Aerophagia

Reduced pressure is doing well for two nights. AHI is up but still less than 5. I was going to have to stop CPAP treatment if the aerophagia continued. Thanks to everyone for help. I will check daily for AHI and adjust accordingly.

Articles tell CPAP people to get a pro to adjust their machines. In my area no pros are available. Online help is all I have so forums like CPAPtalk are essential.

ejbpesca wrote: ↑

Sat Oct 01, 2022 11:46 am

Reduced pressure is doing well for two nights. AHI is up but still less than 5. I was going to have to stop CPAP treatment if the aerophagia continued. Thanks to everyone for help. I will check daily for AHI and adjust accordingly.

Articles tell CPAP people to get a pro to adjust their machines. In my area no pros are available. Online help is all I have so forums like CPAPtalk are essential.

so good to hear you were doing better.

You’ve only scratched the surface of what can be learned here. Glad you found this place.

ejbpesca wrote: ↑

Sat Oct 01, 2022 11:46 am

Reduced pressure is doing well for two nights. AHI is up but still less than 5.

Sorry I forgot to address this issue.

If you are willing and able to post your sleephq night/s here, you would be able to get valuable help regarding any mask leaks you are having, which may explain why you are at 5 or so ahi.

additionally, by posting the sleep charts, one of the more knowledgeable people can look closely at it and probably give you some indication as to whether you were actually asleep or not. You had mentioned at one point that you felt like you were tossing and turning a bit and it’s possible that your AHI really isn’t five because you weren’t really asleep.

Up to you if you want to share though

ejbpesca wrote: ↑

Sat Oct 01, 2022 11:46 am

Reduced pressure is doing well for two nights. AHI is up but still less than 5. I was going to have to stop CPAP treatment if the aerophagia continued. Thanks to everyone for help. I will check daily for AHI and adjust accordingly.

I would encourage you to not adjust the pressure settings every single day.

You need at least 3 or 4 days of data to really get an idea of whether a given pressure level is working well: We don't sleep exactly the same every night and some nights are simply better than others and some are worse. If you change pressure every night based on the overnight data, you never know if you're doing based on a good or bad night.

I am glad to hear that reducing the pressure has helped the stomach.

You say the AHI is pu, but still less than 5. How high did the AHI go? 1.5? 2.5? 3.5? 4.5?

robysue1 wrote: ↑

Sat Oct 01, 2022 8:12 pm

ejbpesca wrote: ↑

Sat Oct 01, 2022 11:46 am

Reduced pressure is doing well for two nights. AHI is up but still less than 5. I was going to have to stop CPAP treatment if the aerophagia continued. Thanks to everyone for help. I will check daily for AHI and adjust accordingly.

I would encourage you to not adjust the pressure settings every single day.

You need at least 3 or 4 days of data to really get an idea of whether a given pressure level is working well: We don't sleep exactly the same every night and some nights are simply better than others and some are worse. If you change pressure every night based on the overnight data, you never know if you're doing based on a good or bad night.

I am glad to hear that reducing the pressure has helped the stomach.

You say the AHI is pu, but still less than 5. How high did the AHI go? 1.5? 2.5? 3.5? 4.5?

I was hoping he/she would come back to post some data. I know you guys really work magic.

The trend data posted for the week was actually very good AHI with the highest being 1.5ish. some nights were much lower. Only 2 out of the 7 had ahi over 1.

Hopefully they will continue to improve.

robysue1 wrote: ↑

Sat Oct 01, 2022 8:12 pm

ejbpesca wrote: ↑

Sat Oct 01, 2022 11:46 am

Reduced pressure is doing well for two nights. AHI is up but still less than 5. I was going to have to stop CPAP treatment if the aerophagia continued. Thanks to everyone for help. I will check daily for AHI and adjust accordingly.

I would encourage you to not adjust the pressure settings every single day.

You need at least 3 or 4 days of data to really get an idea of whether a given pressure level is working well: We don't sleep exactly the same every night and some nights are simply better than others and some are worse. If you change pressure every night based on the overnight data, you never know if you're doing based on a good or bad night.

I am glad to hear that reducing the pressure has helped the stomach.

You say the AHI is pu, but still less than 5. How high did the AHI go? 1.5? 2.5? 3.5? 4.5?

AHI had been very low for a long time with 10/20 pressure setting. At 4/10 setting AHI went to 4.8 then 4 over two nights. I understand <5 is okay. https://sleephq.com/public/f701bfbc-31f ... 4c6b842017

Here's a week trend from SleepHQ: https://sleephq.com/public/3f7d62f7-6b2 ... 01d39fdfbf

ejbpesca wrote: ↑

Sun Oct 02, 2022 7:16 am

AHI had been very low for a long time with 10/20 pressure setting. At 4/10 setting AHI went to 4.8 then 4 over two nights. I understand <5 is okay. https://sleephq.com/public/f701bfbc-31f ... 4c6b842017

Here's a week trend from SleepHQ: https://sleephq.com/public/3f7d62f7-6b2 ... 01d39fdfbf

Yes, technically an AHI< 5.0 is supposed to be ok.

But this is the second day of detailed data with your pressure set 4-10 that shows a significant cluster of events between 5 and 6 in the early morning.

Here's what the cluster for Oct 1 looks like:


Almost all of your events for the night of Oct 1 occur in this one 25 minute period from 5:25 to 5:50.

The data for September 29 looks similar: Almost all the events occur in a 10 minute window between 4:08 and 5:08:



During both of these significant clusters of events, your pressure is maxed out at 10 and the machine can't respond to try to nip the cluster in the bud and prevent it from happening. In today's data, the machine is also having to ramp all the way up from about 5.3cm to 10cm in a 4 minute period. The machine might have done a better job of preventing this set of events if the minimum pressure were slightly higher.

Does the data for September 30 also have that same kind of nasty cluster of events sometime between 5:00 and 6:00 AM?

Now in all seriousness, if this were happening now and then in my my own data I'd just write it off to Pugsy's gremlins: Sometimes we do have a bad night. But I think this has happened every night since you reduced reduced your pressures to 4-10.

And if almost all your events are occurring in one bad small stretch of time and that bad cluster is happening at roughly the same time every day, that indicates something is happening at that time and that dealing with the something is probably worth doing in the long run.

So first the obvious questions: Do you tend to wake up around 5:00 or 5:30 am and drift in-and-out of sleep most days? Do you tend to flip onto your back around then? Or (as I think is likely) is this a prolonged REM cycle and your apnea is simply worse in REM?

If this were my data and I was seeing that kind of a nasty cluster at roughly the same time every night, I'd be looking at seeing if a modest increase in pressure might prevent at least some of the events in the nasty cluster.

In other words, I think long term you may need to increase both your minimum and maximum pressure settings a bit to prevent and/or break up these clusters of events that seem to occur every night sometime between 5:00 and 6:00 AM.

In the short term, I'd suggest using a pressure range of 5-11 cm for the next 3-5 days to see if you are still getting a nasty cluster of events every day between 5:00 and 6:00am. Obviously, however, if the aerophagia appears even with such a modest increase in pressure, then you'll probably need to abandon the experiment and try again after another week or so of using 4-10 for your pressure range.

I would even raise the minimum to 6 - which is still lower that the median.
You can see that a whole bunch of flow limitations started there, and the pressure was 5.32 when the cluster started. So I see no reason to keep the minimum at 5.

By the way, SleepHQ still hasn't fixed the time zone bug -- each of us sees the events at the time for their own time zone, not the sleeper's.

ozij wrote: ↑

Sun Oct 02, 2022 9:54 am

By the way, SleepHQ still hasn't fixed the time zone bug -- each of us sees the events at the time for their own time zone, not the sleeper's.

Thanks for letting me know about that bug. Since ejbpesca is in Alabama and I'm in Buffalo that means ejbpesca's clusters are happening between 4:00 and 5:00 AM Alabama time.

ozij wrote:I would even raise the minimum to 6 - which is still lower that the median.
You can see that a whole bunch of flow limitations started there, and the pressure was 5.32 when the cluster started. So I see no reason to keep the minimum at 5.

ejbpesca is dealing with really bad aerophagia problems that aggravate his/her already serious problems with acid reflux, and s/he seems to be comfortable breathing at 4cm, which surprised me since s/he reduced his/her min pressure setting from 10cm to 4cm in one fell swoop. So right now ejbpesca seems to be much more worried about the return of the aerophagia than anything else. And that's why I think being cautious about increasing the minimum pressure is a reasonable thing in his/her case.

Generally speaking, wouldn't it be the case if getting the minimum set up a bit higher to prevent collapse in the throat wouldn't that potentially lower the need for it to ramp up so much?

That isn't to say you wouldn't want to open up the max a bit but it seems ideally keeping the low end up near where you need it to be should potentially bring down the upper end of pressures?

I hope the poster will come back and not give up due to the slight increase in AHI.

You WILL get this figured out!

PS if your timeline is incorrect, next to where the three dots are to share it also says edit session time. Instructions there and it takes a few seconds to adjust it but I always have to add 3600. Otherwise it has me going to bed at 930 when I go at 1030.

Thank you. I have in increased pressures to min. 5 max. 11.

My times are for Central Time US.

I do not know why I am having a cluster of events an hour before waking. Out of options given of possible conditions at 5 am, I pick REM, but that is a guess.

Two days waking with no aerophagia. Yay.

robysue1 wrote: ↑

Sun Oct 02, 2022 10:02 am

ozij wrote: ↑

Sun Oct 02, 2022 9:54 am

By the way, SleepHQ still hasn't fixed the time zone bug -- each of us sees the events at the time for their own time zone, not the sleeper's.

Thanks for letting me know about that bug. Since ejbpesca is in Alabama and I'm in Buffalo that means ejbpesca's clusters are happening between 4:00 and 5:00 AM Alabama time.

ozij wrote:I would even raise the minimum to 6 - which is still lower that the median.
You can see that a whole bunch of flow limitations started there, and the pressure was 5.32 when the cluster started. So I see no reason to keep the minimum at 5.

ejbpesca is dealing with really bad aerophagia problems that aggravate his/her already serious problems with acid reflux, and s/he seems to be comfortable breathing at 4cm, which surprised me since s/he reduced his/her min pressure setting from 10cm to 4cm in one fell swoop. So right now ejbpesca seems to be much more worried about the return of the aerophagia than anything else. And that's why I think being cautious about increasing the minimum pressure is a reasonable thing in his/her case.

I understand your caution. My thinking was that since the median on all three night was more than 6, and the aerophagia was better, raising the minimum was not that much of a threat. Especially since the max is now where the min was (10) -- and I don't suggest raising the max at this point. A higher min could actually prevent events that make the pressure shoot up.

Min. now 6

ejbpesca wrote: ↑

Sun Oct 02, 2022 11:42 am

Min. now 6

That's a reasonable plan. Are you planning on using 6-10 or 6-11 the next few nights? Whichever you decide to try, you should leave the settings alone for the next 3-4 days as long as you don't experience the aerophagia. At the end of the 3 or 4 day experiment, post links to each of the day's daily data so we can see what's happening with that early morning cluster of events.

But note: If you do wake up with aerophagia, you'll want to go back to the settings that were not triggering it for a couple of nights and then be more cautious about the pressure increases in the next experiment.

ejbpesca wrote: ↑

Sun Oct 02, 2022 11:42 am

Min. now 6

::nodding::

Glad to hear the aero is under control.

Don’t be overly concerned about seeing slight increases in your minimum and your maximum. They are nowhere near what they were when you were getting it really bad.

Good luck!