cramping / 'aerophagia'

Greetings all,
Just started CPAP 2 nights ago. Experienced pretty significant cramping-stomach ache both nights, worse the first.
After first night, symptoms wore off by late afternoon.
After 2nd night, I had fairly "loose" bowels in morning.
I understand this means I'm swallowing too much air, and I've read this site's suggestions but I gather from their comments that this a highly idiosyncratic issue for folks.
So, I'm wondering what has worked for others with similar problem? Any official or "home" remedies you'd suggest?

I should add that that I have chronic gut problems anyway -- food intolerances, low-grade IBS w minor cramping, etc. And I'm wondering if this issue is going to exacerbate those problems on regular basis? Anyone else with similar situation?

Thanks for your help!
Tom

I have found that taping my mouth helps this, although I'm not sure I know why it would. You might want to do a search for "mouth tape" in the search bar above.

Taping the mouth doesn't stop the air from emptying into the stomach and beyond. Believe me, I know, I've been doing it for three years. Every night I fill up with air and it finds it's way out during the course of the entire day. Sometimes it is very uncomfortable as it moves it's way through the intestines. I have not found anything to help with that, and, yes, Roster, I have tried the Bran Bud diet and still use it. In fact, I have added a teaspoon of powdered Phsyllum husk to the mix.

I find that jumping on my mini-trampoline doubles as a gas remover and entertainment for the grandchildren.

Bev (whose grateful for her own office)

My aerophagia disappeared when I found a chin strap that worked for me. I finally settled on the PapCap from Pur-Sleep. As a result, I noticed my APAP machine typically delivers about 2cm LESS of pressure on average, and I think solving my mouth leaks is what led to the lower pressure, which is what in turn led to the aerophagia relief. No longer do I wake up bloated.

I experienced aerophagia and my sleep doctor indicated that some patients cannot tolerate CPAP due to aerophagia. He inquired how frequently I was experiencing aerophagia which was 2 out of 7 days (total) and recommended that I give it another month. He said that if it continued, he would try me out on BIPAP. He then went onto say if BIPAP did not relieve the problem that my next option was an oral appliance.

I would try any and all "home" remedies recommended by other forum members to see if this solves the problem. I would also recommend that you speak to your GI doc and see what treatments are available for IBS if you have not already done so. I hope you feel better. Laurie

Like Laurie, I've been in touch with the physician's assistant a number of times since I started CPAP back on 9/23. Got off the phone with her again today since I was up between 1:30 AM an 3:30 AM with a massive stomach ache due to a tummy full of air. It's been a serious, on-going issue that has triggered some pretty severe insomnia for me. My PA wants me to keep trying CPAP for a while, but watching the aerophagia and if it doesn't get better and continues to interfere with my being able to get a decent night's sleep (where "decent" means "as good as I was getting before CPAP, apneas and all"), then she'll recommend that I talk to the sleep doctor about an oral appliance with a follow-up sleep study to make sure the oral appliance is doing what it's supposed to do.

You can try to sleep on a wedge. APAP can be better than fixed pressure. Some people have had success with lowering their pressure, and very slowly building it back up to where it is supposed to be. Some doctors suggest a PPI, but I do not think there is any mechanism that would explain/support why PPIs should decrease aerophagia, but PPIs, for most people are fairly benign.

I also don't understand why a proton-pump inhibitor medication (PPI) (Protonix, Nexium, Prilosec, etc) would do anything to alleviate air being pushed into the esophagus into the stomach. I am on a PPI for acid reflux and it certainly did nothing to alleviate the severe abdominal distention and pain. My sleep doctor made no mention of taking a PPI. His answer was simply some people get aerophagia and some don't. He said sometimes BIPAP helps, sometimes it does not. I took this to mean that medicine has not come up with a solution to this problem. After all, human physiology was not designed to be subjected to pressurized air being forced into the airway all night long. I wonder what the statistics are concerning the incidence of aerophagia and the percentage of patients not being able to tolerate xPAP due to this very uncomfortable, often painful side effect?

I don't think a PPI will help with the aerophagia itself, but some people have reflux which is triggered by the aerophagia, and treating that with a PPI can greatly increase their comfort.

I've had bouts of bad aerophagia on CPAP and I am certainly still, um, err, "musical" in the mornings , but something that I think has helped reduce the aerophagia is sleeping with my tongue up against the ridge of gum just behind the top teeth. It's taken a while to learn to keep it there but it's now second nature, and I think that really seals off my mouth from the upper airway so that when I swallow I'm not swallowing as much air (it has also stopped me from drooling in my sleep, which was a problem in the beginning, too).

The test is that I can open my lips and not leak any air, even at 15 cm of pressure--though I still have not learned to talk with CPAP on.

Another member is also experiencing this problem. Perhaps some of the replies will be helpful:

viewtopic/t56841/Two-steps-backwards-sigh.html

Hmm, much to ponder here. Thanks for quick responses here

I used to pop PPIs like popcorn for gut pain til I discovered it removes all the acid, good and bad, one needs for digestion. I also got tired of GI docs blithely recommending "take 2 PPIs and call me in the morning" as if it were the waters at Lourdes.
Now I use an herbalist. But I digress.

Question: what is this "oral device" that a couple of you mentioned? It sounds vaguely sinister, like a medieval device for extracting confessions from heretics.
Tom

Doubtful T wrote:Hmm, much to ponder here. Thanks for quick responses here

I used to pop PPIs like popcorn for gut pain til I discovered it removes all the acid, good and bad, one needs for digestion. I also got tired of GI docs blithely recommending "take 2 PPIs and call me in the morning" as if it were the waters at Lourdes.
Now I use an herbalist. But I digress.

Question: what is this "oral device" that a couple of you mentioned? It sounds vaguely sinister, like a medieval device for extracting confessions from heretics.
Tom

It is something like a sports mouth guard. It helps a small percentage of people whos main issue is jaw structure in OSA.