CPAPtalk.com

Let me introduce myself. Recently diagnosed with severe OSA, was treated for 10 days using a Resmed S8 Auto-Pap machine (while I ordered my permanent machine, S9 Elite). I had no problems sleeping during those 10 days, everything was going well. Had a second sleep study for titration last Friday night, had my S9 machine setup (12cm, with a selectable 5- or 10-minute ramp-up from 6cm). The past three nights were not very successful, as I woke up from swallowing so much air, something I hadn't been doing on the Auto-PAP machine. What's both funny and a little alarming is that I have an ileostomy, and my bag was puffed up like a balloon! I'm going to contact the doctor today and ask for advice, but wondered about any comments from the forum members.

While I didn't tape often during those 10 days of the Auto-PAP use, I did tape when I got this S9 machine and noticed I was swallowing air. That doesn't seem to help. BTW, I read some concerns in other posts about taping your mouth and sudden emergencies that might arise. I had wondered about this, myself. The tape that was provided by the sleep hospital here in Seoul is interesting - a "U" shaped piece of tape that goes on your lower-lip and sides of the mouth only. If you had to open your mouth suddenly, such as to vomit, the tape wouldn't stop you. But it seems secure enough that my mouth won't casually open.

Hi, there was just another thread here this week about that U tape - hope it works for you. As far as the air goes, is it possible for you to try lowering your pressure just a little, e.g. to 10.5 and see if it helps, as it often does, and then you might possibly be able to work back up once your system's used to it. Ask your MD what he thinks.

Here ya go:

http://www.chinupstrip.com/Strip_Applied.htm

snores like a train: yep, that's exactly what I have. Too bad it isn't helping with the air swallowing. It does keep my mouth closed, as best I can tell.

Welcome to the forum, SleepyInSeoul! You didn't mention if you're using the EPR (Expiratory Pressure Relief) feature on your S9 Elite. EPR decreases the pressure by either 1, 2, or 3 cm H20 on exhale only, depending on which of those three settings is used, so it makes it easier to exhale against the pressure. It can also be set to Off. You may want to try that at each setting and see if that brings some relief. I have read that others have found that helpful.

Also, read about "aerophagia" here: wiki/index.php/Aerophagia. I hope that helps.

Anecdotally, I believe the EPR is enabled, though at what setting I don't know. I say this because the APAP machine I used for 10 days definitely had it and it was enabled, and I could "feel" it working. Similarly, with this S9 machine, I also "feel" it working, but I will double-check when I hear back from the doctor today.

Since you did well on autopap (APAP), it's too bad the doctor prescribed constant pressure (CPAP) and that you were given a constant pressure machine. I think many doctors view CPAP as the norm, with APAP something to move to if for some reason CPAP doesn't work. I wonder if it's because most of the research verifying the effectiveness of therapy is with CPAP. Anyway, in your case, aerophagia is a problem with CPAP but not APAP. Maybe it's because you spend relatively less time at high pressure on APAP and therefore don't get as much air pushed into the stomach as with CPAP. I swallow a lot of air myself on CPAP, but it doesn't cause cramping or discomfort. It makes me fart a lot, but I don't care, so I don't have a problem. The ostomy makes it a problem for you. If I were you, I would go immediately to the doctor and explain the situation. In my humble opinion, he should recognize that this makes you a candidate for APAP, and he should help you get that S9 Elite swapped for an S9 Autoset. Tell his office that the ostomy makes this urgent and ask them to get you an appointment right away.

PST - at the time, the doctor told me that in most cases they recommend a CPAP when possible. She said the APAP puts some stress on your body - for example, for it to know you've stopped breathing and to increase the pressure, you have to, well, stop breathing a few times. But that may well be the solution, I'll discuss further with them right away - no problem getting an appointment. Also, I know my body needs to adjust, and it's only been three nights. I'm not in a panic yet.

Now I could kick myself for not doing thorough research before I bought the S9 Elite. I didn't realize that the S9 Auto unit can also function as a CPAP - had I known that, I would have spent the little extra and bought the Auto just to cover all my bases (such as might be the situation here). However, looks like I can't return the unit, since I've opened it and used it for 3 nights - not to mention the shipping and customs hassles here in Seoul. If an APAP machine is truly called for, looks like I'll get myself a new S9 Auto machine and put the CPAP machine up for sale - actually, I think the hospital could help me with that.

Thanks for your comments.