Newbie with extreme swallowing air

[Burrells5]

Please help.  I am miserable.  New to CPAP .  Started last tues.  I have resmed 10 set on auto with range of 4-15 pressure.  I tried nasal pillow first 2 nights and it raised my events.  I woke up jerking and gasping several times.  Switched to F&P evora nasal mask.  At first, it feels like I am suffocating but tried to stick it out.  It kept leaking I think because I move A LOT and when I am on my stomach/side the plastic straps move a bit and looses suction.  I had some gas build up also and tried to pass it.  Nights 4 and 5 used F&P vitera full face.  It leaves the bridge of my nose sore, is so extremely bulky, and I can't see to read because there is a plastic piece that attaches from head gear.  The good thing is my events were 1 or less per hour.  Bad is I get so so much gas built up.  I can barely move, am nauseous etc.  This continues all night.  I have raised my head, taken tons of gasx, pepto, nexium etc.  My stomach muscles are actually sore from so much bloating.  Last night, I switched between the 2 masks 3x hoping to find a way to sleep.  I am trying to keep one on while I am in bed but I am getting just a few hours of intermittent sleep and never over an hour at a time.  I also have back issues and have to move a lot.  I have looked at other masks online but so hard to tell until you sleep with it.  Any suggestions???

[OGBF]

I'm only 6 months in to my CPAP life but in the absence of any other replies for the moment, I can tell you what helped me with air swallowing, also known as aerophagia.

For a start 4-15 pressure is a huge range, often used in the beginning to help dial in the settings that work for you, it's likely your sleep clinic/doctor will want to look at your results at some point and change the settings. I found my aerophagia was reduced by increasing the Expiratory Pressure Relief (EPR) settings on my machine, this decreases the machine's pressure when you are breathing out and in my case reduced the amount of air I was swallowing. Sometimes aerophagia is related to your sleeping position too.

Often the suffocating feeling is because your pressures aren't optimised, once that's sorted things should be a lot better. In my case I almost completely stopped moving about in bed once I got my settings dialed in so it's possible the mask moving/leaking problem will be reduced or solved. Eventually I think my body got used to the therapy and my aerophagia has almost completely stopped.

I would contact your sleep clinic when you can and ask them to review your settings, in the mean time if you have a CPAP machine that has an SD card, you could download the OSCAR software and post the results here for the more experienced members to look at, they'll put you on the right track.

I'm sorry that you are having these problems, please stick with the therapy, it'll get easier soon and, hopefully like me you'll have the best sleep you've had in ages.

[RedNailz]

I have had issues with aerophagia, too.  It can take a while to work through, which exacerbates the frustration that comes with starting CPAP therapy.   None of this is easy. I agree that getting your pressure addressed is the first step.   Then choose a mask and do your best to get it fitted properly and wear it several days in a row.   I watched many YouTube videos about my mask and read tips on this site before I got it right.  I am no expert on this, but if I had changed mask types 3 times in the first week of therapy, I would have made no progress.   It was 2 weeks before I stopped removing the mask during the night.  

Sleep position can make a difference in how much aerophagia you have.  I sleep on an incline and I also wear a soft cervical collar.  I read about what GERD sufferers do prevent symptoms when they sleep, and their tips helped me (like how to sleep on a wedge pillow and not eating and drinking 3 hours before sleep).

Finally, there is a psychological component to aerophagia for me.  The more I stressed about getting to sleep, staying asleep, and swallowing air, the worse it got.  Winding down before I get into bed helps, as does staying off the internet.   Like you, I also read before I go to sleep.  I also learned to recognize the benefit of taking even the smallest steps and making any amount of progress.   You are farther on your CPAP journey now than you were last week.  Just posting here and thinking through your challenges is progress.

[robbob2112]

On the Evora -

Loosen the 4 straps along the sides and the strap over the head.  
Hold the mask to your face where it is comfortable.
flips the straps over your head and attach the lower straps
pull the upper straps until the top of the mask touches and just holds the nose in place.
tighten the lower straps until the mask squishes in at the bottom a bit but not more than 1/2 way.
Latch the top so ot is just laying on your head

Now connect, lay down,  and run mask fit....

If you are getting leaks from the nose area up your cheaks or out tighten the top strap to pull it up.
If you feel like the nose is being mashed from the bottom and reaching for your scalp loosen the top strap.  

Once the top is correct you can tighten upper or lower straps for the leaks.  Now roll side to side and see if you leak.

Over time I had trained myself to fix my mask leaks in my sleep.  Sometimes I am aware of it and sometimes I am not.

I use the Evora verse the F30 because I use the Evora large.  The medium of both pinch my nose and the resmed went wide while F&P went large.


settings wise - the EPR of 3 would help you a lot. 

Also try when you go to sleep to avoid chin tucking - I typically and a side sleeper and try to put my head a little back from straight to open the throat up and avoid tucking.  I hardly move a muscle when I am breathing good.

And it takes a few weeks to get used to the whole thing and for me at least it took a couple of months before I was waking and feeling good.