Possible Aerophagia?

Hi folks,

Looking for a bit of direction here. I started CPAP therapy around 2 years now and it's been incredible. I have tried a range of masks in that time, and started with FFM's but now have settled on the P10. The bonus is, I thought anyway, was my AHI was dropping to under 4 most nights, up from under 10 with a FFM and up from 141 without CPAP at all. I have noticed teeth grinding etc and possible mouth breathing with this mask, but had previously been trying to tape my mouth, I've been kinda lazy on that front as I stupidly thought with the AHI results I was getting, it indicated I wasn't breathing through my mouth etc, which I have since learned is very naive of me.

The last month or so however has been utter pain. Stomach cramps that make me want to rip my insides out, weird tasting burps, and (apologies) the worst diarrhea I've ever experienced. The doctors could find no reason for this and continue to be perplexed when I stumbled across posts about aerophagia on this forum and well there are so many overlapping symptoms that I've damn well convinced myself I'm a doctor and it must be it because after the battery of tests I've had this last month there hasn't been anything else that explains it

I've uploaded my Oscar Data (apologies if it's not been done right) and am currently using a Resmed Airsense 10 Elite with a pressure of 14.4. I've only last night put EPR back on, but still this morning awakened with all the fun symptoms. I guess for those who are better at reading these charts what I'm asking is is anything popping out that would indicate I'm doing something wrong, or I can adjust the pressure setting possibly to try alleviate the symptoms before doing a deeper dive with a gastro doc.

Sorry for the long spiel, and thank you for any suggestions going forward, it really is appreciated.

I would suggest a reduction in pressure (still using EPR at 3) and see if you can get to a pressure that doesn't trigger the aerophagia and still doesn't allow too many OAs/hyponeas to pop up.
Maybe there's a line where your unwanted symptoms abate and you don't have too many OAs/hyponeas show up.

That's really about all you can do.
Maybe elevate the head of your bed if you aren't already doing that.

You could either go down slowly or just take a big leap downward and see what happens.

i would agree with pugsy here. reduce that pressure until the aerophagia and the rest go away. be advised that your ahi is going to go up. but that's not the main concern right now. getting over the air swallowing is the goal right now.

once you are at a pressure where you are stable, you can slowly increase the pressure a bare minimum amount at a time until your body is used to it. and i mean a bare minimum. lucky for you, the resmed can be increased by increments of .2 which means not a hell of a lot for your body to get used to.

this is how i overcame aerophagia, even though my case was different. i started with it. it didn't come upon as yours did.

please let us know how it goes, won't you?

good luck!

Thanks for the responses here pugsy and zonker. I've been pretty wrapped with being under 1 for my AHI of late, but I think I'll be happy with anything under 5 considering I started at 141+ from my sleep study. I will drop my pressure tonight and see how things go and report back over the next week or so.

MBix wrote: ↑

Tue Dec 21, 2021 11:13 pm

Thanks for the responses here pugsy and zonker. I've been pretty wrapped with being under 1 for my AHI of late, but I think I'll be happy with anything under 5 considering I started at 141+ from my sleep study. I will drop my pressure tonight and see how things go and report back over the next week or so.

sounds good!

MBix wrote: ↑

Tue Dec 21, 2021 9:14 pm

I have noticed teeth grinding

That's one of the symptoms of having obstructive apneas. During the struggle to breathe, the jaw is reflexively clinched.

MBix wrote: ↑

Tue Dec 21, 2021 9:14 pm

Aerophagia

You might find some good tips in the wiki ----> https://www.cpaptalk.com/wiki/index.php/Aerophagia

MBix wrote: ↑

Tue Dec 21, 2021 9:14 pm

Stomach cramps that make me want to rip my insides out, weird tasting burps, and (apologies) the worst diarrhea I've ever experienced.

Stomach cramps and burping can be symptoms of CPAP-induced aerophagia. Diarrhea from CPAP would not be common. If this continues for a week or so, I would seek a colonoscopy.

ChicagoGranny wrote: ↑

Wed Dec 22, 2021 11:50 am

Stomach cramps and burping can be symptoms of CPAP-induced aerophagia. Diarrhea from CPAP would not be common. If this continues for a week or so, I would seek a colonoscopy.

Sadly have been there already. It's been happening in bouts over the last 4 weeks, at times the cramps were so severe I had to go to ED. Ended up having a ridiculous amount of tests including colonoscopy, everything came back negative. I did read a couple instances of diarrhea being caused by aerophagia, obviously it's not common though. Right now I was pretty much at my wits end though when I stumbled across posts about aerophagia. I'm hoping it is the cause, even if it's rare it would just be a relief!

I dropped my pressure from 14.2 to 9.2 last night, my AHI did go up to 1.6 but that's still pretty good I think. Will see how the symptoms go over the next couple days

MBix wrote: ↑

Wed Dec 22, 2021 6:24 pm

I dropped my pressure from 14.2 to 9.2 last night, my AHI did go up to 1.6 but that's still pretty good I think. Will see how the symptoms go over the next couple days

perfectly acceptable until you get a handle on the aerophagia.

zonker wrote: ↑

Wed Dec 22, 2021 6:49 pm

perfectly acceptable until you get a handle on the aerophagia.

Yep considering I was well over 141 AHI when first diagnosed with OSA I think if I can maintain it around 1-2 the result speaks for itself. Still not totally ruled out, but the quality of life difference I've experienced is incredible!

Still feeling a little bloated today, I did tape my mouth again last night for the first time in awhile, so kinda two birds with one stone approach and will adjust as we go!

MBix wrote: ↑

Wed Dec 22, 2021 6:54 pm

zonker wrote: ↑

Wed Dec 22, 2021 6:49 pm

perfectly acceptable until you get a handle on the aerophagia.

Yep considering I was well over 141 AHI when first diagnosed with OSA I think if I can maintain it around 1-2 the result speaks for itself. Still not totally ruled out, but the quality of life difference I've experienced is incredible!

Still feeling a little bloated today, I did tape my mouth again last night for the first time in awhile, so kinda two birds with one stone approach and will adjust as we go!

So in the past week/10 days, have got my pressure down to 10 and my AHI has held steady at below 4. I definitely have caught myself at the beginning of snoring for the first time since using CPAP but I still manage to sleep through the night.

The possible aerophagia symptoms have slowed but remained. They're not every day now which is a welcomed relief, and I have been wearing a Scunchi thing to aid keeping my mouth shut but I seem to still have incredibly loud rumblings in my stomach, some terrific flatulence and the worst - random rotten egg burps. The cramps are few and far between now and much less bloating, which is very welcomed as it felt like my insides were being ripped apart at one stage. Another side effect I've noticed is my tongue is seating itself in weird positions that I've not noticed before when I've woken up in the middle of the night - pushing up against the back of my top front teeth etc. And lastly the diarrhea has finally mostly cleared up after over a month of zero fun.

I originally started CPAP with a FFM a couple years ago, my AHI was probably around 7 with it, but I had major issues of my face being irritated by the silicon, would leave horrible marks that just didn't go away through the day no matter what I did (mask liners etc) I tried the gel based masks also but couldn't get a comfortable fit. Wasn't too sure how I'd go with the Resmed P10 but it's been fantastic. Comfortable sleeping + my AHI results have been pretty great. But am wondering if it's maybe the fact I'm using just nasal pillows that's causing this. I've looked up masks today and stumbled across the hybrid masks and am considering giving one a go and getting the best of both worlds - just not looking forward to dealing with the reaction on my face.

I am speaking with my doctor this week to follow on from this as it's still possible it's not aerophagia of course but hopefully I may be able to get a referral to an ENT and go from there