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New to CPAP and getting aerophagia - MissConstrue - 06-15-2024
Hey guys this is my first time posting here. Also new to cpap. Ive only had resmed10 a week now. first day i couldn't use it as it was set to APAP 4-20 and was just struggling with breathing (both in and out). I immediately changed to low levels like 4-6 to get used to it but only like 30 min - 2hr a night. The more I try to use it the more sleep deprived Ive been but thats probably a me problem.
Ive had improvement with APAP 6-10 with EPR 1 last night and was able to wear the mask over 4 hours (sleeping at most half the time worn), but breathing with the mask is relatively comfortable now. Thing is, 2 nights now since going over 7 pressure Im getting aerophagia. burping and farting (mostly the latter) all night into the morning. i dont think i should go to lower pressure as thats probably not enough air? But I have IBS and all the air in my gut is uncomfortable during the night and making me sick the next morning. not sure what to do. Considered VCOM but found out its not appropriate for low preure levels or EPR. Im including oscar images wondering if maybe someone can take a look and give some advice. Thanks
RE: New to CPAP and getting aerophagia - staceyburke - 06-15-2024
I would try min 7. EPR 3 for a night and see if that helps. Is should calm down the fluxulation of pressure.
RE: New to CPAP and getting aerophagia - LuminousOne - 06-15-2024
I understand that aerophagia usually goes away as the body adjusts to the cpap. In the meantime, here are some remedies that may help you:
1. Good old Gas-EX before bed.
2. A soft cervial collar to prevent forward neck flexion. Flexing the neck so your chin moves toward your chest creates a narrowing of the airway - this results in additional obstruction and will redirect airflow from the cpap towards the gastrointestinal tract. The collar does not need to be tight, just enough to keep the head and neck in neutral position while you sleep.
3. A wedge pillow while sleeping may help prevent the air from traveling further into the gastrointestinal tract.
3. Lie on your back with a pillow under your head and bring your knees to your chest while bent. This helps to release trapped abdominal gas.
Disclaimer: I don't get my machine until Tuesday, but got the worst case of aerophagia during my titration test - most certainly from flexing my head and neck forward due to an over thick pillow and the need to assume a fetal position due to anxiety. I researched what to do just in case.....
I hope this helps.
RE: New to CPAP and getting aerophagia - LuminousOne - 06-16-2024
P.S. That should read cervical collar.
RE: New to CPAP and getting aerophagia - MissConstrue - 06-16-2024
Thanks. Last night was really rough (painful) because of the aerophagia so I'm really hoping this resolves soon. I tried reducing the pressure to CPAP setting a little under 7 and I quickly accumulated tons of bloat. I put the machine aside because it was too painful to continue and tried it again but at pressure 5.6. Seems a little better but I can tell it still happens, just a little slower. Like you said I've started to wonder if it isn't necessarily a pressure problem but more that my body isn't used to the machine. The days it wasn't happening were the first few days that I wasn'nt using it beyond 2 hours.
I'll keep all the other advice in mind. Unfortunately I have servere neck and back issues and can't change my pillow or use an incline. I use a cervical pillow and it's extremely hard to troubleshoot in that area.
I've seen the opposite advice in a popular YouTube channel that said tilting head sightly down should help as tilting the head up can cause it but who really knows ?
RE: New to CPAP and getting aerophagia - Dormeo - 06-16-2024
Your AHI is so nice and low I'd suggest you try min = max = 6, with an EPR of 2. Normally I wouldn't suggest making several changes at the same time, but we have to figure out quickly the sweet spot where your apnea is controlled AND your aerophagia backs down.
Try those settings during the day or evening just to make sure you don't feel air-starved with them. If you do, revise to min = max = 7 with EPR of 3 and see if that's better.
Keep us posted.
RE: New to CPAP and getting aerophagia - MissConstrue - 06-16-2024
Thanks that sounds reasonable to me. Is expiration pressure related to aerophagia? I thought it was supposed to be more caused by inhalation pressure. I keep reading/seeing conflicting opinions and advice on pretty much everything about cpaps though so I keep second guessing everything about my settings.
I don't know if ahi from the screenshots can be taken seriously as I'm not actually sleeping most of the time wearing CPAP yet. Just laying in bed hopelessly wishing for sleep.
My home sleep study a couple years ago was ahi 5.2 iirc (yes it took forever to actually get a CPAP) and I think just 1 apnea with 30 some hypopneas for avg of 5 something hypopneas an hour. So pretty mild. But symptomatically I've felt extremely sleep deprived for decades despite usually getting 9+ hours a night. Hence the CPAP
RE: New to CPAP and getting aerophagia - Dormeo - 06-16-2024
People who've had aerophagia report different things: IPAP matters; EPAP matters; the average of the two matters. So you'll need to figure out how it's working for your body.
About lying in bed awake: Try setting the machine up outside your bedroom during the day or evening and watching TV, reading, or using your devices. This will help you get used to things without the pressure of waiting for sleep. If it won't louse up your insurance, I'd actually recommend doing that without night-time use for 4-5 days before trying night-time use again.