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[Symptoms] Help with Aerophagia please
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khafer Offline

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Location: Baldwin City, KS USA

Post: #1
Help with Aerophagia please
I just discovered this forum today. I was diagnosed with moderate OSA and have been using CPAP for almost 4 weeks now. Things have been going pretty well and I have been adjusting to using the machine. However, for about the last week I have started having a significant amount of air in my stomach, which apparently (thanks to the Googles) is called Aerophagia. So this is the first time I have really seeked out any help. I learned that my CPAP machine has an EPR setting (I think) and that I could access it through the "Clinical Setup". I have requested the manual via email but have not gotten it yet. I am anxious to try something tonight as the amount of air in my stomach is causing me to wake up. I have to sit up to burp the air out and the rest of the night seems to be fairly uncomfortable.

Anybody else with this problem? I could use some advice on what things to try. Also, I am kinda baffled why it all of a sudden started about a week ago.
03-21-2016 03:41 PM
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becker44a Offline

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Machine: ResMed S9 Autoset
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Post: #2
RE: Help with Aerophagia please
(03-21-2016 03:41 PM)khafer Wrote:  I just discovered this forum today. I was diagnosed with moderate OSA and have been using CPAP for almost 4 weeks now. Things have been going pretty well and I have been adjusting to using the machine. However, for about the last week I have started having a significant amount of air in my stomach, which apparently (thanks to the Googles) is called Aerophagia. So this is the first time I have really seeked out any help. I learned that my CPAP machine has an EPR setting (I think) and that I could access it through the "Clinical Setup". I have requested the manual via email but have not gotten it yet. I am anxious to try something tonight as the amount of air in my stomach is causing me to wake up. I have to sit up to burp the air out and the rest of the night seems to be fairly uncomfortable.

Anybody else with this problem? I could use some advice on what things to try. Also, I am kinda baffled why it all of a sudden started about a week ago.

Hi khafer,
Welcome to the forum.
I also have issues with aerophagia. Here are several suggestions:

1) You fortunately have a machine that provides access to ALL the data about how it is treating your apnea. There is a terrific program for viewing and monitoring that data, called Sleepyhead. It is free software, available via download from a link at the top of every forum page. Sleepyhead runs on Windows, Mac, and Linux. I suggest you download and start using this software to see what is happening during your sleep.

2) I have found that my aerophagia is worse at higher pressures. I also have found that sleeping on my back increases the frequency and duration od apnea events, which causes my machine to raise the pressure to compensate.. I now sleep wearing a backpack stuffed with numerous light, lumpy objects to make it uncomfortable to roll on my back. You might try some various means to encourage yourself to avoid supine (back) sleeping, and see if that has a similar effect for you.

3) I use the EPR setting of 3, as I appreciate the added comfort of exhaling into lower pressure. My machine is the predecessor to yours, so the procedure is probably slightly different. On my S9, the Clinical menu has a setting for EPR that includes an option called "patient". If set to patient, the EPR level can be adjusted in the regular menus. I would find out if your machine has a similar setting, and one way or another, try the various EPR settings to see if you get some relief.

4) Keep a sleep journal. I have found that memory of what occurred during sleep fades very quickly, so I pull the SD card from my machine every day, copy the data to my computer, and review it in Sleepyhead. I immediately make an entry in my sleep journal (text file), recording the essentials: date, time slept, AHI, wakeups, leaks, and anything unusual I happen to remember. This has been invaluable in reviewing to see what I have done that worked well, or not.

Hope this helps,
Good luck on your PAP journey.

A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
03-21-2016 04:22 PM
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FrankNichols Offline

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Post: #3
RE: Help with Aerophagia please
khafer, There is a button at the top of every page here that will take you to an area for manuals on most CPAP machines. It will also instruct you on how to get to the clinicians menu (I think on yours you push two buttons on the front at the same time for 3 seconds.)

Frank
03-21-2016 05:28 PM
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Sleepster Offline
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CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #4
RE: Help with Aerophagia please
(03-21-2016 03:41 PM)khafer Wrote:  I learned that my CPAP machine has an EPR setting (I think) and that I could access it through the "Clinical Setup".


Press and hold the dial and the Home button for three seconds. You can then set EPR to its maximum value of 3, if that has not already been done for you by the DME.

Quote:I am kinda baffled why it all of a sudden started about a week ago.

My guess is that you are now getting more deep sleep, your airway muscles relax more, your machine responds to the reduction in air flow and raises the pressure more. The more time you spend at higher pressures the more air you swallow.

You can try lowering the upper end of your pressure range from 15 to, say, 13. You will need to monitor this closely with software to be sure that what you're doing is working.

The real solution is to upgrade to the VAuto. This will allow you to raise the pressure support above what you can get by setting the EPR to 3. I suggest you complain to your doctor about the problem and ask for the VAuto. Do not let them stick you with a machine with fewer features than the VAuto.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-21-2016 08:58 PM
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trish6hundred Offline

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Post: #5
RE: Help with Aerophagia please
Hi khafer,
WELCOME! to the forum.!
You could try elevating your head with pillows and see if that helps you.
,I would opt for the Resmed Aircurve10 VAuto or the Respironics, ( I can’t think of it’s model number,) BIPAP machine if you have exhausted all these suggestions. but hang in there, someone will have more ideas.
Much success to you with your CPAP therapy.

trish6hundred
03-21-2016 09:44 PM
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khafer Offline

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Sex: Male
Location: Baldwin City, KS USA

Post: #6
RE: Help with Aerophagia please
Thanks everyone for the information and ideas.

(03-21-2016 04:22 PM)becker44a Wrote:  1) You fortunately have a machine that provides access to ALL the data about how it is treating your apnea. There is a terrific program for viewing and monitoring that data, called Sleepyhead. It is free software, available via download from a link at the top of every forum page. Sleepyhead runs on Windows, Mac, and Linux. I suggest you download and start using this software to see what is happening during your sleep.

I actually just learned about this software yesterday on this forum. I will try that as soon as I get a chance...hopefully tonight. I am definitely data driven so seeing the data will be helpful to me.

Quote:...You might try some various means to encourage yourself to avoid supine (back) sleeping, and see if that has a similar effect for you.
I will definitely try to sleep on my side more.

Quote:3) I use the EPR setting of 3, as I appreciate the added comfort of exhaling into lower pressure. My machine is the predecessor to yours, so the procedure is probably slightly different. On my S9, the Clinical menu has a setting for EPR that includes an option called "patient". If set to patient, the EPR level can be adjusted in the regular menus. I would find out if your machine has a similar setting, and one way or another, try the various EPR settings to see if you get some relief.

Just learned about the clinicians settings in my S10. Also received the manual last night. Learned that my EPR was "off". So I turned it on and tried it at the lowest setting of "1". It was maybe slightly better last night but I will try increasing it to "3" tonight.

Quote:4) Keep a sleep journal. I have found that memory of what occurred during sleep fades very quickly, so I pull the SD card from my machine every day, copy the data to my computer, and review it in Sleepyhead. I immediately make an entry in my sleep journal (text file), recording the essentials: date, time slept, AHI, wakeups, leaks, and anything unusual I happen to remember. This has been invaluable in reviewing to see what I have done that worked well, or not.

I am really bad about journals and documentation but I definitely can see the benefit of doing it. Time will tell.

(03-21-2016 05:28 PM)FrankNichols Wrote:  khafer, There is a button at the top of every page here that will take you to an area for manuals on most CPAP machines. It will also instruct you on how to get to the clinicians menu (I think on yours you push two buttons on the front at the same time for 3 seconds.)

Frank

I figured this out yesterday from this forum and played with the EPR setting last night...see above response

(03-21-2016 08:58 PM)Sleepster Wrote:  Press and hold the dial and the Home button for three seconds. You can then set EPR to its maximum value of 3, if that has not already been done for you by the DME.
Figured this out yesterday.

Quote:My guess is that you are now getting more deep sleep, your airway muscles relax more, your machine responds to the reduction in air flow and raises the pressure more. The more time you spend at higher pressures the more air you swallow.

You can try lowering the upper end of your pressure range from 15 to, say, 13. You will need to monitor this closely with software to be sure that what you're doing is working.

That all makes sense about why it just started. You said to monitor closely with softare to make sure what I am doing is working? What should I be monitoring? AHI? Should I be looking at the pressures? I will hopefully be downloading SleepyHead software tonight and start looking at it. Any advice on what I should be looking at would be helpful.

Quote:The real solution is to upgrade to the VAuto. This will allow you to raise the pressure support above what you can get by setting the EPR to 3. I suggest you complain to your doctor about the problem and ask for the VAuto. Do not let them stick you with a machine with fewer features than the VAuto.

So more than one of you said to upgrade to the VAuto. Any idea how this is handled through insurance? Would I be able to trade in the unit that has only been used for a month? It is technically only being rented by my insurance company. I was already planning on going in for a followup visit with my doc as it is required after 30 days of use to satisfy the insurance requirements. Should I go to the equipment provider (and the respiratory therapist) to discuss first, or start with my doc?

Thanks,
Kevin
03-22-2016 02:05 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #7
RE: Help with Aerophagia please
(03-22-2016 02:05 PM)khafer Wrote:  You said to monitor closely with softare to make sure what I am doing is working? What should I be monitoring? AHI? Should I be looking at the pressures?

Yes, both. You will see details of both. The three indices that add up to give you the AHI. And statistics about your pressure: the median value, 95th percentile, and max value. We will help you figure it out. It's overwhelming at first but not really all that difficult once you get into it. The best way to learn it is in the context of one person's data, and that one person is always you!

Quote:So more than one of you said to upgrade to the VAuto. Any idea how this is handled through insurance?

The doctor writes the prescription for the new machine. The DME is under contract with your insurance company to make the change in machines at some agreed-upon cost. The same is true for mask exchanges. It's expected that you will need to make changes when you're a beginner, especially with the mask.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-22-2016 10:04 PM
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DonC Offline

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Post: #8
RE: Help with Aerophagia please
Khafer,
Welcome to the forum. You will get lots of help here. I certainly have.
There are lots of suggestions in this thread and the one thing that I must emphasize as you like data is that you must use Sleepyhead. I find it invaluable.
Anyway back to the issue at hand. I was told by one of the technicians at my Titration, when I first started with CPAP, that if the symptoms of Aerophagia that you are experiencing change from irritation to real discomfort you have to let the doctor know. Please play it safe.
DonC

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03-23-2016 02:48 PM
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khafer Offline

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Machine: ResMed Airsense 10 AutoSet
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Location: Baldwin City, KS USA

Post: #9
RE: Help with Aerophagia please
Update. I changed the EPR setting to 3 (tried 1 last night and previously it was not enabled) and the discomfort did not wake me up at all. I also tried sleeping more on my side, so this may have made a difference as well.

Downloaded my data into SleepyHead and looked at that. Last night my max preasure was under 13 while the night before it almost hit 14. And shortly after it spiked to almost 14 (the night before) was when I remember waking up.

So want to try the current setting for a few days and see how it goes. But I think my next step might be to change my max pressure setting from 15 to 13.

Thanks again for all the help,
Kevin
03-23-2016 03:46 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #10
RE: Help with Aerophagia please
(03-23-2016 03:46 PM)khafer Wrote:  Downloaded my data into SleepyHead and looked at that. Last night my max preasure was under 13 while the night before it almost hit 14. And shortly after it spiked to almost 14 (the night before) was when I remember waking up.

There are two things that high pressure can do for you: Lower your OA and hypopnea indices (a good thing) and raise your CA index (a bad thing). If the higher pressure is elevating your CA index and also causing aerophagia, then lowering the pressure is a no-brainer move. On the other hand, if the higher pressure is keeping your OA and hypopnea indices down, then lowering the pressure is a bad thing.

The only way to tell is to monitor and experiment. Pay attention to what's happening during times that the pressure is high. Sometimes optimizing things involves a trade-off between comfort and treatment.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-23-2016 08:43 PM
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