+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: aerophagia (/Thread-aerophagia--31034)
aerophagia - jerry1967 - 12-02-2020
Does anyone have any ideas that would help me with aerophagia? My wife is complaining because I am burping all the time. I have looked on here and read about lifting my head up with my bed and that really helped with my centrals and hypopneas. I very rarely get obstructive but I get a lot of aerophagia.
Any other suggestions? My numbers are 12.4-17 and I usually fall about 13.5. I use a ResMed machine Auto. At one time Dr. wanted me to switch to the machine that helps with Centrals but I kept putting him off and now my central run about 2 per hour. MY main problem is hypopneas. I was going to lower my pressure to try and help with the aerophagia but I don't want to increase my hypopneas.
RE: aerophagia - srlevine1 - 12-03-2020
When I started on CPAP therapy. I had a problem with aerophagia (swallowing air). I tried antacids, simethicone to break up bubbles, different masks, sleeping positions, and playing around with pressure settings to balance my discomfort with an acceptable AHI and leak rate. None of this produced an acceptable result.
After much experimentation, what seemed to work for me was to use ResMed's EPR (expiratory pressure relief.) feature to reduce exhalation pressure. It appears that by not fighting against exhalation and swallowing air because of the effort, the issue resolved itself. My current settings are 12-15.6 with an EPR = 3. My AHI is sub-1 (normally 0.4 - 0.7) with a 14.6 (95%) pressure.
I do not know if this is a one-off that works only for me, but you might try it.
RE: aerophagia - Sleeprider - 12-03-2020
I agree EPR can improve aerophagia, and we use it to treat obstructive hypopnea. I suspect your problem is actually a complex apnea, and your doctor was trying to have you try ASV at one time. Try using EPR to give exhale pressure relief, but understand this could increase hypopnea and CA events. If you do have complex apnea, you can reduce your minimum pressure to achieve comfort and better efficacy with centrals and hypopnea. The lowest pressure will be where OA starts to overtake CA as the predominate event.
Your profile shows you are using Sleepyhead. The current version of OSCAR is 1.2.0 and is available at the top of the forum. I recommend you upgrade and post some charts.
RE: aerophagia - becker44a - 12-03-2020
Hi Jerry,
Your Airsense 10 Autoset machine has 2 treatment modes: Autoset/Standard response, and Autoset/Soft Response. When I recently upgraded to one of this family of machines, I experimented and found that Soft Response works best for me, and my 95% pressure dropped more than 2cm. The experiment is reported here:
http://www.apneaboard.com/forums/Thread-Product-Review-Migrating-from-S9-Autoset-to-Airsense-10-Comparing-Therapy-Modes
Any reduction in pressure is helpful for Aerophagia, so it would be worth your time to run the experiment.
Hope this helps
RE: aerophagia - jerry1967 - 12-04-2020
(12-03-2020, 01:34 AM)srlevine1 Wrote: When I started on CPAP therapy. I had a problem with aerophagia (swallowing air). I tried antacids, simethicone to break up bubbles, different masks, sleeping positions, and playing around with pressure settings to balance my discomfort with an acceptable AHI and leak rate. None of this produced an acceptable result.
After much experimentation, what seemed to work for me was to use ResMed's EPR (expiratory pressure relief.) feature to reduce exhalation pressure. It appears that by not fighting against exhalation and swallowing air because of the effort, the issue resolved itself. My current settings are 12-15.6 with an EPR = 3. My AHI is sub-1 (normally 0.4 - 0.7) with a 14.6 (95%) pressure.
I do not know if this is a one-off that works only for me, but you might try it.
I will try this but I was told it would increase my Centrals. right now mine EPR is one so I will try 2 for a while and see how that works out. Thank you for your time.
RE: aerophagia - jerry1967 - 12-04-2020
(12-03-2020, 09:12 AM)Sleeprider Wrote: I agree EPR can improve aerophagia, and we use it to treat obstructive hypopnea. I suspect your problem is actually a complex apnea, and your doctor was trying to have you try ASV at one time. Try using EPR to give exhale pressure relief, but understand this could increase hypopnea and CA events. If you do have complex apnea, you can reduce your minimum pressure to achieve comfort and better efficacy with centrals and hypopnea. The lowest pressure will be where OA starts to overtake CA as the predominate event.
Your profile shows you are using Sleepyhead. The current version of OSCAR is 1.2.0 and is available at the top of the forum. I recommend you upgrade and post some charts.
I have switched to Oscar when it came out but have not put it on my profile. Sorry about that. Also right now I start at 12.4 but it goes up very quickly. So I was wondering if it goes up fast if reducing the minimum pressure would help. I will try the suggestion one at a time and let you know the results.
RE: aerophagia - jerry1967 - 12-04-2020
(12-03-2020, 06:01 PM)becker44a Wrote: Hi Jerry,
Your Airsense 10 Autoset machine has 2 treatment modes: Autoset/Standard response, and Autoset/Soft Response. When I recently upgraded to one of this family of machines, I experimented and found that Soft Response works best for me, and my 95% pressure dropped more than 2cm. The experiment is reported here:
http://www.apneaboard.com/forums/Thread-Product-Review-Migrating-from-S9-Autoset-to-Airsense-10-Comparing-Therapy-Modes
Any reduction in pressure is helpful for Aerophagia, so it would be worth your time to run the experiment.
Hope this helps
RE: aerophagia - jerry1967 - 12-04-2020
(12-03-2020, 09:12 AM)Sleeprider Wrote: I agree EPR can improve aerophagia, and we use it to treat obstructive hypopnea. I suspect your problem is actually a complex apnea, and your doctor was trying to have you try ASV at one time. Try using EPR to give exhale pressure relief, but understand this could increase hypopnea and CA events. If you do have complex apnea, you can reduce your minimum pressure to achieve comfort and better efficacy with centrals and hypopnea. The lowest pressure will be where OA starts to overtake CA as the predominate event.
Your profile shows you are using Sleepyhead. The current version of OSCAR is 1.2.0 and is available at the top of the forum. I recommend you upgrade and post some charts.
your right about the centrals, but they have redused quite a bit. Now I might git about 5 a night.
RE: aerophagia - Sleeprider - 12-04-2020
(12-04-2020, 01:08 PM)jerry1967 Wrote: I have switched to Oscar when it came out but have not put it on my profile. Sorry about that. Also right now I start at 12.4 but it goes up very quickly. So I was wondering if it goes up fast if reducing the minimum pressure would help. I will try the suggestion one at a time and let you know the results.
Jerry, it is fairly common for flow limitation to be associated with CA events. Unfortunately, individuals sensitive to EPR and pressure support will have a lot of problems treating flow limitation without making the CA worse. It is flow limitation that causes any Resmed auto CPAP to increase pressure. As long as flow limitation is present, it will try to increase pressure to the maximum setting allowed. It is in cases like this that we intentionally limit the maximum pressure so the machine does not "run-away". In these cases we use pressure to manage obstructive apnea, and we balance pressure against CA and aerophagia as needed. A reduction in minimum and maximum pressure may help your comfort without increasing OA events, and it may actually improve CA events.
RE: aerophagia - jerry1967 - 12-05-2020
By reducing these numbers will that affect my Hypopnea numbers. Sleeprider?