Help with aerophagia and nausea during use of CPAP

[Naama]

Hello everyone,

I am quite new to CPAP - was diagnosed with Sleep Apnea late March (of this year) and have been using the CPAP since April 1st. I have the Phillips DreamStation Auto CPAP, with nose pillows mask, and all in all I have become accustomed to it, if ever you can really get accustomed to sleeping with a machine attached to your face

That said, I am occasionally experiencing aerophagia and nausea, sometime to the point when I wake up in the middle of the night looking pregnant! Seriously... During the day the feeling goes away, but honestly, it is very uncomfortable and sometimes quite unbearable, especially if I have a little too much to drink that evening (which I probably shouldn't do, but on some occasions it happens). One of the nights I woke up feeling actual pressure in my chest, literally feeling that swallowed air locked inside me due to the CPAP use!

I think the pressure setting is fine for me, as the AHI normally stays bellow 5 (an average of around 3.5), and 90% of the time the pressure doesn't go above 9 (I learnt how to see that in the setting section of my machine). the mask is well sealed (100%). 

I read that maybe I should use the C-flex option (I am now set with A-flex), and increase it to 3 (I think now it is set to 2). Also, I use the humidifier at a level of 3, perhaps I should decrease it? I honestly don't know if it has any effect on the gassy stomach issues... I did also read about the need to elevate of my pillow, though I quite like sleeping on my side, and then it could possibly not work well with an elevated pillow when it comes to my neck...

As a side note - I sleep with a night-guard that was originally prescribed for orthodontic reasons, but I learnt it helps with teeth clenching (which have gotten MUCH better since I use CPAP, but I still sometimes wake up with sour jaws, so I try and use it). 

Any advice? Please share if you've had this issue and how (if at all) you solved it.

All my best to you all, and may we all get wonderful night's sleeps!

[Gideon]

Welcome to the forum
A nice description by the way. We like to see detailed data because many of us are real good at reading the charts and they help us with our advice. My guess is that you need to increase your min pressure a bit and decrease your max.

A flex of 2 works for more people better than 3.

I will suggest lowering your max to 9 to try to eliminate the aerophagia. The goal being to reevaluate observing your numbers and restore your settings to your optimized settings after some time without aerophagia.
I would also increase your min pressure to 6 to take advantage of your flex setting of 2 to allow it to have room to work. This should not change your theraputic pressure.

Please download OSCAR and organize your detailed daily charts per the organize link in my signature then attach them to your post. How important are they? We sent another user to his doctor because of what we saw. Doesn't happen often and I'm not anticipating anything like that with you.

[Naama]

Thank you very much, I will give it a trial today (the higher min and lower max). 
As for Oscar: how do I migrate the data from my CPAP into the software? I suppose I need some sort of memory card...
Thanks for the help,
Naama.

[Sleepster]

Hello Naama and welcome! To combat aerophagia you might try a soft cervical collar to help keep your neck straight and hopefully stop the air from entering your stomach. For most people, this problem tends to subside as we adapt to CPAP therapy.

Setting the EPR to its maximum value of 3 means you lower the pressure by 3 when you exhale. The lower the pressure the less chance you have of swallowing air.

[Dormeo]

There may already be a card in your machine. If there isn’t, just get a basic SD card that will fit in the machine’s slot. If your computer doesn’t have a card reader built in, you’ll also want to buy a card reader.

[mesenteria]

I never get aerophagia when sleeping on my side.  On my back, that's a whole 'nuther story...

If you can remember to do it, you have two choices to reduce the inflated feeling and to expel any accumulated in your stomach:

a. Actually sit up, lean forward a bit, and try to belch.  Rock your hips a bit, too.  It can be done, even with the mask in place, and you'll see weird stuff on your chart next day, but it will help...a lot!

b. ...or, you can lie in a fetal position on your LEFT side and wait for the air in your stomach to work its way back up the esophagus and belch when it must be done.  Happily, this is also a great way to express gas the other direction, but it's your show...  This will only take a few minutes and you may fall back asleep fairly quickly. 

Back sleeping (for many of us), but also pressure that maybe could be reduced a fraction, might be the solution (mentioned by a couple of members already).