Air in stomach

Hello Everyone, I am a new user and will begin using CPAP very soon. When I had my trial with nasal mask I got a lot of air in my stomach. I had no issue with the comfort of the mask and I did try a variety of styles. I find out today what my setting will be. This is my only concern is waking up with a belly fully of air as it was very uncomfortable after I completed my trial. Just wondering if anyone else has experienced this or perhaps it is something I will also have to adjust to. Thank you.

kinimtennis wrote: ↑

Fri Sep 13, 2024 5:36 am

Hello Everyone, I am a new user and will begin using CPAP very soon. When I had my trial with nasal mask I got a lot of air in my stomach. I had no issue with the comfort of the mask and I did try a variety of styles. I find out today what my setting will be. This is my only concern is waking up with a belly fully of air as it was very uncomfortable after I completed my trial. Just wondering if anyone else has experienced this or perhaps it is something I will also have to adjust to. Thank you.

Air in the stomach is called aerophagia. And it can be a very real issue for some people. And I'm someone who had a really, really bad adjustment caused in part by very bad aerophagia problems that kicked in right from the start.

Now many people have a bit of aerophagia now and then. And many newbies who have problems with aerophagia do find that within a few days to a couple of weeks, the aerophagia starts to ease up simply because their bodies are adjusting to CPAP and as part of that adjustment, you learn to swallow less air and your stomach gets more efficient at expelling the excess air through farting and burping.

Things that can help with run of the mill aerophagia include:

1) Get any kind of acid reflux problems you might have under control. One way air gets into the stomach is the same way that acid can get out: A weak lower esophageal valve.

2) Use EPR = 3. Pressure relief on exhale will help with the problem.

3) If you can sleep on a slight incline, that may help.

4) Try different head positions. Some people will find tucking their head towards the chest leads to more problems with aerophagia. Others will find this positions may help with aerophagia. It all depends.

5) Avoid lying in bed and not sleeping. Lying in bed and not sleeping can cause you to swallow more air, particularly if air is getting into your mouth. If you are lying in bed and the stomach is getting uncomfortable, go ahead and get out of bed and go into another room to allow your stomach to relax a bit.

6) If the idea of a full face mask is not a problem, consider trying one. One cause of aerophagia is swallowing air that manages to get into the oral cavity from the back of the throat rather than opening the mouth and letting the air escape that way. In a nasal mask, opening the mouth causes a significant leak, which in turn causes the machine to blow additional air through the mask. As a result, there can be even more air that gets trapped in the oral cavity when you shut your mouth after opening it. In a full face mask, however, the pressure is not lost when you open your mouth to allow the excess air to escape. So for some people with aerophagia problems, a switch to a full face mask seems to help.


If you are unlucky enough to have really serious aerophagia problems that don't get better on their own in the first 2-3 weeks, this is what you need to know in order to get the people in the sleep doc's office to pay attention to you and help you deal with the situation:

1) Keep a log detailing how often you are dealing with the aerophagia and how bad it is. You can do this every morning after you get up. Jot down the following information:

• Did you wake up during the night with aerophagia? If so, did you wake up multiple times during the night?
• How painful was the aerophagia during the night? (Use a simple scale: 0 = no aerophagia, 5 = severe aerophagia and rock-hard bloating)
• Did yu wake up in the morning with aerophagia? If so, how painful was it? (Use the same scale.)
• How rested do you feel on waking? (Use a simple scale: 0 = not rested at all, 5 = bright eyed & bushy tailed and ready to go)

The reason for keeping the log is to document just how bad the problem is if you need to contact the sleep doctor's office about it.

2) Call the sleep doc's office and insist on being seen by somebody If you are dealing with really bad aerophagia---as in you are in enough pain that you cannot sleep at night or you cannot function for several hours after you get up. They might not be able to help you, but you need to get your problems documented. If problems persist for more than a couple of weeks, you may need to have your pressure range reduced. If a reduction in pressure doesn't help and you continue to struggle with significant aerophagia, then a switch to bi-level may be needed. Bi-level PAP allows for a greater reduction of pressure on each exhalation. And the increased pressure relief usually is enough to fix even really severe, long term problems with aerophagia. But before a sleep doc is going to recommend a switch to bilevel, they are going to need to document to your insurance company that you have had serious problems with aerophagia while using APAP/CPAP for several weeks and after attempts have been made to address this issue through such things as a pressure reduction or a switch between APAP and CPAP.

kinimtennis wrote: ↑

Fri Sep 13, 2024 5:36 am

by kinimtennis

Here is a wiki with some tips on gastric insufflation (air in stomach). Note, I don't agree with all the tips especially the one about surgery in lieu of CPAP.

BTW, you may never have gastric insufflation once you are relaxed in your own bed.