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Aerophagia is making me lose my mind
#1
Ohmy 
Aerophagia is making me lose my mind
Hi,

I have been diagnosed with an AHI of 33.3 back in June. Started CPAP therapy in July, with a nasal mask. I ended up switching to a full-face mask recently (December 16th, I believe) thinking it would solve the issue, but it didn't.

The problem: I always wake up 30 minutes to 2 hours after falling asleep with the feeling of being bloated, and belly hurt. I end up taking off the mask at that point because it gets painful. My therapy started at a pressure of 8 (back in July), but I decreased it all the way down to 4 and it still gives me aerophagia.

I've done some experiments to try and find out the cause: 

- I can wear the CPAP just fine for 2-3 hours while being awake and lying down (no aerophagia issue - I haven't tried longer but I felt good so called it a day.)
- I don't think I've ever had aerophagia sleeping on my back. It only happens when I sleep on either side (problem is - I'm a side sleeper so supine sleeping is torture to me.)
- My first day of wearing the full-face mask (Dec 16th), I managed to sleep more than 3 hours side-sleeping without any aerophagia issue. So I'm guessing there is something else happening I'm not aware of. But recently I've been having aerophagia issues again with said full-face mask.
- I potentially also have some acid reflux/gerd issues - lots of burping while drinking water and eating food, and sometimes waking up to a small stomach ache until I stand up, which has been a thing all of my life. But it would sound weird to me that this is causing it even though I can sleep on my back just fine, or lay in bed awake for hours without aerophagia.

That's all I can think of. I'm always so tired and low on energy that I'm determined to treat my apnea but this aerophagia just won't let me. Hoping I could find some answers here. As I can only attach 3 pictures, 2 of them are from last night and the 3rd one from two days ago, where aerophagia kicked in as usual. Let me know if you need more data, maybe posting the report of when I slept for 3 hours with no issue may be helpful in finding patterns? Let me know.

Thank you in advance.


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#2
RE: Aerophagia is making me lose my mind
I think soft cervical collar is the solution. Have you tried those?

Also working on your posture should help in the longterm.

I have this rule set up. Every time I leave or enter my room, I do a couple of sets of this excercise. It's very simple and easy.
https://www.youtube.com/watch?v=2xSlX7n-IHw
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#3
RE: Aerophagia is making me lose my mind
(12-26-2023, 12:44 AM)airwaystent Wrote: I think soft cervical collar is the solution. Have you tried those?

Also working on your posture should help in the longterm.

I have this rule set up. Every time I leave or enter my room, I do a couple of sets of this excercise. It's very simple and easy.

Thank you! I have not. I will look into it, as well as the video you shared.

What makes you think cervical collar + posture exercises would help? What do you think my issue is? Trying to get a grasp of what's happening to me.
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#4
RE: Aerophagia is making me lose my mind
(12-26-2023, 01:01 AM)urachan Wrote: Thank you! I have not. I will look into it, as well as the video you shared.

What makes you think cervical collar + posture exercises would help? What do you think my issue is? Trying to get a grasp of what's happening to me.

Basically the thing that separates your esophagus and your trachea is the eppiglottis.
When you have poor neck posture, your eppiglottis will be position abnormally causing cpap air to go into your stomach.

But I am not expert nor experienced on this topic. Let's wait a bit for what others say about this.
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#5
RE: Aerophagia is making me lose my mind
(12-26-2023, 01:10 AM)airwaystent Wrote: Basically the thing that separates your esophagus and your trachea is the eppiglottis.
When you have poor neck posture, your eppiglottis will be position abnormally causing cpap air to go into your stomach.

But I am not expert nor experienced on this topic. Let's wait a bit for what others say about this.

I see, makes sense! 
I've never thought this could be related so just the fact that I get to experiment something new makes me happy. I'll wait for other people's opinions as well, thank you for your much appreciated input!  Thanks
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#6
RE: Aerophagia is making me lose my mind
I'm having the same problem.  Been blaming it on diet, on GERD, etc.  But, I think the CPAP is also doing it. I'm going to try the exercises.  I don't know about the cervical collar....can't stand to have anything around my neck.  Going to also try a flatter pillow to see if I can get rid of "chin tuck."  I'm a retired nurse and when we wanted to pass a tube down someone's esophagus, we asked them to chuck their chin down vs if you wanted to slide a tube down the airway, you pushed the head back, raising the chin.  So, if I want air to go down my airway....chin raised up is the way to go.  I can see how the collar might help.  Maybe I can try one and get used to it.
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#7
RE: Aerophagia is making me lose my mind
I’m new to this (only 6 months of pap therapy) but here is what has helped me with aerophagia:

-Soft cervical collar:  I started using it to prevent jaw drop based on advice here, and then my sleep doctor said it would keep my neck in alignment and help with the air swallowing.

-Incline sleeping: The doctor told me raise the head of my bed, which is not practical for me, so I experimented with pillows and got some improvement.  I bought a foam wedge pillow and it helps, but there was definitely an adjustment period.   

-Back sleeping:  If I sleep on the pillow arrangement and shift to my side, I can feel the air building up in my stomach,  so I have to sleep supine.  Plus,  this is the only way I can sleep on the wedge.    

-No eating 3 hours before bed.

-Lower pressure:  This is the only thing that eliminates, or nearly eliminates, the aerophagia.  Between this and sleeping on my back, AHI is higher than it was, but it’s still less than 5.

If I do have air issues in the morning, sipping sparkling water relieves the pressure better than anything.  I wish I knew this before buying the giant bottle of GasX at Costco!

I was at the sleep doctor this week and he insists that I try a nasal mask.   He believes it will really help, and doesn’t think my concern about jaw drop is valid.  We’ll see.
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#8
RE: Aerophagia is making me lose my mind
So, based on the cervical collar advice I got I've been trying to adjust my sleeping positions the past 2 days and so far so good, haven't got any aerophagia. Could be just good luck, but I feel confident this might be the answer:

Basically I normally tend to sleep with my chin close to my chest in a probably very unhealthy way. The past two days, I've been forcing myself to keep my neck nice and straight (as if I had a cervical collar) and this seems to do the job. No upset stomach. This probably explains why I could sleep on my back just fine (straight neck) but not on the side (curl up)

It may be too soon to claim victory but that's a nice step forward, and I can still go the cervical collar route if it's not enough.

Now, my issue is that I can't sleep for more than 2-3 hours straight without waking up, is this normal?


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#9
RE: Aerophagia is making me lose my mind
What model soft cervical collar is everyone using? How hot are they?

My wife sleeps with the electric blanket on and tons of covers, I sleep with just a sheet or uncovered and I still sweat.
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#10
RE: Aerophagia is making me lose my mind
(12-30-2023, 11:27 PM)urachan Wrote: So, based on the cervical collar advice I got I've been trying to adjust my sleeping positions the past 2 days and so far so good, haven't got any aerophagia. Could be just good luck, but I feel confident this might be the answer:

Basically I normally tend to sleep with my chin close to my chest in a probably very unhealthy way. The past two days, I've been forcing myself to keep my neck nice and straight (as if I had a cervical collar) and this seems to do the job. No upset stomach. This probably explains why I could sleep on my back just fine (straight neck) but not on the side (curl up)

It may be too soon to claim victory but that's a nice step forward, and I can still go the cervical collar route if it's not enough.

Now, my issue is that I can't sleep for more than 2-3 hours straight without waking up, is this normal?

Currently experiencing the same thing starting my pap therapy. It could mean that your body is adjusting to better sleep. Again, I am not an expert. :Big Grin  But I tend to feel better even with less sleep and pap therapy
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