gettingbetter - Therapy Thread

[Aurelius]

Perhaps a chin strap might help with the aerophagia.

As for getting rid of gas, carbonated water might get things moving.

[Sleepster]

I also had aerophagia really bad when I first started therapy. For most people it subsides as we adapt to the CPAP therapy. My pressure is much higher than yours, which is perhaps why they switched me to a BiPAP (also known as a bilevel or VPAP). I also had to lower the pressure.

I would recommend that you go ahead and set EPR to the maximum setting of 3, even though you won't get 3 cm of pressure reduction on exhale unless your pressure is set to at least 7 cm. You also want to try to set your pressure as low as you can. I realize that a lot of people feel starved for air when the pressure is set to 4 cm, but I don't understand why. We go around all day breathing at a pressure of zero.

I also found that exercising in the morning is a good way to burp up some of that swallowed air. I rode my bicycle, but I think anything that gets you moving will do the trick.

We had a member here, RobySue, who also happens to be the author to the SleepyHead guide (SleepyHead was the predecessor to OSCAR) who had a very low pressure similar to yours and suffered from aerophagia. She used an auto-adjusting BiPAP.

I found that positioning my neck correctly would help. I know the conventional wisdom is to keep your neck straight to allow the inhaled air to go into your lungs instead of your stomach, but I found I had to do the opposite. I had to tuck my chin against my chest. Not a comfortable position but it was something I tried with some success for awhile. Getting the machine I have now is what really worked for me. It allows me to keep the pressure low for most of the night, rising only when needed. And the exhale pressure (EPAP) is always 4.4 cm lower than the inhale pressure (IPAP).

[gettingbetter]

Sleepster:  

How long did it take your aerophagia to settle?  Thanks!

[Sleepster]

Sleepster:  

How long did it take your aerophagia to settle?  Thanks!

A few weeks. Everyone is different, though.

[gettingbetter]

Thank you, everyone, for all of your advice.  It is greatly appreciated!  I have an appointment with my physician tomorrow to rule out other reasons for the symptoms.  Hopefully it's just aerophagia from CPAP but better to be safe and get it checked out.

[Rice95]

I had it really bad initially and it has taken a few weeks to get to where I don't have it at all. Adjusting the EPR and pressure was the key thanks to Opal. Now I'm up to a pressure I would have never thought I could handle. Weening away from Ramp wasn't as hard as I thought either. Took a few weeks but I'm off.

I also run every weekday morning within 30-45 minutes of waking. Running is a great way to get your body moving---if you can't run, then walking regularly is very good. 

[gettingbetter]

I want to sincerely thank each one of you for your responses and support.  It is greatly appreciated!!  This is an amazing community that I'm thankful to be a part of.  I have become increasingly dismayed at the medical community's general lack of willingness to be involved in the inner workings of PAP therapy.  My experience with my physician thus far has been disappointing.  If you have a physician that partners with you and will discuss Oscar details, you are very fortunate.  I'm searching for one, but they are hard to find.

I'm still experiencing a lot of of what I assume to be aerophagia.  I had some medical testing today (thanks for the suggestion cathyf!).  The big, scary things were ruled out (no pancreatitis, etc).  But I need to have further GI workup (and probably an EGD) to look at the LES, etc.  I'm also going to have a urea test for H Pylori (causes ulcers).  Just basically looking for any other medical reason to have this severe bloating.  My symptoms just seem worse that what a typical aerophagia would be.  Or maybe it's aerophagia, and I am a whiner lol!

Have a great night everyone!

[Rice95]

Good Morning! Keep us all posted ! 

[always_tired]

I posted the same question. I've been dealing with it for over 12 years. The following is what everyone recommends:

1) Either you are a mouth breather, such that you are breathing through your mouth at night and when you do, air is going into your esophagus.
2) OR, you have a "weak" for lack of a better term, upper esophogeal sphincter, and air simply goes into your esophagus.

So there are 3 things you can try.

1) Sleep with your head raised up so your chin is tucked into your chest. Sounds difficult, actually works, but is difficult to turn into a habit of sleep over time. That closes the esophagus.
2) If you are mouth breather you can try two things:
A) Get mouth strips that tape your mouth shut. Somnifix is a brand.
B) Try a full face mask. That Resmed Airtouch F20 is popular.

Me:

I could never learn to tuck my chin.
I do sleep on an elevated mattress on an electric base, that helps.
I sometimes experience terrible pain within a few minutes of starting CPAP. I'll sit up and burp and burp and burp for 30 minutes.
The things that made the most difference for me were to 1) elevate my mattress, 2) to use the full face, 3) take Tums and Gas-X hours before bedtime.
This makes the pain mild to moderate.
When the air builds up, about every two weeks or so I have to decompress. So I have to sleep a couple of nights without the CPAP and reset.

Personal note: I couldn't tolerate the EPR. I was sensitive to what many people never notice, which is a slight pulsing of pressure. I don't use EPR.

[Rice95]

One word of caution...If you sleep with your chin purposely tucked into your chest your OA's are going to go nuts. Your chin must be AWAY from your chest.