[Symptoms] Aerophagia relief?

[pnfog]

I'm on the forum searching because I woke up this morning with horrible cramps in my diaphragm (that's what it feels like).  I've had this off & on for years.  It's actually what made me put off using the cpap for over a year.   However with some motivation, I have been on cpap for a year now with mostly good results.  I don't wake up rested yet but I'm not waking with what used to feel like a stove in side of my head, for lack of a better description.  

Every few weeks or months I have milder versions of what I had this morning & EVERY doctor I have mentioned this to looks at me & says, "That's odd" and that's the end of that particular part of the conversation.    I found "aerophagia" this morning googling while waiting with a heating pad on for the diaphragm to relax/doctor's office to open.    The nurse gave me the same response and I have yet to hear back as to any suggestions from their office.   Today I'm still feeling the cramping at the end of the day & I'm nervous about sleeping tonight.

From what I've read this morning, I understand aerophagia can result from too much OR too little pressure.  How does one know?
My settings are 10-12 with a ramp up starting at 4.  I do wake at least a few times every night to ramp it down.  This makes it sound to me like perhaps too much.   I just checked my machine & see a FLEX feature with a range of 1-3.  I'm at 3 & it sounds like that is the setting that is intended to provide the most relief.

I've recently figured out how to load the software from my cpap into Oscar but am not sure how to post the readout.   I just tried & my preview was solid code.   So I would appreciate a gentle poke in the right direction for how to do that.     For for the life of me, I'm really not sure what I'm looking for with Oscar.  My numbers seem good, but why am I waking with such pain?  My next compliance visit is in October and I'm not really expecting much from my doctor's office just now.

Just looking for suggestions right now.
thanks-

[OpalRose]

Aerophagia is the swallowing of air. This can be very painful. Most of the time, folk will try a lower pressure to see if that helps. Also, a Flex setting of 3 will be the least helpful. flex just does not give the same relief as EPR in a ResMed machine. For now, try setting your Flex to 2.

Please post a screenshot of the daily page. If we can see what’s going on, someone can advise on a pressure setting that may give some relief.

Follow the links in my signature line.
Pay attention to the organization of your chart. (Daily page)
Then use the attachment feature to post your data here.

[pnfog]

Thank you.  I think I've followed you well enough to post this.   I'll give a try to lowering the flex setting to 2.     I'm sorry, but I'm not sure what you mean by pay attention to the organization of my chart.   If I don't have the pertinent data displayed, I can edit as needed.

[sheepless]

just a comment as I have no particular relevant expertise.

in my experience excessive belching and passing gas is the hallmark of aerophagia. minor instances last a few hours in the morning after cpap. more serious instances last longer, include cramping and may be quite uncomfortable, even painful.

you mentioned cramps but not the movement and expulsion of air. that and the fact that you say you had this for years before cpap leads to the suspicion that it's something other than aerophagia.

otoh, while I have not experienced it, others on this site have complained about chest and/or lung discomfort with cpap, unrelated to aerophagia, and rather something to do with the effort of breathing with or fighting the machine (not sure I remember the upshot of those threads). but that doesn't explain why you'd have it before cpap either.

[Gideon]

If Flex= 2 doesn't work try Flex = 1.

If that doesn't work post your OSCAR dailies and ask if your pressure can be reduced for a while. That is a tradeoff that usually results in an increase in obstructive events, but it isn't always a significant amount and if we can for a while at least get rid of your aerophagia the trade-off is a good one. Then after a period of time we can increase pressure and your threshold for aerophagia would be higher.

[SarcasticDave94]

Make sure to include the right side with the various graphs. I swallowed air at times when I first started therapy. I don’t know how, but after a bit of time it ceased to be an issue for me.

[OpalRose]

Your chart should look like this:

[attachment=14489]


The instructions are in the second link in my signature line. (Chart Organization)

[pnfog]

I've added the attachment.  attachment=14490]

The numbers look very low to me but I'm not positive what I'm looking for. 
When I said that I've had this symptom for years, that wasn't very clear.   When I read about aerophagia it has more than my experience.  I wake up with a cramping diaphragm.  I can't say that belching or flatulence are a big issue (tho I wouldn't say they are nonexistent either) -- it's just that I have had bouts of intense diaphragm cramping off & on at extremely irregular intervals (I can go years without having it happen & then it pops up for a day).  What I meant to add here too is that I've had issues with breathing all my life (in a "can't quite catch my breath" way) these days it's always first thing in the morning and typically resolves with a little heat.  Not today.  

For background: i am 57, average height (5'6") and at my heaviest weight of close to 130.   For a long time I was well under 120.   This seems more related to a narrow airway for which I had surgery for 4 years back.  That helped with my waking in the morning out of nightmares, gasping for air but moving to a new life at altitude has not helped the airway.   Every few weeks I wake with a cramping diaphragm but it seems to ease within a while.   
I do have a sense of fighting the cpap (the blowing) when I put it on but i can typically tolerate it sufficiently to fall asleep.  I'm not sure about the expulsion of air part.   I'm really not clear on that.   Would this have anything to do with blood tests that show up a bit of an excess carbon dioxide?  That's been a very slight flag on my blood test the past 2 years that I've never noted before.

I'll try ratcheting down the Flex to 1.

[sheepless]

by expulsion of air I just meant (excessive) belching and flatulence.

it sounds like your breathing might have required some effort prior to surgery. if you still have to work at it sometimes, maybe that's a factor.

to my way of thinking, the effect of heat also suggests something muscle related more than aerophagia.

[OpalRose]

Just curious, have you tried a straight pressure? Put your machine in CPAP mode.
Set to a pressure of 9. Set Flex to 1.

I’m just thinking more for comfort, and limiting the pressure spikes.