Aerophagia - some basic questions

I'm two weeks into treatment and need to understand aerophagia, which I seem to have a terrible case of! I've looked at prior posts on this topic but can't seem to glean out some basic info. First of all, what causes it? Does taping the mouth make it worse? And most important of all, how is it related to pressures? I have three pressures on my VPAP machine - which could possibly be related to aerophagia? My settings are: epap - 7; ipap - 13; sp - 4. I had to beg the doc one week ago to drop the pressure, and he dropped the supporting pressure from 6 to 4. That did cause my centrals to go away and made the machine more tolerable. I don't know why he is leaving the ipap at thirteen. Any advice would be greatly appreciated, as I need to know what I'm asking for with this fellow.

I'm fairly new to CPAP and experienced aerophagia, which left me uncomfortable and gassy in the morning. I'm not familiar with VPAP settings as I am using an APAP machine, but I lowered my max setting from 13 to 12 and my aerophagia disappeared. From what I researched, IPAP (inspiratory-PAP) is the pressure setting for inhalations and EPAP (expiratory-PAP) is the pressure setting for exhalations. With the data you provided, that means that you're swallowing more air than you are exhaling, which makes sense. I suggest that you let your doctor know about your aerophagia and ask them to lower the correct pressure settings. Also, you should consult your doctor before changing any of the pressure settings yourself. Good luck!

There is some thought that aerophagia is caused by the laxity of the sphincter that is at the distal end of the esophagus where it enters the stomach. Higher pressure needs puts more pressure on the sphincter and increasing the odds of it opening up and allowing air to enter the stomach. Also some thought that damage from GERD might lessen the closing ability of the sphincter. In your situation if that was part of the problem then your IPAP pressure would be the likely first suspect. EPAP being tied to IPAP with PS would be secondary suspect.

Not everyone who uses higher pressures (even to the upper teens) will have problems with aerophagia and some people who use what normally are considered very low pressures will experience aerophagia. So there is no hard fast rule.

Also some people do get accustomed to things and aerophagia symptoms go away with time and no change in pressures.

Some people with serious aerophagia problems will reduce their pressure and go up slowly in steps to find the threshold where there is no aerophagia and hopefully still treat the obstructive events effectively and stop before one steps over the pressure threshold where aerophagia rears its ugly head.

You may need to talk to your doctor about temporarily lowering your pressure settings in an effort to gradually increase pressures to optimal therapeutic level and allow the body to adjust more easily and hopefully limit the aerophagia.