Air as a midnite snack?

tooly125 · Post by **tooly125** » Fri Mar 31, 2006 6:18 pm

Hello,
Anybody have any suggestions on how to prevent the swallowing of air during the night?
After a full nite of snacking on air I awake with a painful stomach.
Its very easy to get rid of the pain but I wont get into that.

Linda3032 · Post by **Linda3032** » Fri Mar 31, 2006 7:00 pm

Tooly, with a pressure setting of 19, I think you should be on a Bi-level machine. It will work better for you than cflex (IMO).

rested gal · Post by **rested gal** » Fri Mar 31, 2006 7:01 pm

tooly125 wrote:setting 19 cm

Using less pressure is probably the best way to stop aerophagia, imho. You might want to talk to your doctor about letting you use less pressure for awhile and gradually work your way back up to the pressure you need to prevent apneas/hypopneas.

Or, ask your doctor to prescribe the REMstar Auto with C-Flex for you instead of the REMstar Plus you have now. The Plus is a basic straight one-pressure cpap machine. The Auto would let you set a range of pressure (like 10 - 20) and the machine would use only as much pressure as actually needed throughout the night.

It could very well be that pressures considerably lower than 19 would keep your throat open most of the night. You might need the 19 you've currently been prescribed only a few minutes occasionally, or perhaps only when in REM, or only when sleeping in certain positions (like on your back), or only when in REM and on your back.

If it were me, and I'd been prescribed that stratospheric pressure, I'd go even a step farther than getting an autopap. I'd shoot for the Respironics BiPAP Auto with BiFlex. That's a combo machine that can work as a autopap and bipap at the same time. Get the benefits of an autopap using only as much pressure as needed,AND a bipap giving the best exhalation relief -- both at the same time in one machine. Prescribe pressure of 19? Whew. I'd get that particular machine even if I had to buy it out of pocket myself. From an online store, of course!

tooly125 · Post by **tooly125** » Fri Mar 31, 2006 7:32 pm

looks like another trip to the doctors office. I don't think she will have a problem prescribing a better machine she seems pretty good that way at my last follow up visit she noticed the red mark across the bridge of my nose and signed me up for a cpap class at the hospital.

It could very well be that pressures considerably lower than 19 would keep your throat open most of the night. You might need the 19 you've currently been prescribed only a few minutes occasionally, or perhaps only when in REM, or only when sleeping in certain positions (like on your back), or only when in REM and on your back.

good call rested gal she did tell me that it was on my back during REM that i needed 19

Wulfman · Post by **Wulfman** » Fri Mar 31, 2006 9:37 pm

Tooly,

Another suggestion I'd like to make is to get the software and Smart card reader that goes with the REMstar Auto or the REMstar Pro 2 (assuming they get you one of those two machines). The machine you're showing in your profile is the REMstar Plus, which doesn't have smartcard capabilities.
The situation I encountered is that my sleep doc prescribed a pressure of 18 cm and I was able to do very well on a setting of 10 cm (which I changed myself on the first day without consulting the doctor) for the last 10 months.
I'm a strong believer in XPAPers taking control of your own therapy.

Best wishes,

Den

CheezWiz · Post by **CheezWiz** » Sat Apr 01, 2006 8:45 am

Tooly,

I too am fighting with that. Although I do not need to swallow to get a stomach full of air. I can just sit there and breathe at full pressure, take the mask off and burp for a few minutes. I wont even mention what happens all night long. For me, moving to an auto BiPap has helped a lot. I also raised our mattress head by placing a couple of folded comforters under it. (Memory foam)

I have found other pages that suggest drinking a full glass of water and Metamucil right before bed. I am guessing that it will keep your stomach busy for a while and the top valve tightly closed. But I have yet to try it, one solution at a time.

There are two possible causes, you are actually swallowing air or the top valve of your gut does not close strongly. If you suffer from acid reflux a lot, the latter might be the issue, it is for me.

As an experiment, hook up and breathe for 10 minutes at full pressure without swallowing. Breathe nice and deep. Pull the mask off and sit up and see what happens..

If you are swallowing the air, you could benefit from a heated humidifier or a higher heat setting if you are already on one. Also, drink lots of water to keep your mouth and throat hydrated. Excessive swallowing is usually due to dry mouth...

That is all the intel I have found in the past few days of looking. I am having a heck of a time too and it is quite painful. Plus it keeps me partially awake at times until I finally wake up and pull off the mask and empty the kettle. I currently have a belch session around 2 and 4 AM each night...

tooly125 · Post by **tooly125** » Sat Apr 01, 2006 12:20 pm

Thank you all for your help.
Last night i lowered my pressure to 10 just to see what would happen. I still wound up with a stomach full of air! (I have returned to my original setting)
I wont tell my doctor that i know this because i still would like a better machine and if she prescribes it I think my insurance will cover it.

I have found other pages that suggest drinking a full glass of water and Metamucil right before bed. I am guessing that it will keep your stomach busy for a while and the top valve tightly closed. But I have yet to try it, one solution at a time.

I"ll try it,it's cheap and even if it doesn't work there is no harm done.
I will also crank up the humidifier because now that you mention it i have been waking up kind of dry the last couple of nights.

CheezWiz · Post by **CheezWiz** » Mon Apr 03, 2006 12:24 pm

I tried the Metamucil trick the last two nights and have had good results. I have not had to setup and pull the mask off for a burp session. I wont even go into the benefits of added fiber in the diet..

Guest · Post by **Guest** » Mon Apr 03, 2006 7:50 pm

I'm going to try the Metamucil next.
Lowering my pressure didn't help.
I have my humidifyer on full blast now...no help with the stomach full of air but i kind of like it at this setting.
I wont know for a few days though my nose is bruising up again so i'll have to give the cpap a break for a few days(new mask on order).
I have found another option to try another "cheap fix" that might be worth considering.........

Aerophagia
The word "phage" in Greek means "to eat." Aerophagia is literally to eat air. In the modern context, it means swallowing too much air, a common cause of gas in the stomach and belching.

This is sometimes a result of CPAP Therapy. Unfortunately, the best solutions for this problem are not a catch all but instead an attempt to find the middle ground between needed CPAP pressures.

Here's what you can do:

Tell your CPAP prescribing physician. It may be better to decrease the CPAP level a bit and put up with some minor airway problems if we can significantly decrease the bloating. Sometimes this works great, sometimes not at all. An auto adjusting CPAP should also also be considered as these machines reduce the average pressure the user receives. Get help settings the maximum pressure on the auto as the highest pressures can make things much worse.

As the chin of a CPAP user nears the chest, air has a greater change of entering the digestive tract. Where possible, keep chin up in relation to torso.

Sleeping in a position different than normal helps keep the air out of the stomach. Try different sleeping positions. Left side, right side, inclined with pillows, or flat.

If these fail, It may be that you should consider a surgical alternative to CPAP. Many have tried all sorts of other solutions to this bloating problem with little success.

tooly125 · Post by **tooly125** » Mon Apr 03, 2006 7:54 pm

sorry forgot to sign in the above post from guest was me.

CheezWiz · Post by **CheezWiz** » Wed Apr 05, 2006 8:19 pm

Well,

The Metamucil fix is still working for me.
I take two equate gas relief gel caps and chase it with 8oz of water and a heaping teaspoon of fiber. So far so good, I continue to make it through most of the night without discomfort. I start getting air in the gut around 5 AM. Much better than before!