Does CPAP cause acid reflux?

[OntarioKevin]

Been on CPAP for a few years now. Mostly good luck, with a few setbacks.

Lately I've been waking with terrible acid reflux. Zantac helps, but not always even taken prior to sleep.

Never had an issue with reflux before, and my diet is pretty steady.

Does forcing air down your throat via CPAP actually create acid reflux?

[LSAT]

Some people say YES, but, IMO I think the pressure of the air rushing down your throat actually keeps the reflux in your stomach and prevents it from traveling up the esophagus.

[chunkyfrog]

It may be more a result of you swallowing air in response to the pressure.
This is a normal reaction, and it passes for most of us.
Learn to relax with the machine, and it should get better.
The pressure coming out of the machine is not enough to inflate a balloon,
therefore not enough to force out the contents of your stomach.

[hyperlexis]

Fantastic question -- I am sure there must be some info out there about this subject whether it causes or worsens reflux.

CPAP can force air down the esophagus and into the stomach. That pressure can distend the stomach and, perhaps, that worsens and/or causes other problems. Possibly reflux.

Any journal articles on Pubmed?

[chunkyfrog]

If it can't blow up a balloon; no. Got to be swallowing--lots more force.

[BlackSpinner]

Been on CPAP for a few years now. Mostly good luck, with a few setbacks.

Lately I've been waking with terrible acid reflux. Zantac helps, but not always even taken prior to sleep.

Never had an issue with reflux before, and my diet is pretty steady.

Does forcing air down your throat via CPAP actually create acid reflux?

It can't blow up a balloon so you must be swallowing air if it is cpap related.
And life goes on, you get older. The diet that worked before could be at the tipping point of disagreeing with you.
You need to see a doctor.

[OntarioKevin]

And life goes on, you get older.

ahhh... the root of the problem! *lol*

going to try Prilosec - last choice would be a wedge pillow

still think cpap can't be helping, but kinda need it at this point

[hyperlexis]

If it can't blow up a balloon; no. Got to be swallowing--lots more force.

Yes, I imagine it cant blow up a balloon -- but it can certainly inflate one. It likely can press past the sphincter and inflate the stomach. I have had a history of GERD/reflux caused by a weak sphincter valve in my esophagus and when my cpap has gone past 13 or so in a night oh boy sometimes do I feel it. I have even sometimes heard my stomach gurgling as the air gets past. It causes terrible stomach bloating and pain in the morning. The mechanism of that air getting past the valve is perhaps one swallows, the valve opens and whoosh the pressure then rushes past the open door into the stomach, or, perhaps, the pressure just eeks past the valve under its own force because ones airway is pushed open by the cpap's pressure on the windpipe. This is the reason when one has surgery, the anaesthesiologist places an endotracheal tube down into the windpipe, past the junction with the esophagus -- because just using a face mask alone, the risk is the respirator will also inflate the stomach and possibly cause distension or vomiting during the procedure.

[RandyJ]

Acid reflux is often associated with untreated sleep apnea. Are all of your efficacy data numbers good?

[Julie]

I just take half a TUMS before bed if I've had anything acidic for a few hours before bed, and no longer drink coffee or coke at all (and I think many here don't after noon if they can help it). Also, alcohol's a definite no-no for a few hours before bed.

[chunkyfrog]

When I said "blow up", I meant "inflate", not "explode".
Still not enough pressure to inflate a latex or vinyl balloon--will however, inflate a Mylar balloon.
You can do this experiment at home--have fun!
The painful gas is being SWALLOWED, or produced in the stomach.
The swallowing happens with a newbie, sometimes longer--I stopped after a week or so.
OP still needs to see the doctor! The problem referenced appears to NOT be cpap-related.

[Todzo]

I think that acid reflux comes into the use of PAP through the associated carbon dioxide maintenance issues. PAP's constant pressure tends us to breath more. When we do breath more we wash out more carbon dioxide (CO2). That reduces circulation and frustrates metabolism.

The brain in particular despises CO2 washed out blood.

The stomach is rather neuron dense. And indeed I have noted the following:

Blood oxygen saturation (SpO2) vs Stomach symptom:

99% Stomach in a knot, heartburn, nausea
98% Stomach in a knot, possible heartburn
97% Stomach has bloated feeling
96% Stomach beginning to relax
95% Stomach relaxed, digestion continues

If you think about the fact that more breathing means higher SpO2 and as well that frustrated metabolism (specifically the lack of the ability of oxygen to move from blood cell to hungry cell) is also likely to drive up the blood oxygen saturation levels the above numbers imply that perhaps the CO2 maintenance issues are directly associated with acid reflux. I think that the lack of CO2 in the blood both spurs acid production and causes the stomach to spasm pushing the acid up into the airway passage.

Note that this is my own observation. I have not seen anyone looking into this in the research arena.

Simply I think that when the pressure of PAP works with stress to push the CO2 levels down reflux is a likely result.

FWIW,

Todzo

[zoocrewphoto]

I think that acid reflux comes into the use of PAP through the associated carbon dioxide maintenance issues. PAP's constant pressure tends us to breath more. When we do breath more we wash out more carbon dioxide (CO2). That reduces circulation and frustrates metabolism.

The brain in particular despises CO2 washed out blood.

The stomach is rather neuron dense. And indeed I have noted the following:

Blood oxygen saturation (SpO2) vs Stomach symptom:

99% Stomach in a knot, heartburn, nausea
98% Stomach in a knot, possible heartburn
97% Stomach has bloated feeling
96% Stomach beginning to relax
95% Stomach relaxed, digestion continues

I have seen you post this many times. Perhaps I am misunderstaning your terminology, but when I have my oxygen checked at the hospital or sleep study, they want it above 96%. Are you saying that it is BAD for it to be at 96% of above? It seems like you are saying that when we have what is considered a good level of oxygen, that this is bad. Is that what you are saying?

[archangle]

I have seen you post this many times. Perhaps I am misunderstaning your terminology, but when I have my oxygen checked at the hospital or sleep study, they want it above 96%. Are you saying that it is BAD for it to be at 96% of above? It seems like you are saying that when we have what is considered a good level of oxygen, that this is bad. Is that what you are saying?

His CO2 talk is mostly nonsense.

[archangle]

Worsened reflux with CPAP is fairly common. Some people get air in their stomach with CPAP. As you belch this out, or as it distends your stomach, you may get more reflux.

I think some people get reflux when they're struggling with an apnea and this may force acid out of your stomach. Or the stress may cause acid. These people may get less reflux when they treat their apnea with CPAP.