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[Symptoms] Help, I keep getting oxygen overdose
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Patrice Offline

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Post: #1
Help, I keep getting oxygen overdose
Hi I am so new at this. I have been struggling severely with all this. I had a C-Pap, then a C-Pap Auto, and now a VPAP Adapt. I bloat up like I am 6 months pregnant full of air in my stomach, and I throw up air, just air when I get up. (Either in the morning or in the middle of the night depending on how much unconsious swallowing I have done). My Apnea is Stroke related Apnea. Both my diaphram and my brain area for sleep control has been affected by my stroke. I so far like the VPAP the most, but it hurts a lot when I bloat up and also my sinuses and allergy problems are being forced down into my lungs so that I end up coughing chunks of phlem out of my lungs. Can anyone HELP me on how to get my body more adjusted and be in less pain less oxygen overdosing issues?? Thanks, PatriceHuh
02-03-2014 09:14 PM
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trish6hundred Offline

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Post: #2
RE: Help, I keep getting oxygen overdose
Hi Patrice,
One thing you might try is to make sure your machine is lower than your bed.
the problem you are talking about is called "aerophagia," it means that you swallow air and that's what is causing you to bloat or blow up.
I think there are some threads here on the board dealing with "aerophagia."
Hang in there for more suggestions to help you along.

trish6hundred
02-03-2014 09:40 PM
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Patrice Offline

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Post: #3
RE: Help, I keep getting oxygen overdose
(02-03-2014 09:40 PM)trish6hundred Wrote:  Hi Patrice,
One thing you might try is to make sure your machine is lower than your bed.
the problem you are talking about is called "aerophagia," it means that you swallow air and that's what is causing you to bloat or blow up.
I think there are some threads here on the board dealing with "aerophagia."
Hang in there for more suggestions to help you along.

OMG Thank You so much!!!!!! I have been looking to see if there was even a term for this and now that you gave it to me I can have my sleep center look into this as even they have never seen anyone with my symptoms and I thought that weird to be honest. Must be rare?? Anyways I did put the machine down on the floor on top of two big Bibles so it was not directly on the cold floor, and I still started to bloat and fell nausiation settling in so I took it off after only 2.5 hours. My average is 4 hours thank God for that for insurance perposes, but lately after the first week of great use, my body went back to doing this and fighting it while asleep. I am so scared that when I am not using it, I will die in my sleep (stroke related). Thank you so much for your help again. Patrice
02-04-2014 07:10 AM
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Nozzelnut Offline

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Post: #4
RE: Help, I keep getting oxygen overdose
Some folks can help reduce the aerophagia by changing their sleeping positions; might be better for you on your left or right side as opposed to your back....

Others say starting with a lower pressure and then building up when the body gets used to it helps too.
02-04-2014 09:12 AM
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robysue Offline
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Post: #5
RE: Help, I keep getting oxygen overdose
Patrice,

You need to report the aerophagia to your sleep doctor instead of just the DME. There are a number of things that can be done to try to minimize the amount of air you swallow, but like so many CPAP related things, which ones work depends very much on the individual patient.

Some things to consider and try:

Your pressure settings. In general, the higher the pressure, the more likely a patient is to develop aerophagia. But simply lowering the pressure is not an answer because that leads to more events. In other words, if you are working with high pressure settings, you may need your doc's involvement in figuring out whether the pressure(s) can be reduced and by how much. For many people using a bi-level of some sort (like your VPAP Adapt), the EPAP pressure may be more directly related to the aerophagia than the IPAP.

GERD and acid reflux type conditions. Some people with serious aerophagia problems also have acid reflux at the same time---either GERD or a version of acid reflux called "Silent GERD." Some people have silent GERD without being aware of it. It's worth talking to your primary care physician about whether you might have GERD. The problem in GERD is that the lower sphincter of the esophagus has problems staying tightly closed. In classic GERD, the weak sphincter allows stomach acid to back up into the esophagus, but when a person with GERD uses CPAP, sometimes that weak sphincter also allows air to leak into the stomach.

GERD self-help techniques. These are sometimes useful when you are fighting aerophagia even if you don't have GERD. In particular, the following GERD self-help tips often help relieve some of the aerophagia and its bloating and pain:
  • Raise the head of the bed by about 4 inches. It's better to put the bed on blocks than it is to simply try to raise the head by using a massive amount of pillows. Sometimes, however, a sleeping wedge (a very firm triangular wedge that goes on top of the mattress) is enough and you don't need to put block under the bed feet.
  • Watch what you eat and when you eat it during the evening hours. A smaller supper meal may help. Eliminating any foods that cause you problems can help. No food for 3-6 hours before bedtime can help. Limiting liquids right before bedtime can help.
  • Sleeping position. For many people with GERD and or areophagia, sleeping on the left side tends to cause much fewer problems than sleeping on the right side or back. It has to do with where the stomach lies inside the body.

Head position when sleeping. This is a highly individual thing, but for some of us, certain head positions tend to lead to more problems with areophagia. I am predominantly a side sleeper and I prefer sleeping on my left side. For me, I found that if my head is tipped back away from my chest, the aerophagia tends to be worse, sometimes much worse. If I tilt my head down where my chin is a close to my chest as possible, that usually helps minimize the problem with swallowing air. But other people are just the opposite and find they swallow less air when the chin is pointed away from the chest. So experiment with head position.

Overall restlessness. Sometimes there's a nasty "positive feedback loop" involved with aerophagia and arousals: Humans have a tendency to swallow a bit whenever they first wake up or arouse from a sleep. And so in some people (I'm one of them) the aerophagia is part of a cycle that feeds on itself:
    ... arousals lead to swallowing which leads to areophagia which leads to more arousals which leads to more swallowing which leads to more aerophagia which leads to more arousals, which leads to more swallowing .....
In this situation the long term fix is to try to reduce the number of night time arousals and night time awakenings. Fewer arousals means less swallowing of air, which means less aerophagia, which reduces the chances of the feedback loop from becoming firmly established. In my case that means I have to be able to get to sleep within about 10-15 minutes of masking up or I start swallowing air while I'm awake, but very drowsy, which will immediately increase the chances of a bad aerophagia night. It also means not lying in bed when I know I'm extremely restless for long periods of time. If I find myself tossing and turning for what feels like 30 or more minutes, I really try to get up and go into a different room until I'm both sleepy and settled down.

Embrace the burping, belching, and farting needed to get rid of the aerophagia. Guys tend to have fewer problems with this than women do. There is this cultural expectation that we should try hard to hold in offending gasses trapped in our gastric-intestinal system, but burping, belching, and farting are really good ways of getting rid of the excess air. (And the excess air usually is oderless, so the main problem is noise, not smell.) When you wake up with the pressure from serious aerophagia, you need to take the mask off for several minutes and move around and try to burp or belch if possible. If the air pressure is further down the GI track, then moving around can encourage some badly needed farting to take place. If necessary, get out of bed and move around until the belching, burping, and farting relieves enough of the pressure so that you can lie back down with the mask on and still be reasonably comfortable.
(This post was last modified: 02-04-2014 09:48 AM by robysue.)
02-04-2014 09:46 AM
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PaytonA Offline
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Post: #6
RE: Help, I keep getting oxygen overdose
(02-04-2014 09:46 AM)robysue Wrote:  If necessary, get out of bed and move around until the belching, burping, and farting relieves enough of the pressure so that you can lie back down with the mask on and still be reasonably comfortable.

Well, I have heard of BFF before but this is the first time for BBF. Seriously though my wife has been able to BBF around me whenever she wants or needs to. No sense trying to hold in stuff that your body wants to get rid of.

Thanks Robysue, I just learned a little about something that I did not even recognize the existence of.

Best Regards,

PaytonA
02-04-2014 03:33 PM
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Lukie Offline

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Post: #7
RE: Help, I keep getting oxygen overdose
If you are swallowing air from your mouth while you sleep you might consider getting a chin strap. I wear a chin strap even with a full face mask because my jaw drops and I used to suck in a lot of air and belch and fart all day.
02-07-2014 10:24 AM
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archangle Offline
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Post: #8
RE: Help, I keep getting oxygen overdose
By the way, it's not oxygen overdose, but aerophagia/bloating is a real problem.

There are some good suggestions above.

If the sleep center is not familiar with aerophagia, they are grossly incompetent. I suspect they're just trying to bully you into not complaining about it because they don't want to deal with it.

Some people have gotten considerable relief by having a COMPETENT person adjust their settings, especially if they have a higher end machine like you have. There are a lot of settings to tinker with. You may have to really fight hard with them to get them up off their fat backsides and take the effort to do things right. Many of the DMEs and technicians are lazy and don't really care enough to adjust things right for the patient, they only care about doing what's necessary to get the insurance company to ring the cash register. Many "sleep" doctors don't really understand what the CPAP machine settings can do.

However, it's not a sure thing that you can fix bloating by adjusting the pressure settings.

If nothing else, they can probably lower the maximum pressures and reduce the bloating at some risk of not getting good therapy. Your machine records your breathing every single night, so they can safely lower the maximum pressure and see if it still stops your apnea.

Some people find wearing the machine during the day while reading or watching TV will help them adjust to the machine. It also counts towards your 4 hour requirement for insurance, since the machine doesn't know you're not asleep.

One warning, though. If you need to move your machine to use it while reading or watching TV, take the water tank out before moving the machine, so you don't kill the machine by spilling water back into it.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
02-12-2014 02:57 AM
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JohnNJ Offline

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Post: #9
RE: Help, I keep getting oxygen overdose
(02-07-2014 10:24 AM)Lukie Wrote:  I used to suck in a lot of air and belch and fart all day.

TMI Dielaughing
02-12-2014 02:49 PM
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Patrice Offline

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Post: #10
RE: Help, I keep getting oxygen overdose
(02-04-2014 09:46 AM)robysue Wrote:  Patrice,

You need to report the aerophagia to your sleep doctor instead of just the DME. There are a number of things that can be done to try to minimize the amount of air you swallow, but like so many CPAP related things, which ones work depends very much on the individual patient.

Some things to consider and try:

Your pressure settings. In general, the higher the pressure, the more likely a patient is to develop aerophagia. But simply lowering the pressure is not an answer because that leads to more events. In other words, if you are working with high pressure settings, you may need your doc's involvement in figuring out whether the pressure(s) can be reduced and by how much. For many people using a bi-level of some sort (like your VPAP Adapt), the EPAP pressure may be more directly related to the aerophagia than the IPAP.

GERD and acid reflux type conditions. Some people with serious aerophagia problems also have acid reflux at the same time---either GERD or a version of acid reflux called "Silent GERD." Some people have silent GERD without being aware of it. It's worth talking to your primary care physician about whether you might have GERD. The problem in GERD is that the lower sphincter of the esophagus has problems staying tightly closed. In classic GERD, the weak sphincter allows stomach acid to back up into the esophagus, but when a person with GERD uses CPAP, sometimes that weak sphincter also allows air to leak into the stomach.

GERD self-help techniques. These are sometimes useful when you are fighting aerophagia even if you don't have GERD. In particular, the following GERD self-help tips often help relieve some of the aerophagia and its bloating and pain:
  • Raise the head of the bed by about 4 inches. It's better to put the bed on blocks than it is to simply try to raise the head by using a massive amount of pillows. Sometimes, however, a sleeping wedge (a very firm triangular wedge that goes on top of the mattress) is enough and you don't need to put block under the bed feet.
  • Watch what you eat and when you eat it during the evening hours. A smaller supper meal may help. Eliminating any foods that cause you problems can help. No food for 3-6 hours before bedtime can help. Limiting liquids right before bedtime can help.
  • Sleeping position. For many people with GERD and or areophagia, sleeping on the left side tends to cause much fewer problems than sleeping on the right side or back. It has to do with where the stomach lies inside the body.

Head position when sleeping. This is a highly individual thing, but for some of us, certain head positions tend to lead to more problems with areophagia. I am predominantly a side sleeper and I prefer sleeping on my left side. For me, I found that if my head is tipped back away from my chest, the aerophagia tends to be worse, sometimes much worse. If I tilt my head down where my chin is a close to my chest as possible, that usually helps minimize the problem with swallowing air. But other people are just the opposite and find they swallow less air when the chin is pointed away from the chest. So experiment with head position.

Overall restlessness. Sometimes there's a nasty "positive feedback loop" involved with aerophagia and arousals: Humans have a tendency to swallow a bit whenever they first wake up or arouse from a sleep. And so in some people (I'm one of them) the aerophagia is part of a cycle that feeds on itself:
    ... arousals lead to swallowing which leads to areophagia which leads to more arousals which leads to more swallowing which leads to more aerophagia which leads to more arousals, which leads to more swallowing .....
In this situation the long term fix is to try to reduce the number of night time arousals and night time awakenings. Fewer arousals means less swallowing of air, which means less aerophagia, which reduces the chances of the feedback loop from becoming firmly established. In my case that means I have to be able to get to sleep within about 10-15 minutes of masking up or I start swallowing air while I'm awake, but very drowsy, which will immediately increase the chances of a bad aerophagia night. It also means not lying in bed when I know I'm extremely restless for long periods of time. If I find myself tossing and turning for what feels like 30 or more minutes, I really try to get up and go into a different room until I'm both sleepy and settled down.

Embrace the burping, belching, and farting needed to get rid of the aerophagia. Guys tend to have fewer problems with this than women do. There is this cultural expectation that we should try hard to hold in offending gasses trapped in our gastric-intestinal system, but burping, belching, and farting are really good ways of getting rid of the excess air. (And the excess air usually is oderless, so the main problem is noise, not smell.) When you wake up with the pressure from serious aerophagia, you need to take the mask off for several minutes and move around and try to burp or belch if possible. If the air pressure is further down the GI track, then moving around can encourage some badly needed farting to take place. If necessary, get out of bed and move around until the belching, burping, and farting relieves enough of the pressure so that you can lie back down with the mask on and still be reasonably comfortable.
Robysue, Thank You so much for your info. I am in the process of just switched to a full mask and had the pressure turned down as well and the doctor is now aware of my situation and said this is related to having the stroke. However I am going to talk to my doctor about the GERD....out of three times using the new pressure setting, and full face mask I got sick once. The other two nights including tonight I was pretty big like a pregnant woman, but didn't have to throw up, was able to flatulate and burp a little bit out. More flautation than burping. Still hurts being bloated up like this but I think I might be slowly getting the hang of this with the new reduced pressure and full face mask. Fingers crossed....been praying and praying too. Again thank you so much for your information it truly is wonderful seeing people out there willing to help!! God Bless and I will keep you posted on how things pan out as well as talking to my doctor about GERD. Sincerely, Patrice SHa_biggrin5

(02-12-2014 02:49 PM)JohnNJ Wrote:  
(02-07-2014 10:24 AM)Lukie Wrote:  I used to suck in a lot of air and belch and fart all day.

TMI Dielaughing

LOL John, it is kinda funny when you think about the walking farts and burping like old folks do and I am not even that old LOL CoffeeToo-funny
(This post was last modified: 02-13-2014 04:01 AM by Patrice.)
02-13-2014 03:59 AM
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