[CPAP] New to therapy and CPAP, Aerophagia issue

[Aplar]

Hi there,

As the title says, I am new to CPAP and the therapy to combat my sleep apnoea issues.

Results so far:

• Better time waking up
  
• Throughout the day, a bit/not much difference
  
• No real issues sleeping with the mask on (not waking up in the night, sleeping through the night, and no leaks)
  

Problem:

• Bloating and gas in the morning (aerophagia)
  
• Stomach pain to the point I would wake up at night and feel super bloated (fall asleep right after)
  
• Extreme gas in the morning
  

After the first night, I increased my lower pressure and set the EPR level to max (3). The next night, I noticed a slight improvement in terms of aerophagia - the bloating wasn't as noticeable, but the extreme gas persisted.

After increasing EPR, I also noticed that my AHI score went up a little bit, and CA events increased as well. I was worried about the CA events but read that they are fairly common for new CPAP users while the body adjusts for the first couple of weeks. I also slept a fair bit longer so this could change everything a bit. I still wonder if the increase in AHI and CA events is related to my EPR adjustment, although it seemed to help a bit with aerophagia.

Additional info:

• At night, I was a mouth breather and drooling a lot pre-therapy (never mouth breathing during the day).
  
• CPAP helped me with this; my allergies/nose are much better through the night, helping me breathe through my nose only.
  
• Previously, when I hit the pillow, I would immediately start mouth breathing and drooling even before falling asleep. Now, I can at least fall asleep with my mouth closed.
  
• I still open my mouth a bit throughout the night, mainly when on my back, but it's much less compared to before.
  

I am attaching my Oscar data from past three days.

I have spent a lot of hours learning Oscar and reading posts on this forum and Reddit about these and other issues, but I would appreciate your tips/advice or a review of my data - thank you in advance!

My gear:

• AirSense 10 AutoSet
  
• Full Face CPAP Mask by Fisher & Paykel
  
• HumidAir™ Heated Humidifier Air10
  

           

[Jay51]

Welcome to ApneaBoard, Aplar.  

The first thing that I see is leaks that occur all night long (the entire length of your therapy).  The best 1st thing to try would be to reduce these leaks (and then your data will be more accurate).  Here are some tips to try.  Try these and post again and see if your OSCAR charts look better.  

Mask Primer

[paulag1955]

If you had CA events during your sleep study, you may find that you'll get better results with fixed pressure, however, you need to resolve your mask issues before making any decisions concerning pressure settings.

[Aplar]

Thank you very much for the replies

Regarding mask leak, I have read in few places I think on manufacture website that for my full face mask anything below <25lpm is very good and looking at my data it seems to be 100% below that threshold all the time.
Is that information incorrect?
If so, what could I do to help with reducing lpm even further? I found the tightest fit I could get with the CPAP pillow and didn't feel any leaks throughout so based on that and information from manufacture I thought I am doing okay.

I will also be looking and reading into setting up fixed pressure, just not sure what would I set it to yet.

Again cheers for trying to help out and looking at all of this!

[paulag1955]

Right, any of those leaks wouldn't be a concern on its own, but you're leaking all night long. That is a concern.

[Jay51]

paulag1955 hit the nail on the head.  Even though you are below 24 (or 25L/Min like you have read); your leaks continue all night long.  That is certainly affecting therapy.  Reducing them would help.  A suggestion is to put most of your energy into solving these "all night" leaks first to see how much your therapy improves after the leaks are improved.  Have a read of the "Mask Primer" link provided in the post above; as it has many tips to reduce leaks with your current mask.  If these tips don't work, you may have to find a better mask.

[paulag1955]

For comparison's sake, I'm posting a graph of what kind of leaks one might expect with a well-fitting mask.

   

[Aplar]

For comparison's sake, I'm posting a graph of what kind of leaks one might expect with a well-fitting mask.

Looking good, nice one thanks! 

Is that same type and model of mask that I have?

[paulag1955]

No, I'm using a ResMed P10, which is just the nose piece and a small strap. But you should be able to get the same kind of results.

[SarcasticDave94]

Hopefully a helpful bit of info, despite you not mentioning about it, no mask should be adjusted so tight that it is uncomfortable to wear. Tightened too much and the force will distort or crush the cushion, causing more leaks than less.

Still on the Vitera? Try this:

loosen all straps

hold mask to your face with CPAP on

position mask as low as you can while still sealing below your mouth

fasten over the head strap

next, fasten the lower set moderate tension

last is the top set, go fairly light

next, without undoing any strap pull mask straight up and off your face then reset, paying close attention to the nasal bridge area to make certain there's no folded over cushion material

Note top side leverages against to lower mask section and vice versa...too tight bottom pulls mask off nasal bridge