've called your insurance company you will know if they are going to cover a new mask or not.

[Axxel]

Doesn't look to me that the machine Axxel has is data capable. So, it's not going to be easy with that machine.

Axxel, if you want your new insurance to pay for a new machine and supplies, it MAY require a new sleep test and you'll have to meet their requirements for coverage. BUT, the only way to find out is to CALL the insurance company and ask--nobody here knows your insurance and what they will or will not pay for. So, if you don't want to work with your current machine, that's got to be your first step. ASK your insurance company.

Be sure to find out what your deductibles and co-pays are for a sleep study and CPAP equipment and supplies if you qualify. As the year winds down you may want to time everything to minimize your co-payments, even if it means waiting until the next calendar or fiscal year so you don't pay two deductibles.

If you want to continue working with the machine you have meanwhile, you should understand that without data all is guesswork. Your oximeter can certainly help, though. First, are your desats occurring at 2 hour intervals with your wakeups? If so, that's a good indicator that apneas may be causing the wakeups. If you are not desaturating when those wakeups occur, it may or may not be related to apneas--difficult to say. Second, as you change pressures, your oximeter can help you see if you're on the right track or you're causing more problems with the change. If you increase pressure and see MORE desats or worse desats, then obviously, the change was not for the better.

IF you decide to make changes to your therapy, make only one change at a time and leave it for a few days, so you can see what effect the change really has. Make sure you have a well-fitting, clean mask--if it's old it may be time for a new one. Once you've called your insurance company you will know if they are going to cover a new mask or not.

Good to know.
Last year I setup a webcam to watch myself sleeping for a couple different reasons. First, to see if apneas/desats were responsible for my 2 hr wakeups. Also, to see if I saw anything such as hose tangling that would explain why I every single night take my mask off in my sleep and thus giving up on cpap.

I was able to determine that at 2 hours when I was waking was usually NOT due to an apnea or desats. Oximeter at 2 hours was usually normal and I usually wake up on my side, which during my sleep studies I had very little to no apneas at all while side sleeping.

I also was not able to determine why I always take the mask off. There were no hose tangles or anything I observed on my webcam to figure this out. I pretty much just attest that to me doing crazy stuff in my sleep. I have a history of childhood sleepwalking/eating episodes that happened several times a week and it lessened as I grew up. As an adult, it rarely happens. However, my wife says I still talk alot and situp in bed alot and I have no recollection of it in the morning so I just take my mask off and have no control over it or what I do in my sleep. The sleep centers were aware of these issues also. Just so frustrating that I forked out the 1000 dollar coinsurance payment during my last test and they were not able to tell my jack squat for why I wake up every 2 hours or why I take my mask off. I was told to "come back for a second night and maybe we can find out more". Well, easy for them to say since they arent paying the thousand bucks per pop. Frustrating.

I do believe I do need a cpap though because of my desats that I said I still have. It may not solve my 2 hour wake up, but its still necessary and this time I am going to try a higher pressure and see if it helps.

I will call my insurance and inquire of a new machine and what copays are for that and sleep studies.

[john_dozer]

My CPAP treatment is better when I'm on my acid reflux medicine. Ironically I believe the reflux is caused by the CPAP and happens primarily at night.

As for the potential to affect your breathing, I was affected by acid reflux up into throat and the first symptom was a persistent cough that I couldn't be sure if it was respitory or not. I also would wake up with a burning back of my mouth and throat. Again I wasn't sure if that was a respiratory infection related sore throat or not.

Once I was on medicine the cough disappeared 90% and time fixed the rest although I think there was a minor infection component to that last 10%.

So yes, I believe acid reflux can affect your treatment.

[jandchiggins]

Went to the Dr. today and whined about going through the study again and he wrote a prescription for a machine and mask. I have two questions:
- Can I assume the claim goes through the medical insurer, not the prescription insurer?
- Where the heck do you take the prescription to get the equipment? I assume you cannot just go to the pharmacy.

[Carl LaFong]

As for the potential to affect your breathing, I was affected by acid reflux up into throat and the first symptom was a persistent cough that I couldn't be sure if it was respitory or not. I also would wake up with a burning back of my mouth and throat. Again I wasn't sure if that was a respiratory infection related sore throat or not.

When I've had bad bouts of reflux I would aspirate stomach acid and wake up coughing and gagging violently. The acid would burn and inflame my airway to the point that lost my voice for day or two. So, yeah, I believe reflux can definitely spoil your cpap therapy. But I don't think cpap contributes to reflux.

[Janknitz]

When I've had bad bouts of reflux I would aspirate stomach acid and wake up coughing and gagging violently. The acid would burn and inflame my airway to the point that lost my voice for day or two. So, yeah, I believe reflux can definitely spoil your cpap therapy. But I don't think cpap contributes to reflux.

I'm one of those lucky people for whom CPAP (as long as I'm wearing it) completely stops my reflux, but others have reported INCREASED reflux on CPAP, often because of aerophagia. When they can get the aerophagia under control (sleeping position, tongue position, sometimes meds or decreased CPAP pressure) the reflux is under control too.

[Carl LaFong]

aerophagia

Hmm, yeah. I see that. Damn, there's always something!