Belching as we speak........

[littletigercat]

So today makes 6 nights i believe. i am using an ASV? machine. not as bad as i was anticipating - sleep for a full 6 hrs the first night as opposed to 2-3 hrs before machine. seems i have been averaging 6-7 hrs which is nice. i do have a question though about air. i have been waking up every morning with a fullness or heaviness, almost a dull soreness in my chest. i read somewhere that this is possibly from all the actual breathing i am now doing at night, using muscles etc that haven't been used or used so vigorously in the past. the big issue is GAS!!! only belching -thank goodness, but still, i am belching nonstop - all day until i go to bed. belching like a beer drinking sailor. not very attractive and somewhat annoying too. any ideas how to combat this issue? i am a side sleeper, have made a conscious effort to sleep with my mouth closed. i use the humidifier on the unit, cranked up to about halfway. when i went for the sleep studies, they said the cpap and bipap were not helpful so i ended up with this ASV. i do not have any health insurance at the moment so my doctor referred me to a local pharmacy/medical equipment supplier. they said someone just traded this machine in (which evidently is rare for this type) and donated it to me. i believe the sleep study doctor said i should be at 14 pressure but since this is an older machine it only goes up to 10 which is what we are trying. i'm supposed to go back next week or so to get some kind of pulse/oxygen thing to see if it is working for me. that being said, any ideas at all on the belching thing? thanks!

[justMongo]

I am not well acquainted with ASV machines. I believe 10 is the baseline pressure; and the ASV can push air, with a pressure above baseline, at a timed rate to ventilate a person with CA. Since it's expanding the intercostal muscles, some soreness appears to be a common complaint at the start of therapy. A few people complain of aeropaghia with all types of PAP machines. Someone who has experienced it will come along and relate their experience. I think it has to just be tolerated -- but, I am not sure.

BTW -- the "some kind of pulse/oxygen thing" is a recording pulse oximeter that clips on the finger and passes two wavelengths of light through the finger. Oxygenated blood is red; and deoxygenated blood is blue. By measuring the differential transmissivity, it measures the percent of oxygen saturated hemoglobin. Long story made short: It will record your blood oxygen levels during the night; and tell the doctor if your machine is doing a proper job.

[Ghost1958]

My wife when she first started had a terrible problem with gas. Belching wound have been good but hers was the distended belly pain etc type. At pressures of 10 max and 7 min. Shes self treated so we were on our own dealing with it.

First thank your lucky stars its only burping. Tips that worked for her some of which may not be possible for you with your type apnea and some that may.
We reduced her pressure for two weeks to let her get used to the machine and set her flex on aflex with maximum exhalation relief.

A difference of .5 cm raise could bring back the problem for a while. But she gradually got past the painful distended belly thing and to the burping stage. She still does that but can run enough pressure to bring her AHI down to under 1. But she doesnt need that much set at min 8 to 12 max and rarely goes above 9.5.

To help stop the burping all day get some carbonated water or the like that you like and drink that first thing in the morning. It helped her to get rid of the gas pretty quickly in the am instead of burping all day. Yes you will sound like a ships fog horn four or five times in the am but after that most of the gas is gone. Or was for her.

She still wakes up with a few burps every morning but no longer needs the carbonated water.

It seems that your body will get more resistant to the problem but if you have a night of bad post nasal drip etc and swallow a lot you will swallow air.

Another trick she learned was if she had to swallow while awake was to time her swallowing so that she swallowed right at the end of an exhalation while the Aflex had her pressure dropped, then inhale. Helped alot with awake swallowing not so much if she swallowed in her sleep or half awake where she didnt think of it.

It can be managed to an extent. And most tend to get better with it that have the problem over time.

I can tell you the goal is to not worry so much about the burping and do your best to just stay at that stage. You need to get rid of the gas by burping. The effect is cumulative if you dont over days it will go deeper causing distended belly and passing gas out the other end LOL.

[3porpoise]

Welcome littletigercat. That's great you have an SV. Would you mind please , giving us the the ref # off the back of the blower unit so we know which generation the machine is , so we could make additional suggestions. It's good they are going to use the pulse oximeter to make sure the treatment is sufficient.
I also use the ASV . When titrated, the sleep techs advised me to really watch mask leaks as the machine ramps quickly in response ,which of course can effect us if we're sensitive to increased pressures. Make sure you mention chest soreness to your sleep Dr./ respiratory therapist , it may be breaking in period ,however it's better to err on the side of caution or have other health issues. Do you find the belching eases the chest discomfort ?
3

[DeepBreathing]

G'day Littletigercat. Not sure what to do about your gas problem, but Ghost's suggestions seem very sensible.

The fact you're on an ASV machine probably means that you have central (or mixed) apnea or Cheyne-Stokes respiration. Unlike obstructive apnea (when the airway is obstructed by soft tissue and effectively chokes you) central apneas occur when the brain stem doesn't send the "breathe now" message to your lungs and diaphragm. This requires a more sophisticated machine which will provide support on a breath-by-breath basis. There is a pretty good explanation here: http://www.resmed.com/assets/documents/t...ow_eng.pdf

Because of the way these machine are set up they need a bit of specialised knowledge - they can't just be set at a single optimum pressure like straight CPAP. Depending on the model they need a range of different parameters set and monitored. Unfortunately Resmed's naming conventions for the S9 are a mess, with machines known by different names and model numbers in different localities. As suggested by 3porpoise, please give us the model number so we know which particular model you have.

Best of luck.

[Amie87]

I personally have a CPAP but have found that while I'm awake, if I need to swallow, I push my tongue up to block the air coming down from my nose and swallow on an exhale, it's much easier. I don't need to wait until the end, but I usually do it after half way.

I've also heard the positioning of the head can make it better or worse. When your head is tilted up, it's much easier to swallow, when your head is titled down, it's harder to swallow. (Try it while awake, even sitting up). So it makes sense that when you are sleeping, try to have your head tilted down slightly. (Don't go doing some weird yoga pose or something!) But yeah, it makes sense to me but I've never had to try it. As long as you are not trying to push your chin on her chest, it shouldn't cause any discomfort with your neck and may help.

[littletigercat]

well, i tried drinking the club soda upon awakening and it seemed to help a bit. pain in the chest feels ALOT better so maybe it was indeed a breaking in period that i needed. still sleeping roughly 6 or 7 hrs a night. i believe i could probably sleep longer if i can just get myself into the bed earlier but prior to having the machine i was going to bed very late as to avoid sleep. i looked at the back of the machine and it says #26008. so i guess it's the Resmed with humidifier. as i said, it was a donated machine so i'm sure it's an older model but it seems to work fine. i guess i will find out when they give me the pulse oximeter to check my oxygen levels. biggest problem otherwise is every night it seems as soon as i mask up and turn the machine on, my nose gets itchy LOL. another question i just thought of - i've been trying to keep my mouth closed and only breathe through my nose. my nose gets stuffy alot just from allergies or whatever, i don't know, but if i am managing to still keep my mouth closed, even though my nose is stuffed up, am i sure the correct amount or enough air is getting where it needs to be? btw, thanks for all your responses - i really appreciate them!

[Sleeprider]

The ingestion of air as a consequence of positive air pressure is fairly common. Air pressure, can exceed the Lower Esophageal Sphincter (LST) pressure thresholdj, allowing air to enter the stomach. Doing a search on that term, and on that term in conjunction with CPAP will return many results that can help you explain the problem, and consult with your doctor.

There are things that can weaken the LES like smoking and GERD. Problems with bloating due to LES bypass can be resolved with lower pressures that do not exceed the LES threshold. It is not an easily solved problem, but the more you learn about it, the better off you will be in finding a solution.

[3porpoise]

well, i tried drinking the club soda upon awakening and it seemed to help a bit. pain in the chest feels ALOT better so maybe it was indeed a breaking in period that i needed. still sleeping roughly 6 or 7 hrs a night. i believe i could probably sleep longer if i can just get myself into the bed earlier but prior to having the machine i was going to bed very late as to avoid sleep. i looked at the back of the machine and it says #26008. so i guess it's the Resmed with humidifier. as i said, it was a donated machine so i'm sure it's an older model but it seems to work fine. i guess i will find out when they give me the pulse oximeter to check my oxygen levels. biggest problem otherwise is every night it seems as soon as i mask up and turn the machine on, my nose gets itchy LOL. another question i just thought of - i've been trying to keep my mouth closed and only breathe through my nose. my nose gets stuffy alot just from allergies or whatever, i don't know, but if i am managing to still keep my mouth closed, even though my nose is stuffed up, am i sure the correct amount or enough air is getting where it needs to be? btw, thanks for all your responses - i really appreciate them!

Glad the soda seems to be helping as well as your machine. I tried to find the manual and read about your machine to relate setting parameters but haven't found it yet... hopefully someone else comes along .Sorry I can't be of more assistance in that regard.
I had to lower treatment settings and stay off sleeping on my back in order to find the balance between treatment and air.
As for stuffiness, I've read folks use a saline nasal rinse at night , think there's different brands at the drug stores.
Hope this helps. All the best and let us know how you're making out.
3

[Rivky]

well, i tried drinking the club soda upon awakening and it seemed to help a bit. pain in the chest feels ALOT better so maybe it was indeed a breaking in period that i needed. still sleeping roughly 6 or 7 hrs a night. i believe i could probably sleep longer if i can just get myself into the bed earlier but prior to having the machine i was going to bed very late as to avoid sleep. i looked at the back of the machine and it says #26008. so i guess it's the Resmed with humidifier. as i said, it was a donated machine so i'm sure it's an older model but it seems to work fine. i guess i will find out when they give me the pulse oximeter to check my oxygen levels. biggest problem otherwise is every night it seems as soon as i mask up and turn the machine on, my nose gets itchy LOL. another question i just thought of - i've been trying to keep my mouth closed and only breathe through my nose. my nose gets stuffy alot just from allergies or whatever, i don't know, but if i am managing to still keep my mouth closed, even though my nose is stuffed up, am i sure the correct amount or enough air is getting where it needs to be? btw, thanks for all your responses - i really appreciate them!

Hi, I use a BiPAP and have similar problems. You can try taking Nexium (esomeprazole ) or Prilosec(omeprazole). I take the latter occasionally & find it a big help when the gas gets really bad. Discuss these symptoms with your doctor & respiratory therapist. But do not be embarrassed to relieve the gas the old fashioned way.