Air in stomach after using cpap

[Sleeprider]

I meant the OP should stick with the 5 to 7.6 settings.  I was disagreeing with the previous post, which had seemed to suggest switching to a bi-level machine in order to address flow limitations, which I assumed would mean changing the settings.  Sorry for the confusion.

I sometimes find it difficult to follow from thread to thread as well. I was hearing that the aerophagia problem was happening as pressure approached 8-cm, and I sometimes just move towards a fixed pressure as things get to this point where problems occur with minor changes in auto-pressure.  The 5-7.6 could eventually work, but since that results in almost fixed EPAP, I thought we'd just try for fixed pressure at 7/4, and move lower if needed.  The confusion was probably mine.

Let me try to clarify....
I think SR meant to question the OP’s statement in post #10 where he wondered if he should raise his pressure in response to a mper6792 post.  Dormeo responded that she thought he should not raise pressure or keep the same for awhile.

OP’s question:
“I am wondering if my spikes up towards 8 mean that I should increase pressure from 5-7.6 to 9 or 10 - but I do feel that 10 feels like to much airforce into my lungs, like they are involuntarily expanding beyong my comfort level. Too me that reads like the opening or access through my airpipes is not constricted enough to warrant this pressure (doesnt seem like this is considered very high pressure, but this would depend on how tight the air passage is I suppose?).”

Thanks Rose! That is exactly the case. I thought I was losing it.

[censor]

Trying out recommended settings with further reduction of flow rate - now at 4-7.
Had a good nights sleep (more than 7 hrs), which is a lot for me. Nasal pillow mask is working ok, not a nuisance when sleeping anymore - though I am seeing a lot of leaking at certain periods in the chart. Leaks seem to be at times when I am trying to sleep on the side.

Still waking from bloated stomach, but seems to be marginally better. Perhaps there is some info in the chart that gives indications for further adjustments. (I don't fully understand what an optimal chart should look like, but will search around in this forum later today and see what I can learn).

Going on a trip tomorrow, bringing my new airmini from Resmed. Will adapt same setting to that unit and continue working on this... Thanks for the enthusiastic support - I love the team effort going into this whole forum!

   

I also attach the report from the day before. This a bit messed up. Tested the mask for a lie down after work, and fell asleep for 20 minutes or so. Didnt get to sleep until very late, and woke from gas in stomach after only 5.5 hours. Will focus on more regular sleeping hours moving forward.

   

[censor]

So... I have been away for a week and half, using the airmini instead. I used the same settings of 4-7 on that unit, and I had less aerophagia problems than using the stationary unit.

First night back home, using my stationay airsense 10 - and waking up with aerophagia again. Seems to be a little less than before, but still very uncomfortable - and interrupting my sleep.

Anyway, I am wondering if I have too little pressure going here - I sometimes have trouble noticing that the machine is even on   , especially for the inhales when I am at around 4 in pressure. Would also appreciate some comments on my chart, if my setting now look correct or if there is something I should work on... ( was awake from 4:45 for about an hour, had to walk around a bit due to air in stomach. time not adjusted on unit, so it is lagging behind an hour).

Have a great day friends.

   

[Sleeprider]

The machine appears to be properly mitigating obstructive events, and I think we mentioned that your therapy would be a compromise between obstruction and comfort for aerophagia. Some of us can use much higher pressure and not notice it until we pull the mask away and the machine blows air, but remember we are talking about pressure not flow, and pressure is something you probably have trouble detecting as it gently inflates your airway and prevents obstruction. You seem to be doing just fine at these pressures, however I think a minimum of 5 would be better than 4.

[censor]

Seems I am made for low-pressure treatment...

Tried 5-7 this night, and woke up after the now usual 5 hours due to aerophagia.

I notice that my chart shows pressure peaking at a near constant at 7, whereas I am seldom below 6. My thought is that this is were I am effectively at, and that the most important parameter for me to adjust now is the top limit, trying out areas in the 5 - 7 range. This feels like very little, but my AHI is so low that I suppose this is unproblematic - but perhaps I am misunderstanding something here?

Anyway, I plan to set the unit at 5 (low) - 6 (high) for this coming night. Let me know if I am approaching this wrong...  

Have to say again that getting feedback on this has already been very helpful - I started out at 4-20 on this unit...

   

[mper6794]

Hi, censor
You might already known my opinion on your case: awful charts concerning FL/RERA s all the way through, aerophagia, and pressure bumps bothering you large stretches of your nights.
As i mentioned earlier on this thread, you would end up as one more case of lingering untreated fellow, unless you move as soon as you can to the bilevel Vauto.
Reasons would be: yet medical literature suggests FL/RERA could be treated by Just raising pressure, quite often this become detrimental because aerophagia come first treatments are completed. Bilevel woul d allow work out FL/RERA at lower levels, in your case maybe no more than EPAPmin: 5.6 to 6.0. A large number of cases here, some 20's in the last 6 months, people started with situations similar to yours; luckly some of them quickly realized what was happening and moved to bilevel.
Good luck

[Sleeprider]

I'll disagree with Mper on this. There is no benefit to a bilevel when you cannot tolerate pressures abobe 6.0 cm. The same effect could be had by putting EPR on full time at 2 on your machine. I think the more steady your pressure is, the better. So if you want to try 6.0-6.0 with EPR 2 that might be more comfortable.

[JoeyWallaby]

Have you tried sleeping with a wedge?

[censor]

Yes, I have tried wedge (bunch of pillows at various angles). 
In the last period I felt that I had exhausted all option, all possible permutations of settings. Still nothing helped. 

But I have stuck in there, and kept on cpap'ing. Now it seems to have stabilized somewhat. I am still waking up feeling bloated, but a little less than before. Instead of always waking up after 5 hrs, I have now had two nights with 6-7 hrs sleep. This may be only due to being overtired, but I also feel less air these two last days.

Am going to nurse tomorrow (called in about a week ago and was freaking out about the pains that sometimes came with the gas), and am curious about what they will say about my settings. Am currently at 4 - 6,2. My plan is to perhaps increase a little pressure max as I get used to the treament - but I am not sure I need to with the AHI count being below 1?  

Anyhow, I also got a tip on drinking Fennel or Camomille tea an hour or so before bedtime. I tried the fennel last night, no side effects. I let the bag stay in for about ten minutes, only making a small tea-shot of fennel. They also say that minifom can help, but I didnt try anytning in that direction (gave this to one of my kids who had gas pains as an infant).

Attaching charts  for my last two nights - with today being the best sleep I have had for a while. 

Today 7hrs +   
(I think leak rate at some points is becase I was suddenly feeling comfortable enought with my nose pillow mask to sleep on my side for small periods.
   

Yeasterday (woke up, tried to sleep with mask on but gave up)
   

[mper6794]

hi, censsor

empathizing with your aerophagic drawbacks. Let me put this rationale, and see what other would think and shed more lights:

(a) you would be a completely unresolved case of FL/RERA/UARS, and, because of this, you arising/awakening a great deal, which in turn, would lead you to move a lot.

(b) you are fighting against the machine with EPR:3.0, with a very compromised Exp/Insp ratio close to 1. Please, refer to my analysis of this here: http://www.apneaboard.com/forums/Thread-...wer?page=4

© people with UARS tends to sufferer also from PLMS (just in case, would there be any signal of this on your lab studies, RLS, etc?);

(d) it appears there would be other causes for aerophagia, other than pressures. JUST IN CASE, for instance, take a look at this from Dr. Barry Krakow's book citation: "With the advent of pressure transducer technology for measuring breathing, we see many more cases of PLMD interrelated with SDB. Thus many patients use PAP therapy and RLS/PLMD drugs. And this combination of treatment is especially important to mention in light of an unusual side effect to PAP therapy known as air swallowing. It seems that many cases of air swallowing are caused by leg jerks, where the jerking motion causes the person to awaken and swallow air, which can cause painful bloating. By treating the leg jerks effectively, air swallowing is often eliminated."

Therefore, first: would there be chances  your aerophagia could be caused by moves? ...if you post ten-minutes windows, outside of your REM periods, we could eventually explore further for this, i.e., nature of your moves, either respiratory-driven or PLMS-driven. After this, me and other here could reinforce (or not) going to BPAP.

It would help if you post charts like this:
Don't need event chart (so long events appear in the others).
Pressure,
FR (-120 to 120)
RR(10 to 20; with the median reference line),
FL(can be very compressed),
TV(max 600; with the median reference line)
Leak(can be very compressed).

Good luck