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What most effects Aerophagia - GuppyDRV - 12-02-2017
So.....is it the EPAP or IPAP that most effects the severity of Aerophagia? What effect does FLEX or EPR have?
I know higher pressure is a factor as well as positional issues but there are many ways to twist pressure. Trying to figure out the best way to twist the @&$T out of this so as to put this one to bed once and for all.
GuppyDRV
RE: What most effects Aerophagia - Sleepster - 12-02-2017
(12-02-2017, 12:20 AM)GuppyDRV Wrote: So.....is it the EPAP or IPAP that most effects the severity of Aerophagia? What effect does FLEX or EPR have?
I know higher pressure is a factor as well as positional issues but there are many ways to twist pressure.
Well, IPAP is higher than EPAP, so IPAP will have a greater effect. You want to get both of them as low as you can without compromising your therapy too much. Flex and EPR lower the pressure, so they help.
Machines that auto-adjust the pressure are helpful because they allow you to spend more time at lower pressures.
Time to allow you to adapt can also help for many people.
Some people advise a cervical collar. I had to tuck my chin down towards my chest.
I beat it, but it was tough.
When you look at the settings in my profile, and the type of machine I have, all of that is to treat aerophagia without compromising my therapy too much. If I lower my EPAP much further that will induce centrals, and if I raise my IPAP much further that will cause more aerophagia, and if I lower it much more my hypopnea and obstructive indices will go up. It took a lot of tweaking to get to the settings I have now.
RE: What most effects Aerophagia - Apnea Infant - 12-02-2017
GuppyDRV
IPAP as noted by Sleepster would most affect aerophagia as that is the max air that is being blown in. Application of EPR and Flex results in EPAP and thereby reduces the volume of air.
For me, air was swallowed when I opened my mouth to breathe and thus open my oesophagus (food tube) as well. Using the P10, with air being blown directly through my nose and into my windpipe, aerophagia was much reduced but not completely till I mastered the tongue trick in association with using a soft cervical foam collar. The collar helped keep my mouth closed and also helped keep my tongue against the roof of my mouth. I have to confess that at time I do wake to some air escaping but it is nothing like in the early days.
My brother who has always kept his mouth closed awake or asleep uses a P10 but has no need for a collar.
I hope you do find what works for you.
RE: What most effects Aerophagia - Sleep2Snore - 12-02-2017
Difficult to say, I would think it should be when the pressure is highest, that should be when you breath in.
However, it would be just when you start to breath out that the pressure would be at its highest and with the change of air direction and just before the pressure drops might be the time everything is under the most stress and some air might get past the valve going to your stomach. Other have told me it is when they breath in.
Most say they are bothered by air in their stomach, but have no idea when it get in.
I have not really been bothered by this, but I have been known to blame it
RE: What most effects Aerophagia - Walla Walla - 12-02-2017
I've only had a problem with aerophagia when I once used a mask I had trouble breathing out with.
For me it was on the exhale that caused it.
RE: What most effects Aerophagia - GuppyDRV - 12-02-2017
I tried dropping pressure from 9 fixed down to 8 fixed. I also turned off Aflex. No issue with settings as far as comfort. My AHI jumped from a .5 average up to 5.0 last night. All Hypopnea no Obstructive or CA. No real Aerophagia but my sleep was a disaster. I also must say that even at .5 average I'm still not feeling the way I think I should be hence my feeling that making changes to fix Aerophagia couldn't hurt. I was wrong. I'll go back to 9 fixed tonight just to get back to my base line. I'll put up some charts on my other thread for additional feedback.
GuppyDRV
RE: What most effects Aerophagia - Sleepster - 12-02-2017
(12-02-2017, 02:40 PM)GuppyDRV Wrote: I also turned off Aflex.
That's the opposite of what you would normally do to treat aerophagia.
Since lowering your pressure from 9 to 8 seemed to help, but raised your OA and H indices, I would try setting it back to 9 and raising flex to at least 2 if not 3.
RE: What most effects Aerophagia - GuppyDRV - 12-02-2017
I found it hard to breath with the machine with Aflex above 1 (my breath would be cut short in an unnatural manner). My CA index also goes up with higher Aflex. My doctor indicated that reducing the spread between EPAP and IPAP by lowering Aflex or turning it off might actually reduce Hypopnea, that was not the case with my one night experiment. My Obstructive index is completely controlled with an EPAP of 7.5 which is achieved with a fixed pressure of 9 and Aflex 1 on the PR machine as the reduction is exactly 1.5 for me. My thought had been if 7.5 worked then setting 8 fixed no Aflex would control the Obstructive, the reduction in IPAP would help with reducing CA and Aerophagia and finally turning of Aflex would help the Hypopnea index remain constant and low as before even though I had reduced pressure.
So......good news the Aerophagia was definitely helped, I could even feel this while lying in bed breathing. No feeling of developing fullness etc.... The bad news....my numbers fell apart and I slept poorly. So much so that in the middle of the night I set my old numbers back to salvage a nights sleep.
A CPAP guru I am not......now what?
GuppyDRV
RE: What most effects Aerophagia - GuppyDRV - 12-02-2017
Small correction to my above post. I'm using Cflex+ set at 1. My understanding is that it functions the same as Aflex but I'll have to defer to a more knowledgeable member for conformation on that. From what I can tell they feel the same. I'll get some Sleepyhead charts up of my failed experiment tomorrow!
GuppyDRV
RE: What most effects Aerophagia - Sleepster - 12-03-2017
(12-02-2017, 11:36 PM)GuppyDRV Wrote: Small correction to my above post. I'm using Cflex+ set at 1. My understanding is that it functions the same as Aflex but I'll have to defer to a more knowledgeable member for conformation on that. From what I can tell they feel the same.
Both forms reduce the pressure on exhale. Lowering the pressure by any means is worth trying as a means to fight aerophagia. Keep in mind, though, that as you experiment with different adjustments, there are lots of other factors that affect aerophagia, so you can't draw a conclusion from a single night's sleep. Whatever you think is causing an effect has to be repeatable to be believable because those other factors, like sleeping position or what you ate or drank, can also have an effect.
But you still need to experiment with different pressure-lowering schemes. They each have their own particular unwanted side effects, so you have to try them all to see which ones work for you.
1. Auto-adjusting pressure machine. These machines allow you to spend more time at lower pressures, but the lower pressures may raise your OA or H indices.
2. Bi-level, whether in the form of a genuine bi-level machine or by using flex to lower the pressure on exhale. This lowering of the pressure on exhale is called pressure support (PS). Having too much of it can sometimes raise your CA index, but it might also raise your OA or even H indices.
Sometimes it's a balancing act between lowering your AHI and relieving your aerophagia. Also, aerophagia tens to subside as we ourselves adapt to the therapy, so you have to give it time to work.
Right now I've got my AHI about as low as I can get it, but even so it varies. My aerophagia just causes a bit extra flatulence on some days, nothing painful anymore.