Best CPAP to prevent aerophagia?

[TiredInTexas]

I was diagnosed with sleep apnea back in 2011, and prescribed a CPAP machine.  I struggled with it for 6 months, suffering from really painful aerophagia (10 out of 10, cramping, etc.).  The sleep Dr. and DME loaned me several different machines (first CPAP, then BIPAP, then finally a ResMed VPAP adapt SV).  Nothing they could do helped the aerophagia, and I wasn't sleeping any better than I was before.  I also started to develop acid reflux and saw a gastroenterologist about it (and the aerophagia).  He basically said that the only thing he could do to help would be surgery more painful than the UUUP that I was trying to avoid with the CPAP, and to come back when I turned 50 (for you know what test).  At that point, I gave up on CPAP.

Now, 12 years later, I've decided that my sleepiness has gotten so bad that I have to do something about it, so I saw another sleep Dr.  They gave me a take-home sleep study which showed that I had 11.6 apnea events per hour and 8.6 hypopnea events per hour.  The combined events (65 obstructive, 7 central, 21 mixed, and 69 hypopneas) gave me an apnea/hypopnea index of 20.2/hour.  I had 110 desats, with the lowest being 81%.  My apnea does appear to be positional with an REI of 12.7 on my left side, 8.1 on my right side, and 44.8 on my back (I sleep with a wedge pillow, and the pillow for my head is behind the wedge, and the same height, so no net pillow, but when I'm laying on the wedge, it compresses more than my head compresses the pillow, giving me a pretty comfortable minimal pillow.)

The Dr. wants me to try CPAP again.  Reading this board, and seeing how much control you can now have over your treatment with OSCAR has given me hope that I will be able to dial in a setting that lets me sleep better while not turning me into a Macy's Thanksgiving Day float.  The experience I had with aerophagia has me afraid to try CPAP, but I know I have to.

My question to the board is: what machine should I request to minimize the chance of aerophagia?  I've read enough on the board to know to avoid Phillips (recall and encryption shenanigans) and ask for a ResMed CPAP.  I've also read enough to ask for a fully data capable machine, but what kind? (CPAP, BIPAP, ASV, ?)  There are at least 7 different kinds of recommended ResMed CPAP devices on the Wiki, and I can't find anything on the board that says if you have terrible aerophagia, you should get an X machine to help avoid it.

Thanks in advance for any help you can give!

[Crimson Nape]

Hi TiredInTexas! -
Will you be using insurance to pay for the CPAP? If so, then the type of CPAP is probably out of your hands. Usually insurance requires that you fail on a CPAP, auto or otherwise, before moving on up to a Bi-level and then to an ASV. The only exception to this, that I am aware of, is if the test results are so bad that the step-up process is bypassed. Based off the information you supplied, it is not that bad.

- Red

[TiredInTexas]

Yes, insurance, but pretty good insurance.  Still, good to know that I need to advance through the different levels of pain before I can get a machine that works for me.  If I do get a choice, what should I ask for?

[Crimson Nape]

The pick of the litter is the AirSense 10 Autoset, followed by the AirSense 11 Autoset.  The reason for the AS10 as the first pick is because all its internal components are the same as the more advanced devices.  The only difference is its firmware.  The newer AS11 uses a little lighter weight parts, but still is an excellent machine.  If you may need to increase to the next level in therapy devices, there isn't an AirCurve series in the 11 series, and you will be going to the 10 series anyway.

It seems that peripheral parts seem to be more readily available for the A10 series.  Things like 3rd party power supplies, humidifier tanks, and ClimateLine heated hoses.  Each time Resmed has released a new model, they change the power supply connector, and the heated hose connection.  This makes any existing supplies worthless if you change model numbers.  Ask me, I have a bunch of S9 stuff too good to throw away.

- Red