Apap vs Cpap vs air in stomach - please help!

In your humble opinions, which I appreciate greatly, which machine is better for aerophagia?

I am currently using an REMstar apap, 6-10 pressure, C-flex 2, Humidifier set at 2.

Month averages:
90% Pressure - 8.2
Average Pressure - 7.8
AHI - 1.8 (which has averaged 0.5 over the last week).

My problem is that I have GERD, which is flaring up right now. When I sleep on my side - my aerophagia sets in. So I am spending so much time sleeping on my back, that it has begun to hurt.

I assuming one answer would be an A-Flex, which I cannot afford right now.

I know this is a loaded post - but any ideas? Suggestions? I'm waking up at 3 a.m. with a horrible back ache and cannot get back to sleep - for the 1st time in my 2 years of cpap therapy.

Would going back to a cpap setting be worth trying with a ramp time? If so, I have not idea what pressure to use.

Thank you very much for any advice!

Hi Red.

Have you done forum searches on "aerophagia" or "GERD"?
I haven't experienced either, but from what I can remember reading, it's pretty much of an individual thing. What works for one may not work for another. And, the remedies (as far as PAP settings or sleep positioning) for the combination of both of those can be conflicting at times.
For some, the Auto mode works (or doesn't) and for some the CPAP mode (with or without C-Flex) works (or doesn't).
I thought I had read once upon a time that laying on one's left side helps GERD due to the location of the entrance to the stomach (puts it to the top).

Don't know if I've been of any help.....but good luck.

Den

I don't think AFlex is going to be any better for aerophagia than the Cflex auto.

Keeping your Minimum as low as you can tolerate seems to help the most. If your SDB is one that just causes the machine to run up in pressure then that probably won't help much either.

I also have GERD, and Esophagitis, which is what happened to me when the GERD had been irritating my esopoghus for a long time.
What are you doing to control the GERD? I take two 40 mg Protonix a day, and a Pepsid comlete at night. This helps greatly.
Recently, I changed from APAP to CPAP just to see if it would improve my therapy, and it did. However, the chest pains were so bad, that I ended up in the Emergency room on Monday thinking I was having a heart attack.
It was just aerophagia.
I went back to APAP and the pains are gone.
Just one person's experience.
Lee Ann

Thank you all!

Lee Ann -

I am on Protonix as well and on reglan. The reglan has side effects and I am going off of that.

How do you feel that the apap is helping your aerophagia? Do you use c-flex or just apap? I am using c-flex at 2 - have not tried straight apap - that might help.

Snoredog - what do you think? Try apap without c-flex?

Thanks!

Sleepyred

[quote="Lee Lee"]I also have GERD, and Esophagitis, which is what happened to me when the GERD had been irritating my esopoghus for a long time.
What are you doing to control the GERD? I take two 40 mg Protonix a day, and a Pepsid comlete at night. This helps greatly.
Recently, I changed from APAP to CPAP just to see if it would improve my therapy, and it did. However, the chest pains were so bad, that I ended up in the Emergency room on Monday thinking I was having a heart attack.
It was just aerophagia.
I went back to APAP and the pains are gone.
Just one person's experience.
Lee Ann

you can try turning off Cflex, doing that didn't help me any.

I try and use my 420e most of the time, its reports are better and less hassle but my aerophagia creeps back so that is what drives me back to my Aflex (Cflex before it).

I don't have any advise since I've only used A-Flex, but I sure hope you find a solution and feel better soon!

I have Resmed machine, and when I use it on CPAP, I use the EPR feature which is like Cflex, I think.
I think the APAP helps the aerophagia because it gives me a break from air shooting straight up my nose.
Best of luck to you and I hope you feel better.

C-FLEX triggers some users to swallow air. I'd suggest that you continue with the APAP but turn the C-FLEX completely off; try this for a few nights and see how you do.

My 95% pressure typically runs around 12-13 when I sleep on my side...I have been using a soccer ball under my t-shirt to keep me on my side. I have found by setting the APAP at 8-15 with a ramp time of 45 that I experience very little aerophagia. It doesn't seem to effect treatment either as the first hour I seldom have any apnea events and at most maybe a hypoapnea or two.
In contrast I was running the apap at 12-16 with a ramp of 10 minutes and the aerophagia was just killing me. It seems as though if I can get through the first hour of sleep on a lower pressure I don't have much aerophagia during the rest of the night when I get in a deeper sleep....or I sleep through it. I have also noticed the aerophagia is worse when I sleep on my left side so I stay on my right side. All that being said, I get very uncomfortable on one side so I have started taking the soccer ball out when I wake up in the middle of the night. Because I know I am going to be getting on my back for parts of the rest of the night I jump the lower pressure up at that time to 10. The higher pressure in the middle of the night doesn't seem to bother me like it does the first hour or two I go to bed....or maybe I just sleep through it since I am already groggy at that time.
IT seems like in the cpap business one thing effects the other....sort of damned if you do and damned if you don't. My AHI is always lower when I sleep on side. On the other hand the aerophagia is much worse and I don't sleep as deeply or as long so I am more tired the next day. If I allow myself to sleep unobstructed..on my back some.. my AHI doubles but I don't have aerophagia as bad and I sleep longer with less lower back troubles the next day....nothing simple about cpap treatment.
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CPAPopedia Keywords Contained In This Post (Click For Definition): Ramp, APAP, aerophagia

Thanks for your responses -

I did turn off the C-flex - has helped a little bit.

I also turned down my lowest pressure a tad and that is helping a bit.

So bit by bit, I seem to be getting better.

I'm wondering if a M series Apap would be better since, from what I've read, it has a ramp time. When I was on straight cpap, the ramp saved me from swallowing air.

Does the M series Apap have a ramp feature?

Snoredog - If I'm looking a the m series - should I bite the bullet and get an A-flex? Pipe dream here for a new machine - but one can always hope!

What is the average time before an insurance company will pay for a new machine? I changed companies last year.

I use an M series APAP and it has the ramp feature, Since I have went on APAP I haven't needed the ramp feature but it is on there if you want to use it.

sleepyred wrote:Thanks for your responses -

I did turn off the C-flex - has helped a little bit.

I also turned down my lowest pressure a tad and that is helping a bit.

So bit by bit, I seem to be getting better.

I'm wondering if a M series Apap would be better since, from what I've read, it has a ramp time. When I was on straight cpap, the ramp saved me from swallowing air.

Does the M series Apap have a ramp feature?

Snoredog - If I'm looking a the m series - should I bite the bullet and get an A-flex? Pipe dream here for a new machine - but one can always hope!

What is the average time before an insurance company will pay for a new machine? I changed companies last year.

I've heard that some insurance providers would require a new sleep study. Then there's the issue of deductibles.....might depend on how much yours are. I've also heard that some won't approve a new machine for 5 years.

Talk to your insurance provider.....then do the math. I'm guessing it would be cheaper to purchase out-of-pocket from CPAP.COM.

Den

[quote="sleepyred"]Thanks for your responses -

I did turn off the C-flex - has helped a little bit.

I also turned down my lowest pressure a tad and that is helping a bit.

So bit by bit, I seem to be getting better.

I'm wondering if a M series Apap would be better since, from what I've read, it has a ramp time. When I was on straight cpap, the ramp saved me from swallowing air.

Does the M series Apap have a ramp feature?

Snoredog - If I'm looking a the m series - should I bite the bullet and get an A-flex? Pipe dream here for a new machine - but one can always hope!

What is the average time before an insurance company will pay for a new machine? I changed companies last year.