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Waking up extremely bloated and full of air
#1
Waking up extremely bloated and full of air
New member here. First of all thanks for an awesome forum, it's an indispensable resource. 

I just started my CPAP therapy, I've had it for 3 days and am trying different masks. I had an index of 30-50, and now I am down on less than 1. So that is great. 

My biggest problem however is that I wake up very bloated, my stomach is stretched to its max, and I have a stomach ache from all the air. I burp and fart a lot due to the high amount of air in me. I tried lowering the pressure range (from min 6 max 14 to min 5 max 10) but I still have the problem, albeit not as extreme as the first days.

Do you have any advice on how to tackle this problem? Should I lower the pressure even more? Will a full face mask help or doesn't it matter?

I have attached a screenshot from last night, the first night I actually slept through the whole night with the machine.
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#2
RE: Waking up extremely bloated and full of air
go2sleep

That is an excellent sleepy head result.

Aerophagia is the medical term for the phenomenon when air enters the esophagus, goes into the belly and causes bloating. Aerophagia occurs when air from a CPAP enters the esophagus and goes into the belly, rather than the airway and into the lungs. This can cause gas pains and distension of the stomach.

This post dissues cures for Aerophagia http://www.apneaboard.com/forums/Thread-Swallowing-air-an-taping-mouth?highlight=Aerophagia

A full face mask might help if you are mouth breathing.
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#3
RE: Waking up extremely bloated and full of air
I don't see a leak problem, and your therapy is apparently very good at low pressures. Your current settings are 5 to 10 with EPR at 3. I'm going to suggest a fixed pressure of 6.0 with EPR at 2. This will give you a constant pressure of 6.0/4.0 (IPAP/EPAP). This lower more constant pressure should help avoid aerophagia.

Aerophagia is often a result of a lower esophageal sphincter (LES) weakness and is frequently related to gastroesophogeal reflux disease (GERD). If that is the case with you, then treating that may provide some relief in the long term. Also, with the lower pressure suggested here, you may find the pressure does not overcome the LES. Hopefully the problem just goes away. To implement the settings either set the machine to CPAP mode at a pressure of 6.0, and EPR at 2, or use a minimum and maximum pressure of 6.0 and EPR at 2. Note he lowest pressure your machine will produce is 4.0 cm so with a pressure of 6.0 or less, the EPR at 3 is pointless. If the pressure at 6.0 does not increase obstructive events, you can try a pressure of 5 with EPR 1. The objective is to keep pressure below the threshold at which your LES leaks, and above where obstructive apnea may occur.
Sleeprider
Apnea Board Moderator
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#4
RE: Waking up extremely bloated and full of air
Thank you very much for you advice. I really don't wanna use tape, so the tweaked pressure settings sound a lot more attractive. I will try using the 6-2 formula and see if it helps! :)
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#5
RE: Waking up extremely bloated and full of air
Let us know how it goes.
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#6
RE: Waking up extremely bloated and full of air
Hello Go2sleep

For 3 nights therapy, you've achieved incredible results and length of use. Well done.

Aerophagia was bad for me too in the early days as I seemed to swallow air quite a bit. I found that nasal pillows contained leaks well for me and I learnt the tongue trick-pressing my tongue against the roof of my mouth-to persuade air to go into my lungs rather than my stomach.

With time, aerophagia has settled for me as did the bloatedness. I feel sure you will too and encourage you to try Sleeprider's suggestions.
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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.
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#7
RE: Waking up extremely bloated and full of air
Thank you Anpea Infant, it's comforting to hear that the aerophagia and bloatedness can subside, I will try the tongue trick too!

Here's last nights report. Do note that I switched from the Philips Dreamwear Nasal pillows mask to a Resmed-provided Full Mask. I also sat the machine to the 6-2 formula. However I woke up a lot and the AHI seems to have suffered. It can be the mask though. I am going to try the 6-2 with the Philips and see if it helps!
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#8
RE: Waking up extremely bloated and full of air
I think if you want to try it you could get away with a 4low and 8max.
Though try the pressure you are on far another night or two, but I see the machine has max'ed out on pressure wanting to give you more.
However, you did change masks and that can confuse the issue.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#9
RE: Waking up extremely bloated and full of air
Go2sleep, the results at 6 pressure with 2 EPR are actually pretty good. The obstructive apnea and hypopnea occur in a cluster or two, and that suggests a positional issue. Most of your night was quiet and event-free. You can either increase the maximum pressure to 7 and keep EPR the same, or consider using a soft cervical collar or other approach to keep your chin from tucking to your chest. Honestly, I would not be too excited about the 2.3 AHI. All of your individual event indexes are under 1.0, so there is a mix of OA, H and CA. The more important question is how do you feel? Did this experiment result in more restful sleep and better comfort?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#10
RE: Waking up extremely bloated and full of air
I second Sleeprider's comments.

Your length of solid use continues to be impressive. Indeed your cluster of events are definitely due to positional issues and chin tucking. I use a neck collar to deal with those and the tongue trick to keep my mouth shut to persuade the air into my lungs.

I still do not sleep that solidly but my numbers are good and only go awry should I get a cold and am blustery. There has been a few days recently that I have had to take off my mask after 3-4 hours and sleep without purely due to a severely runny nose. I did suffer for that and notice the difference when I return to full night sleep, broken though it might be.

It is really early days(nights) for you and there will come a time when you wake up and feel hey, that was a GREAT nights sleep.
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Beginner's Guide to SleepyHead

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.
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