Swallowing air

dylan91 · Post by **dylan91** » Wed Jul 09, 2014 11:08 am

Hey guys,
Lately my nightly average AHI has been around 2. However, there are certain hours of the night, specifically starting at around 4 hours into sleep, where I will have up to 8 apneas/hypoponeas in an hour. Specifically, the first half of the night I will have 0 apneas/hypopneas and the second half I will have an AHI of 4.

If I increase my pressure any more, I swallow air and then have gas. If I leave my pressure the same, my AHI will sit at about ~4 (going up to 8 at some points) for the second half of the night.

Should I bother messing with my pressure to reduce my AHI's in the second half of the night? If I should, how do I fix swallowing air?

I use a cpap.

ChicagoGranny · Post by **ChicagoGranny** » Wed Jul 09, 2014 11:15 am

What position(s) are you sleeping in?

dylan91 · Post by **dylan91** » Wed Jul 09, 2014 12:06 pm

on my back

palerider · Post by **palerider** » Wed Jul 09, 2014 2:28 pm

dylan91 wrote:on my back

well, stop it!

ChicagoGranny · Post by **ChicagoGranny** » Wed Jul 09, 2014 4:16 pm

If I increase my pressure any more, I swallow air and then have gas. If I leave my pressure the same, my AHI will sit at about ~4 (going up to 8 at some points) for the second half of the night.

You might try sleeping on your sides where pressure needs are often lower. But also aerophagia can be worse on the sides.

There are no pat answers for curing aerophagia. Are you getting any dry mouth?

tmr · Post by **tmr** » Wed Jul 09, 2014 4:49 pm

Do you have stuffy nose ? maybe upon waking up?

dylan91 · Post by **dylan91** » Wed Jul 09, 2014 7:18 pm

Since I have upped my humidity, I am not getting a dry mouth.

Almost every night upon going to bed, one of my nostrils is not functional. I don't want to say clogged because I am not sick, but no air goes in or out.

tmr · Post by **tmr** » Thu Jul 10, 2014 6:23 am

dylan91 wrote: Almost every night upon going to bed, one of my nostrils is not functional. I don't want to say clogged because I am not sick, but no air goes in or out.

Addressing it may help. You can try saline rinse and/or breathe right strips, if that solves it.

Also check if leaks go above the limit.

ChicagoGranny · Post by **ChicagoGranny** » Thu Jul 10, 2014 6:56 am

Since I have upped my humidity, I am not getting a dry mouth.

You changed the setting to what from what?

Dry mouth is caused by mouthbreathing with a nasal mask. The humidifier will usually do a good job of hydrating the nasal passages, but it is unlikely to provide enough moisture to an open mouth.

Almost every night upon going to bed, one of my nostrils is not functional.

Too high of a humidifier setting can cause nasal congestion. I am surprised you need the humidifier at all in FL. Make sure there is not an A/C vent blowing on the CPAP machine.

dylan91 · Post by **dylan91** » Thu Jul 10, 2014 3:19 pm

Yeah, this morning I had a dry mouth. I slept for 9.5 hours with an AHI of 2 and I still felt a bit tired through out the day. I also didn't drink coffee this morning.

Why do you ask about dry mouth?

ChicagoGranny · Post by **ChicagoGranny** » Thu Jul 10, 2014 4:40 pm

Why do you ask about dry mouth?

If you are using a nasal interface (doesn't cover mouth also) and breathe or leak air through your mouth you can get a badly dry mouth quickly. Even worse than that, the machine may not be able to maintain the prescribed pressure and you may be having apneas.

Are you using software so you can look at your leak line and try to figure out if mouthbreathing is a problem for your therapy?

Full face masks (FFMs) allow mouthbreathing and mouth leaks but the pressure is still maintained.

ChicagoGranny · Post by **ChicagoGranny** » Thu Jul 10, 2014 4:45 pm

Almost every night upon going to bed, one of my nostrils is not functional.

It's good for new CPAP patients with any congestion problem to be examined by an ENT. They will discuss congestion problems and allergies with you. It's good to also have this procedure:

Office Based Flexible Laryngoscopy
A transnasal flexible laryngoscope can be used for office-based diagnostics. This office exam is extremely well tolerated and often performed multiple times per day to patients of all ages. This can even be performed on newborns if medically required. Prior to passing the scope, the patient's nose is decongested and anesthetized with topical sprays that do NOT sting or burn. The patient then sits in an upright position and the scope is passed along the floor of the nose into the back of the throat to a level just above the vocal cords. At this point the patient is asked to breath deeply and phonate, allowing the physician to directly observe the structure and dynamic motion of the true and false vocal cords. There are no lasting side effects to this procedure and the anesthetic spray wears off over the ensuing 1-2 hours.

Common reasons for performing this procedure during your visit include hoarseness, suspected vocal fold lesions, chronic shortness of breath, difficulty or inability to swallow, longstanding history of smoking, the need for postoperative visualization or tumor surveillance, and inability to otherwise visualize the vocal cords during the exam.

This can be done on the first visit and usually you just have a specialist copay (check your insurance policy).

Addressing issues in the nasal airway can make CPAP easier and more effective.

dylan91 · Post by **dylan91** » Thu Jul 10, 2014 6:55 pm

Alright so here is last nights graph:

Does this graph suggest I leak through my mouth? As you can see, I slept for 9 hours and 40 minutes ( ) and had an AHI of 2.

I have a FFM, I only tried it for a few seconds. If it does appear that I have mouth leaks, I will give it a shot.

Regardless, because one nostril is typically clogged at night time, you suggest I call an ENT with this complaint and ask for a laryngoscopy in case I have something else? Or something that inhibits mouth breathing?

Pugsy · Post by **Pugsy** » Thu Jul 10, 2014 8:41 pm

You have a PR System One machine.
Why did you do the red line at 24 L/min which is the beginning of large leak territory for the ResMed S9 machines because they report excess leak only.
Your large leak territory is up around 80 to 90 L/min...you have a long way to go before you start worrying about any leaks be it mouth breathing or whatever the cause leaks.

palerider · Post by **palerider** » Thu Jul 10, 2014 9:10 pm

Pugsy wrote:You have a PR System One machine.
Why did you do the red line at 24 L/min which is the beginning of large leak territory for the ResMed S9 machines because they report excess leak only.

I think it's the default setting?

Swallowing air

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