New BiPap user - trouble swallowing air

Hi, Im a new user to the BiPap machine. Been total of 5 days now. This is the 2nd time I've woke up feeling extremly gasey and belching. I spoke with my DME assistance and was advised I am swallowing air at nite. Ok, how do I prevent doing something I don't realize I'm doing while I sleep? I curently have a nasal mask, which is what I was fitted with during my sleep study. I find it clinches my mouth shut from the pressure, leaving my mouth/jaws feeling a bit sore in the mornings. I've been told the pressure is set where it needs to be so can't change that for any comfort. Considering changing to full face mask to allow breathing out of nose and mouth. Wonder if this will also eleviate this swallowing of air that is causing me to have such stomach pains? I somehow managed to get one good nites rest out of this machine so far but not sure what I done so differently from the other nites? Would love to hear from someone who has experienced this problem and could possibly offer me some advise on how to correct this problem. Thanking you in advance!

I'm still trying to figure out what I'm doing to "swallow air" (according to my DME rep) which is causing me to feel extremly bloated, gasey and belching so much in the morning. It's a very uncomfortable feeling. My stomach hurts all day as a result of it. Last nite, (my 5th nite with the machine) I found myself yanking it off within 3 hours of wearing it. Now it's nearly time to go back to bed and I wonder if I will have the courage to put it back on, especially because my stomach still feels so bloated. One may think this has something to do with what I'm eating but its not. I am keeping a journal of every day/nite watching for trends so that I have an understanding of why something is happening. Any advise would be greatly appreciated. I wonder if I'm the only one who has ever experienced this problem?

I've been on bipap since August of 2012. I feel great and I'm actually sleeping now. I have a full face mask and I still have this issue. I've talked with my sleep doctor and my pulmonolgist about the issue.

I'm a mouth breather so this is always going to be a problem. However, I've found a couple things that help relieve the uncomfortable feeling. A fizzy drink such as coke combined with gas x. While you will still be belching it's better than the discomfort.

You can also lean over a chair so that your stomach is pressed against the top that will help express some of the air also. I can deal with the discomfort since I'm now sleeping 7-9 hours a night.

Thank you for your response!

I have continued researching this today as it is a serious issue for me. This is something I found that seems to hit the nail on the head and I will be talking to my pulomonologist 1st thing in the morning. I think, based on this, one of my issues my very well be from tilting my head down. I sleep on my right side and I do find myself curling my legs up, almost into a fetal position. Tonight I will try to stay consious on how my head is positioned.

here is the ad I found:
Many things that are designed to make you “feel better” also have the ability to make you “feel worse” in other ways. Continuous Positive Airway Pressure (CPAP) is used to treat sleep apnea, a disorder that can leave a patient feeling as though they didn’t sleep at all. Obstructive sleep apnea is a condition in which the airway is slightly or completely obstructed by tissue in the throat causing a disruption in the flow of oxygen to the lungs. CPAP helps to correct sleep apnea by supplying a continuous flow of air to the lungs, which prevents the airway from closing.

Millions of people use CPAP nightly and have great success with it, leaving them feeling refreshed and ready to tackle the day ahead of them. Unfortunately, CPAP does have side effects that can cause other disruptions in your activities. Some patients report a sore throat, headaches, nausea, nasal congestion, sinus or ear infections, or dry mouth. Other problems include claustrophobia, feeling too much air pressure, and aerophagia.
The Greek meaning of Aerophagia is “eating air”, and often leaves you feeling like you need to belch or vomit, yet are unable to. Aerophagia happens when a person swallows too much air, causing abdominal bloating and belching. Aerophagia can be very painful and cause sleep disruption, sometime not allowing you to fall asleep at all.Since CPAP provides a continuous flow of air to the body, it is not surprising to find that aerophagia is a common complaint for patients using CPAP therapy. CPAP induced aerophagia can be caused by a few different things. One of which is poor head positioning. Like CPR, the most amount of air can get to the lungs when the head is hilted back leaving the airway open for air to get to the lungs. CPAP users who sleep in a curled up position and/or with the head tilted slightly downward, may experience aerophagia because the position of the head is limiting the airway for the air to flow through and into the lungs. When the airway to the lungs is obstructed, the air forces its way into the esophagus and stomach. Aerophagia can also occur during CPAP therapy when the air pressure is too high, resulting in the air being forced into the stomach much like the previous example. Air leaks are another cause of aerophagia. CPAP air enters the body through the nose and for some patients may leak out the mouth causing unintentional swallowing of the air, leaving the patient feeling uncomfortable. Most patients, experiencing air leaks of this sort, will pull off the mask during the night without realizing it.
Fortunately, CPAP induced aerophagia is a side effect that can be eliminated. If you don’t already use the “Ramp” feature on your CPAP machine, you may want to try it. Instead of immediately supplying the full amount of your prescribed air pressure, the ramp feature will start at a lower pressure and gradually increase the pressure for up to 90 minutes, until your prescribed pressure is met. If that doesn’t correct the problem, try sleeping at a slight incline. For some CPAP users, sleeping at an incline will help to keep their head better positioned and let the airway remain open during the night. You should speak with your doctor if you are still experiencing problems with aerophagia and your CPAP. Your doctor may choose to lower your prescribed pressure for the CPAP or add C-Flex to the prescription if it isn’t already. C-Flex will allow the pressure to briefly reduce during the beginning of your exhale and go back to the prescribed pressure prior to inhaling. Not all brands of CPAP machines have a C-Flex capability, so your doctor may suggest that you change from CPAP therapy to BiPAP therapy. BiPAP machines will provide a certain pressure while you breathe air in and a lower pressure as you exhale, reducing the likelihood of swallowing excess air.
If you believe that you may be experiencing Aerophagia, please speak to your doctor regarding the best remedy for you.

SheilaG wrote:Hi, Im a new user to the BiPap machine. Been total of 5 days now. This is the 2nd time I've woke up feeling extremly gasey and belching. I spoke with my DME assistance and was advised I am swallowing air at nite. Ok, how do I prevent doing something I don't realize I'm doing while I sleep? I curently have a nasal mask, which is what I was fitted with during my sleep study. I find it clinches my mouth shut from the pressure, leaving my mouth/jaws feeling a bit sore in the mornings. I've been told the pressure is set where it needs to be so can't change that for any comfort. Considering changing to full face mask to allow breathing out of nose and mouth. Wonder if this will also eleviate this swallowing of air that is causing me to have such stomach pains? I somehow managed to get one good nites rest out of this machine so far but not sure what I done so differently from the other nites? Would love to hear from someone who has experienced this problem and could possibly offer me some advise on how to correct this problem. Thanking you in advance!

Hi SheilaG!

I have dealt with this a couple of times. Mostly while under high stress from Post Traumatic Stress.

The problem may get better over time as you use the machine and so develop better reflexes as you use it.

Things that helped me:

1. I raised the head of my bed a few inches. Some believe that the problem originates with a bad “valve” in the throat. They posit that stomach juices compromise the valve. Raising the head of your bed may help keep them in their place and have other positive effects as well.

2. I did what I could to lessen stress in my life.

3. I spent some quality time with the machine while awake during the day. Some of it in bed learning to breath quietly and gently. I worked to use no more air than if I were not using the machine. Some of it while watching light TV, reading a book, music. The hope was that with all of my resources present hopefully I would build some good reflexes to be better enabled to do well with CPAP. I hoped that familiarity will breed better relaxation. It does seem to work

4. In my case I found that EERS[1] helped greatly with this. Perhaps in the future dynamic CO2 therapy will help. Talk with your doctors about [1,2].

Have a great week!

Todzo

[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741

[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link: http://www.ncbi.nlm.nih.gov/pubmed/19628721

Thank you so much for sharing this information. Willing to try anything for some relief!

I'm fairly new to cpap almost three months. I swallowed lots of air first off, and yes it was horrible and sometimes painful. The things that helped me were, slow breathing. I found that if I slowed down my breathing I didn't swallow air as often. Also if I had to open my mouth while using nasal pillows to not not suck in huge 'gulps' of air as it seemed some would always make its way into my tummy.

register and edit your profile to list your mask & machine that you are using...

then in the comments, post your pressure settings

all of that information will help folks give you suggestions on solving your aerophagia issues

Been on the hose since '98 and when I was switched to an ASV a couple of years ago I had that problem. This solved my problem.

https://www.cpap.com/productpage/premiu ... hleak.html


JeffH