4 months in - Do I have to live with aerophagia?

[Sleeprider]

I don't know of any way to reduce aerophagia other than reducing pressure. Take EPAP max down to 6.0 qne PS max to 5.0 and let's see how it goes. We are running out of room to do much else.

I merged this last question with your previous thread because they are the same topic and your personal therapy. Keeping things together helps us to see the history and better help.

[CPAPfriend]

Our pressure needs can vary a lot between days, between sleep hours, and so on. Look, for example, at your flow-limit profile on the 7th and the 8th, as well as your 95th percentile. It's clear that on the 7th there was more flow limitation, which could theoretically absorb more of that incoming pressure. This is something you should try to compare retroactively against more days.

Make sure not to eat within 3-4 hours of bed, as doing so can worsen your aerophagia. Additionally, try not to expose yourself to bright lights at night, particularly within 2 hours of bed, as this too can worsen aerophagia. Mouth leaks, too, can worsen aerophagia, and that could be what is causing the leak spikes.

[RedNailz]

Sleeprider, thanks for consolidating my threads and for the settings recommendation.  You confirmed what I suspected after looking at the clinical manual for my machine - there just isn’t much leeway at this point.

CPAPfriend, thanks for letting me know what to compare in my charts.  Also, I hadn’t considered mouth leaks because I thought leaks would wake me up like they used to in the beginning.

I’ll change my settings and see what happens.  And, while I practice intermittent fasting and stop eating 3-4 hours before sleeping,  I do need to avoid bright lights and take time to wind down.

[RedNailz]

Here is an update, 7 months after starting therapy:

I took Sleeprider’s suggestions for my settings and managed to avoid aerophagia.   I even took a brief trip in December (first time traveling with the ASV) and slept great on normal pillows.   I had a visit with my sleep doctor and he signed off on my therapy for the next 12 months.  

After several weeks of successful sleep, I got overconfident and started tweaking my set up.   Pillows instead of the wedge!  Sleeping on my side! Stopped tracking my sleep and using OSCAR! And then I got really crazy and went without the soft c-collar for 2 nights!  Yes, this is what wild living looks like for me       

You can guess what happened:  AHI jumped up, aerophagia came back, and I was waking up at odd times, unable to go back to sleep.   So now I have confirmed that  I CAN eliminate aerophagia, as long as I keep  following my routine.

[Sleeprider]

Good to see you follow-up. Sometimes you can grow out of the need for the SCC and sometimes it just puts you back to square one to take it away. It's really helpful when members come back and let us know how things worked in the longer term. In another thread I'm trying to help someone using an Aircurve Vauto who also has positional apnea and aerophagia which limits our options https://www.apneaboard.com/forums/Thread...AP-therapy Sound familiar? One of the best parts of coming back to Apnea Board is when you can share your experience to help others. Feel free to chime in to share some of that experience with Liz.

[CPAPfriend]

This is interesting and could prove super helpful to future patients. What exactly do you believe is responsible for its elimination? Is a combination of things or is it one specific prop / sleep aid?

[RedNailz]

I didn’t eliminate the aerophagia until the pressure was lowered, but that alone is not enough to keep it away.  There is definitely a positional component, as I learned when I tried not using the collar.  Also, I have to have the incline (though the foam incline pillow is not always required) and must be on my back.   Occasionally I shift to my side and then I feel the air building in my stomach.

My sleep doctor thinks a nasal pillow mask will solve the aerophagia problem completely.  He believes that the collar will be enough to stop my chin from dropping.   My DME is skeptical, but will work with me to try a nasal mask if I really want to.

[CPAPfriend]

Interesting, and thanks for the reply.

[RedNailz]

Final follow-up on this thread (I hope):

For practical reasons, like not being able to duplicate my wedge pillow set up when traveling, I experimented with creating an incline with pillows.  The aerophagia returned and I developed a sore back, possibly from the pillows, possibly from trying to remain motionless, or both.   True, the aerophagia was not nearly as bad as it was, but it still seemed to contribute to some digestive issues.    So I took the sleep doctor’s advice and got the AirFit P10.

There’s a learning curve with the nasal pillows,  but the doc was right about this mask stopping the aerophagia, at least so far.  I’m keeping my sleep position the same for now.   I still wear the soft c-collar and started using mouth tape, which has kept my mouth from opening.