[Pressure] Aerophagia and chest soreness

[favosys]

Hello I'm new to this forum and fairly new to this CPAP stuff and OSCAR.

I have an AirSense 11, been using it for about a month and a half. My AHI went form 55 to under 5 so that's good.

About 3 weeks ago I started getting strong Aerophagia, woke up very bloated with a ton of gas, some pain even. My machine was initially set up to pressure Min 4 - Max 20 so I talked to my Dr, she said she would talk to the machine people to reduce the pressure. After a few days it wasn't reduced, I then had an appointment with her, she said she had asked them to reduce to Max 15 or so and that she called them and that it would happen that day... never happened. 

In any case I reduced it to 4.2 - 15.2 (couldn't figure out how to set it to .0). Since then the Aerophagia has greatly improved but it still there, I still wake up with a little bit of gas.

My other concern is a bit hard to explain, it's like chest soreness. I feel like everyday I wake up with this chest or lung soreness, I'm not sure if I'm bloated, it feels a little different. It's not strong pain, it feels like residual soreness. I have also been trying to do exercise and diet so I thought it may be related to that but if I stop the exercise or the diet it doesn't go away.

For example last night I woke up at 3:45 am with a bit of gas and back pain and the chest soreness so I turned off the machine and went to sleep normally and woke up with no aerophagia an no pain.

Maybe I should mention that I have recorded myself sleeping since I got the machine. Without it I would snore like crazy and move around a lot. With it I don't snore, don't move, don't shift, don't make a sound, basically sleep like a baby. I don't feel any different in the morning, I don't feel better or more rested. I feel the same but with the gas and slight pain.

I downloaded OSCAR and started recording but I'm not sure what it all means. Also usually you search something on YouTube like cpap mask fitting or can't breath or whatever and you find something but I didn't find anything about chest pain.

HELP 

[OpalRose]

.........I have recorded myself sleeping since I got the machine. Without it I would snore like crazy and move around a lot. With it I don't snore, don't move, don't shift, don't make a sound, basically sleep like a baby. I don't feel any different in the morning, I don't feel better or more rested. I feel the same but with the gas and slight pain.

The snore graph suggests differently....  it shows quite a bit of snoring.

Snores indicate you may need a higher "minimum" pressure.  A pressure starting at 4cm  
is likely causing you to work much harder at breathing than is normal.  You simply aren't getting enough air.  This over-working of your chest muscles is what causes that chest soreness.  This is a common issue when first staring out.  

Your median pressure is around 12.  Your minimum pressure should be closer to that.  
I very seldom recommend folk use the ramp feature, but in your case may be helpful.

Set Ramp at 7cm for 15-20 minutes.
Set the minimum pressure at 10cm.
Set the maximum pressure at 13cm.  (I don't believe you need higher)  
Set EPR to 2 (full time)

This will keep you at a much narrower pressure range and help with the chest soreness and hopefully keep Aerophagia at bay.

[WakeUpTime]

The above advice is excellent, of course, coming from OpelRose.

Personally, I've extended the ramp to 30 or 45 minutes; not so much for the first shift, but for one's middle night wake (if they get them) when it's a little more difficult to get back to sleep.  Ideally, there'd be an external ramp button that one could hit multiple times per X amount of add'l increments of minutes.  

Regarding bloating, be careful of what you're eating near bedtime, or within 2-4 hours of bedtime.  Be careful of carbinated drinks, beer, or any other items that might produce extra air in your stomach.  I've had a couple of serious nights of extreme bloating issues.  Never had them much before.  One I blame on eating a lot at an event and sitting the entire afternoon and evening.  The other I blame on drinking 3 soda cans in the later evening.  

But you mention "chest" rather than stomach, so this may not be relevant to you. Having the above suggested max capped at 13 may help a lot with that.

[favosys]

Set Ramp at 7cm for 15-20 minutes.
Set the minimum pressure at 10cm.
Set the maximum pressure at 13cm.  (I don't believe you need higher)  
Set EPR to 2 (full time)

Thank you very much.

I remember turning off the ramp feature a week or two into treatment because I saw a a couple of videos on YouTube suggesting turning it off. I will turn it back on, I remember it had a time setting, I don't remember a pressure setting but I will check.

I will set the pressure as suggested but what is EPR if I can ask?

[favosys]

Personally, I've extended the ramp to 30 or 45 minutes; not so much for the first shift, but for one's middle night wake (if they get them) when it's a little more difficult to get back to sleep.  Ideally, there'd be an external ramp button that one could hit multiple times per X amount of add'l increments of minutes.  

Thank you, does the machine detect the ramp automatically? What I mean is if I wake up in the middle of the night and take my mask off to go to the bathroom and I come back and put it on does the machine know and start ramp again? Or do I have to do something like turn the machine off and on again or something? Like you say it only has one button hehe.

I have heard eating before sleeping can cause bloating so I'm working on reducing that. The pain is hard to explain, it's like in the rib cage, it's like I was in a wrestling match a week ago so it's not strong, it's not constant but when I wake up I feel it and during the day certain positions in bed or in a chair I feel it.

[OpalRose]

EPR (Expiratory Pressure Relief)

Using EPR drops the pressure by 1, 2 or 3 cm. of pressure on exhale, depending what setting you use. Example: minimum pressure of 10 with EPR set at 2 gives you an exhale pressure (EPAP) of 8cm.

This not only helps with breathing against pressure, but helps lower Flow Limitation and Hypopnea. The downside in some folk is that it may cause clear airway events to rise. This is something to watch. Sort of a balancing act.

How you feel is more important than AHI numbers.

[favosys]

Using EPR drops the pressure by 1, 2 or 3 cm. of pressure on exhale, depending what setting you use. Example: minimum pressure of 10 with EPR set at 2 gives you an exhale pressure (EPAP) of 8cm.

I see thanks again.