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My husband just got diagnosed with OSA and started using APAP about a week ago. (Overall AHI 8.0, REM AHI 20.4.) You all helped me a ton when I first started my sleep apnea treatment (about 6 years ago), which I hugely appreciate.
He's using my backup AirSense 10 Autoset while he waits for a new AirSense 11 from the DME. Currently he's using Bleep Dreamports while waiting for a ResMed P10 to try out. And he uses mouth tape because as soon as he starts to fall asleep, apparently he opens his mouth (even though he is able to breathe through his nose).
Aerophagia is his biggest problem right now, so he's hoping for some guidance on how to get rid of it. I don't have any personal experience with this, so I'm at a loss. Does this often go away on its own as you get used to the pressure? Should he lower his max pressure for now, and then slowly increase it when the aerophagia is no longer an issue?
I've attached a few nights of data. Any advice and input is much appreciated.
RE: Posting for my husband - new to CPAP, aerophagia
Here's an update:
A max pressure of 9 was still causing painful aerophagia, so for now, he's been using the machine in CPAP mode with a pressure of 8, EPR 3. He also started cutting a small slit in his mouth tape (kind of like Somnifix tape) to let air escape if necessary, but small enough that he doesn't automatically default to mouth breathing. Both seem to be helping a lot. He had just the tiniest bit of aerophagia this morning, without any painful symptoms.
He's also been trying different masks. He liked the P10, but was having trouble getting it to stay sealed when he rolled over to either side. The Bleep Dreamports were too fiddly (but we are both interested in trying the new Eclipse version when it's available). Last night he used my spare N30i mask, and actually really liked it (even though he had tried it earlier and had trouble with the seal). He's got an N20 on order.
I attached a screen shot from last night, which actually wasn't too bad at all. However, he felt like he wasn't getting enough air (possibly needs more pressure with the N30i?), which is why he gave up and took off the mask around 2:30 and slept without it. He's going to try a pressure of 8.4 tonight. I also showed him how to adjust the pressure himself, which he was a little hesitant to do on his own. Hopefully he won't have any more "I quit" moments and can instead adjust in the middle of the night, if needed.
Once the aerophagia has been fully resolved, I will back for input on optimizing his pressure. It looks like he might need more, especially towards the end of the night.
RE: Posting for my husband - new to CPAP, aerophagia
Just wanted to post an update on my husband and hopefully get some additional input.
First, here are his latest equipment and settings:
ResMed AirSense 11 AutoSet
Heated tubing, temperature on auto
Humidifier off
Bleep Dreamports
Pressure range 8.0 - 9.4
EPR 3
He is still struggling with aerophagia every night. The mouth tape with a vent that I mentioned in my previous post didn’t end up working for him, although it was marginally better than tape with no vent. He still had aerophagia symptoms with this tape and sometimes found himself trying to inhale through the mouth vent.
Lately, he has been using the Knightsbridge dual-band chinstrap without mouth tape, which seems to help somewhat, but doesn’t fully resolve the aerophagia either. Part of the problem is that he can’t seem to get the strap positioned so that it stays in place all night and keeps his mouth closed. The strap usually slides toward his neck, and then his mouth can open. If he tightens it enough to keep his mouth closed all night, it ends up giving him a headache. He sleeps on his back and both sides, so he’s moving around a fair amount all night. Even if his mouth stays shut, he sometimes wakes up trying to breathe through his mouth. Mouth tape with the chinstrap makes the aerophagia worse.
He has tried using the machine on CPAP mode with a pressure of 8, and didn't feel like he was getting enough air, so he went back to auto mode with range 8-9, and has lately tried a max of 9.2 and now 9.4. So lowering the pressure further probably isn't going to work.
He is capable of breathing through his nose, but he seems to have a habit of mouth breathing. He’d like to avoid a full face mask if at all possible, but will consider it if nothing else works.
I've attached his last two nights of data. Let me know if you need more info.
Questions:
1. Does aerophagia often resolve itself over time? He’s been using CPAP for about 2 months now. We’re wondering if he just needs to wait it out.
2. The original advice was to lower his pressure, which does make sense, but he is still having aerophagia. Is it possible to have aerophagia because the pressure is too low, rather than too high? His attempts at mouth breathing have me wondering about this, like he’s not getting enough air and is mouth breathing to compensate.
3. I’ve seen advice here and there to try sleeping propped up, like in a recliner or with a bed wedge. It seems like people who benefit from this also have GERD, which he doesn’t appear to have. Can someone clarify whether this is worth trying even without GERD? We have neither a recliner nor a wedge, so trying this would be an additional expense we’d like to avoid if it’s not likely to help.
4. Does anyone have any magic tricks for getting the Knightsbridge chinstrap to stay put? Or is there a better option for keeping his mouth closed – different chinstrap, or completely different method? He doesn’t seem to tuck his chin when sleeping, so I don’t think a soft cervical collar will do anything for him.
