Unexpected Aerophagia

[michael9346]

In November 2016, I decided to get a sleep study done before I retired in April of 2017 as my healthcare plan took care of the cost. Immediately after retiring we moved half way across the country to be closer to our kids, grandkids & great-grandkids. I was told after we moved, our new state would not honor our sleep study prescription as it was ordered by a NP and not a doctor. (lost my doctor due to Obamacare) Due to delays getting Medicare B coverage I finally took my 2nd test 13 months later.

For some reason and I am sure it's quite possible, my first test was AHI 29.4 with minimum pressure set at 7 cmh2o and the second test taken a year later was AHI  34.1 with minimum pressure set at 12 cmh2o. My machine was set at12 cmh2o. After awhile through the fine help of this forum, my numbers were great.(mostly <2.00) Then recently for no reason that I could figure out I started to acquire bouts of aerophagia. It started to get severe and lead to intense bloating, severe diaharrea and dehydration. I sent an e-mail to the doctor but as expected, no response. 

I know most aerophagia is caused with higher pressure and mouth breathing or mask leaks so I discontinued my nasal mask and now only use either the F20 Airtouch or Airfit mask. I also decided to try my first sleep study's number of 7 cmh2o. I slowly backed down to 7 from 12 over a weeks time. I started to use A-flex and first set it to one and then a few days later to 2 and increased my pressure to 9 to compensate for the flex. I also elevated my headboard 4 inches and things are seemingly improving. My AHI has been mostly <2.00 again for the last 5 days. I've attached todays numbers just in case anyone may have any more suggestions. I still have smaller instances of aerophagia, but they are much improved from where they were and I know they do no harm. I do use a soft cervical collar and it didn't help the aerophagia.

[Sleeprider]

In this graph, your pressure is effectively 9.0 to 10.0 and AHI is still less than one. If this is representative, I think you can safely lower max pressure from 18 to 10 or 11 at most, and experiment with lower minimum pressure. Most of what you have done is solid titration, and resolving aerophagia is often a matter of compromise between the AHI and air ingestion. In your case, this narrow pressure range, or even fixed pressure at 9.5 looks pretty good.

[michael9346]

Thanks Sleeprider. I will lower the maximum pressure and see where I can go with lowering minimum as well. As I said in my post I was completely surprised I functioned fine on the lower titration than the higher newer one. The most important thing is I seem to sleep better. Now if I could only sleep longer....Mike