Aerophagia help

[willigorilla]

Hello,
I have been using a CPAP machine for about 4 years. In the last year aerophagia has got worse. I've tried adjusting my pressures to no avail. Any guidance would be greatly appreciated. Thank you.

[Jay51]

I have and still do struggle with aerophagia a bit.  Several things can help.  
1.  I see some large leaks that increase your pressure.   Mask Primer  This may help decrease them. 
2.  Usually decreasing pressure helps decrease aerophagia.  BUT, that needs to be balanced against performance (AHI, etc.).  
3.  I see some hypopnea and other clusters in your chart.  Possibly using a soft cervical collar could reduce these and keep your pressure and aerophagia down more.  I wear one every night.  
4.  CPAP since March 22, still dealing with aerophagia, wakings, and heart rate problems ( 1 2 )

manacles[url=http://www.apneaboard.com/wiki/index.php?title=Mask_Primer][/url]
This thread has a unique solution that worked for this member.  I tried this, but it did not work for me personally.  I am currently at 10 max epap and 20 to 22 for ipap (PS).  I may try to raise my epap significantly so less ipap and see if that helps decrease aerophagia.  

Lots of things to try.  There is the possibility something has happened to your esophageal sphincters over time as you have aged.  GERD can affect this.  Something neurological can also for example.  

[staceyburke]

I Agee with most of what Jay said.  Where I differ is what is causing your higher pressure. Compare your Flow Limits and high pressure,you can see they are driving up your pressure. We use ERP to lower FL.  

I would try the following :

Min 7
EPR full time
EPR 3
Leave max where it is

The reason of increasing the Min is to give EPR room to work.

[willigorilla]

Thank you for your input. I did up my pressures. Seeing that there's still a large league I'm going to use a new mask tonight. My old one may be worn out. Thanks again.

[Sleepster]

What about your EPR setting? Raising that to its max value is key. If that doesn't work, I recommend you go to your care provider and complain about the aerophagia. You will need bi-level therapy. Ask for the ResMed AirCurve VAuto. Accept nothing less.

[Deborah K.]

You are also having positional apnea.  This shows up where you see Hypopnea or Obstructive apneas clustered together on your chart.  These occur when you are tucking your chin towards your chest.  This causes something similar to a kink in a hose and makes it difficult for the air to get through.  This can be corrected by sleeping on a flatter pillow or by wearing a soft cervical neck collar to bed.  No setting change can fix it.

[willigorilla]

My EPR is set on 3. Positional makes sense. What again are you seeing on the graph that indicates that to you? I would like to learn.

[staceyburke]

We can not see some of the information the top chart is missing. You need to have the rope of events showing so we can see O, H events. 

Positional apnea is shown when there are grouped O or H events.

[RedNailz]

In my case, positional issues contribute to aerophagia.   A soft cervical collar helps, as does sleeping on my back on an incline.   A nasal pillow mask eliminates the aerophagia but it’s taking me a while to adjust to it.

[Sleepster]

You are also having positional apnea.  This shows up where you see Hypopnea or Obstructive apneas clustered together on your chart.  These occur when you are tucking your chin towards your chest.  This causes something similar to a kink in a hose and makes it difficult for the air to get through.  This can be corrected by sleeping on a flatter pillow or by wearing a soft cervical neck collar to bed.  No setting change can fix it.

When your airway is obstructed, the pressure from the CPAP machine can force air into your stomach. This could be contributing to, or may even be the cause of, your aerophagia.

I highly recommend the soft cervical collar.