CPAP ergo GERD?

OK. After a day with no tortilla soup and night sleeping on my back, I feel so much better today (at 6 AM).
I still feel some air, but it's not deep down. No upset stomach at all.

Thank you thank you.

I will continue with other suggestions made to me.

Second night on back, no tortilla soup. AHI's waaaaaaayyyyyyyy down. (I don't have a card reader, just the average on the machine itself).
Thank you again, I feel so much better.

I have GERD, was diagnosed about 20 years ago. I used to take omeprazole, but for the past 6 years I take 40 mg of pantoprazole (Protonix, a proton pump inhibitor) every morning. There is a generic form now, thank goodness, because it used to be very expensive. I've tried tapering down, taking one every other day, but the fires returned. I get an upper endoscope about every 3 years.

My husband was diagnosed with Barrett's Esophagus in 2002. Since then he's had 2 other upper scopes and no one sees evidence of Barrett's anymore, so I think the first diagnosis could have been due to all the inflammation he had. The reason for the inflammation was H. pylori, something else for you to think about. Turns out he'd probably had H. pylori for at least 15 years, long before we met.

Years ago when people had fire and pain in their gullets, they were accused of not knowing how to handle stress, and told to change their lifestyle, change their diet, take stress management classes, slow down, because they were doing it to themselves, it was their own fault. Then lo and behold a bacteria (H. pylori) was discovered to be the cause of the majority of stomach ulcers (and painful reflux) and it wasn't their fault at all. It is eradicated by a cocktail of antibiotics and pepto-bismol given on a strict schedule for 3 weeks. An upper endoscope will automatically take tissue samples for biopsy and if you do have H. pylori, they will find it.

Now, regarding the air from cpap, I wear a chin strap or tape my mouth shut, but I still feel the air backing up into my throat when I sleep. I am down to around 1 to none AHIs per night, but the air wakes me up. It doesn't seem to matter if I sleep on my back, my tummy, or either side. The air comes up and it wakes me up, every night. Whatever belched-up air that does not escape through my nose during the night, well, it goes south and it winds its way down, through my lower GI tract to the exit point. This ends up being somewhat of an issue the next day, and discreteness can be difficult at times because the sound effects are quite "tooty."

I have not slept on my back for years, because of the apnea (even before I was diagnosed I'd figured that out). After I got the machine, I just automatically didn't. As was suggested earlier, I switched to my back the last two nights and it's been good. Are you side sleeping? I honestly felt like I'd been blown up like a balloon when I got up in the morning, but the last two mornings have been quite a relief.

I think tonight I'll try just sleeping on my back to see what happens. It's just that it gets boring after awhile and I like to change positions during the night.

You were right! I slept on my back half the night and swallowed no air! As soon as I switched to my side, the air started coming up. Sleeping all the time on the back hurts my L4L5 disc though (it's pretty much not there anymore). So I guess I have to decide which is worse, lower back pain or air all day long. Or I could let them take turns!

http://www.medicalnewstoday.com/articles/32944.php
Excerpt:
"All patients with sleep apnea should be evaluated for gastroesophageal reflux," said J. Barry O'Connor, M.D., of Duke University Medical Center, one of the investigators.


www3.interscience.wiley.com/journal/118774317/abstract?CRETRY=1&SRETRY=0
Symptomatic gastro-oesophageal reflux, arousals and sleep quality in patients undergoing polysomnography for possible obstructive sleep apnoea
Excerpt:
Conclusions: Gastro-oesophageal reflux is common in patients with sleep disorders, is associated with increased arousal, decreased durations spent in the deeper stages of sleep and poorer sleep-related quality of life.

http://www.medicalnewstoday.com/articles/13671.php
Excerpt:
Medical researchers have long suspected a relationship between gastro-esophageal reflux disease (GERD) and obstructive sleep apnea (OSA), two medical conditions which can have a deleterious effect on a patient's quality of life. Now, a team of Canadian researchers has determined that there are significant relationships between laryngopharyngeal reflux (LPR), OSA, and upper airway sensory impairment.


http://www.entnet.org/healthinfo/topics/GERD.cfm
Excerpt:
"What Is LPR?

During gastroesophageal reflux, the acidic stomach contents may reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), and into the back of the throat and possibly the back of the nasal airway. This is known as laryngopharyngeal reflux (LPR), which can affect anyone.



Silent gastroesophageal reflux disease

Excerpt:
Silent gastroesophageal reflux disease (GERD) is a very common phenomenon that involves the incidental finding of erosive esophagitis, Barrett's esophagus, and the evolution of esophageal adenocarcinoma in asymptomatic patients. The reasons for having advanced GERD without clearly identifiable symptoms are poorly understood, primarily due to lack of recognition of this important phenomenon. The clinical implications of silent GERD are vast and should provide the impetus for further research into this group of patients. Recent studies have suggested that sleep disturbances and poor quality of sleep could be the needed clues to identify individuals with silent GERD.

_____

Silent GERD

http://www.medscape.com/viewarticle/516189

http://www.sciencedaily.com/releases/20 ... 080008.htm

Sierra: I usually put a small pillow or something under my low back, just because it feels better and it also keeps me from rolling over. Maybe that will help.

Rested Gal: Having the world shortest attention span ( lots of times I can't remember why I logged on to the computer), I'll just ask. So I should go to my regular internist and ask him to test me for GERD and LPR? Or should I go to the sleep dr and ask him for a referral? Sticking a tube down my throat is scary. I can't even take big pills.

OCNorsk, the esophageal endoscope is really easy, not painful, and you won't remember anything anyway. I believe the only prep for it is nothing to eat or drink past midnight. You'll have twilight sedation through an IV and when you wake up you'll most likely ask them when are they finally going to get started with the procedure. You'll think you're still waiting to have it done, but they're already finished--that's how fast it is.

ewwww so it's like a colonoscopy at the other end?

It's not just a quickie little thing then.

Yes it is, as far as you'll be concerned. I've had a few of them and would rather do that anyday than e.g. go to the dentist!

OCNorsk wrote:ewwww so it's like a colonoscopy at the other end?

It's not just a quickie little thing then.

Sort of. Make sure they use a clean scope.

sierragail wrote:You were right! I slept on my back half the night and swallowed no air! As soon as I switched to my side, the air started coming up. Sleeping all the time on the back hurts my L4L5 disc though (it's pretty much not there anymore). So I guess I have to decide which is worse, lower back pain or air all day long. Or I could let them take turns!

Sleeping all night in one position is difficult for many of us. I use the Falcon position for about half the night. See viewtopic.php?f=1&t=43663

I have bruxism and if I sleep on my stomach I wake up with a headache. I've had a night guard for twenty some years.

This is why I've wanted to develop a hanging by my knees method, but now my knees are shot.

Stomach: teeth grinding=headache
Back: stop breathing=got CPAP
Right side: arm and shoulder killing me when I wake up... hurt all day
Left side: same as right: plus now I know side positions fill me up with air.
Sitting up is good at the beginning, but as the night goes on, I slip down and wind up any which way.

Does Dracula sleep upright or is the coffin flat? Do you think there are seatbelts in it?

In addition to a pretty fascinating thread in its own right, do you guys realize how weird the subject line "CPAP ergo GERD" looks? I was thinking about explanations for it (other than the fact that it really does have meaning):

1. A line from The Day the Earth Stood Still
2. Someone's cat, or maybe gerbil, got onto their keyboard
3. Words spoken by someone who's been slipped some kind of drug
4. ...or maybe hasn't had enough sleep