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+--- Thread: Experience with Aerophagia? (/Thread-Experience-with-Aerophagia)
Experience with Aerophagia? - OnFlight1978 - 08-25-2020
Hi all .. I'm new to the Apnea Board. Perhaps this question has been asked before, so I apologize in advance if this is a repeat. I originally started with a ResMed AirSense 10 back in November of 2019. About a month into using it, I started to notice discomfort in my abdominal area, gas, bloating, acid reflux etc. I followed up with my doctor, he explained that I should try sleeping on a wedge pillow and take Prilosec. However, none of that worked. I eventually got switched over to a ResMed AirCurve 10 VAuto. This has helped to some degree, however I am still battling what I believe to be Aerophagia. I've even discussed with my GI Doctor and he said the symptoms I have are classic to Aerophagia.
By chance does anyone have experience with my situation? If so, did you find a remedy? or are there any type of tests I should request from my doctor to confirm that it is Aerophagia?
I appreciate your time and insight!
RE: Experience with Aerophagia? - Sleeprider - 08-25-2020
Excellent question and since your title discusses aerophagia, there are some good related links at the bottom of this thread. At this point it looks like you are using IPAP 7, EPAP 4, which is a very low bilevel pressure. It appears that you are using a wedge, prilosec and other mitigation measures. I hope we can help you achieve efficacy and comfort with your Vauto. I want to encourage you to upgrade from MyAir to using OSCAR software. This can give us all a better view of your therapy efficacy. Aerophagia and sleep disordered breathing tends to be a compromise between controlling apnea and preventing excessive air ingestion. Have you seen a specialist like a ENT or Gastroenterologist to help you with the problem of aerophagia or GERD?
RE: Experience with Aerophagia? - OnFlight1978 - 08-25-2020
Thank you for your reply. I did see a Gastroenterologist and when I explained my symptoms he told me they were spot on for Aerophagia. I also inquired about any tests that could confirm that and was told no test exists to test for Aerophagia. However, I did have an MRI of the abdomen and nothing showed abnormal. What I find interesting is between the usage of the initial ResMed Machine and my current one, there was a period of about 30 days with no type of PAP usage. I would think between that time my system would had reset back to feeling normal, but it did not. I am not sure if that helps in providing some answers...
RE: Experience with Aerophagia? - Sleeprider - 08-26-2020
About the only thing I can think of is to take a look at your results in OSCAR and see if there is any room for reducing pressure.
RE: Experience with Aerophagia? - RNeil - 08-26-2020
You talk about acid reflux or gurd and aerophagia. You can have acid reflux or gurd without aerophagia (swallowing air). I don't know if aerophagia causes acid reflux. I suspect it does. The wedge pillow and prilosec can mitigate acid reflux, but not aerophagia. You should talk to the sleep doctor or the helpful people here about aerophagia because it is caused by pressure in your nose and mouth being higher than the stomach pressure from CPAP therapy.
RE: Experience with Aerophagia? - SarcasticDave94 - 08-26-2020
GERD, acid reflux, can be linked to aerophagia and PAP use. I myself have GERD; mine is caused by a hiatal hernia. My scripted med to treat GERD is Protonix. I've had aerophagia from time to time, especially when I first started on PAP therapy. It tended to reduce over time.
At the top of your stomach is a valve that should seal to prevent air from entering and acid from escaping up. When the valve muscles are weak for some reason, you get acid reflux and possibly aerophagia. Besides the GERD med, I sleep on my left side to help. You may want to try left side sleep to see if it's helpful.
RE: Experience with Aerophagia? - Sleepster - 08-26-2020
(08-25-2020, 11:32 PM)OnFlight1978 Wrote: there was a period of about 30 days with no type of PAP usage. I would think between that time my system would had reset back to feeling normal, but it did not. I am not sure if that helps in providing some answers...
The problems can't be due to aerophagia alone. Symptoms of that would disappear, it seems, almost immediately after stopping the CPAP therapy. There is a connection between GERD and obstructive sleep apnea, it seems that sleep apnea makes GERD worse. A lot of people report their GERD going away after they got adapted to CPAP therapy.
You will need to follow the advice you've received about OSCAR. The trick for me was getting the pressure high enough to treat most of the apneas, but low enough to not cause pain from the aerophagia. Then as time went by I was able to raise the pressures higher. Aerophagia does tend to subside, but not for everyone. We had a user here with very low pressures like yours but would still experience aerophagia with even slight increases in pressure.
RE: Experience with Aerophagia? - Sleeprider - 08-26-2020
Aerophagia can occur with or without CPAP treatment, and it is actually a swallowing behavior that carries the air to the stomach. I don't know how you suppress that swallowing at night, but that is the transport mechanism. I think with CPAP some people feel a need to swallow or reflexively do so.
https://www.webmd.com/digestive-disorders/what-is-aerophagia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525982/
Probably the best article: ttps://www.intechopen.com/books/sleep-and-its-disorders-affect-society/swallowing-gastroesophageal-reflux-and-sleep-apnea
We can limit the amount of pressure to try to mitigate aerophagia, but when it occurs even without CPAP then another therapeutic approach needs to be taken. CPAP is not the root cause of this problem. Most CPAP users never experience ingestion of air, however the condition is not uncommon. On the forum, we have often been able to coach individuals with aerophagia to find a pressure that does not exceed the pressure that can open the lower esophageal sphincter (LES). In this case we are dealing with someone on BiPAP using nearly minimum pressure already, and that experiences aerophagia even without CPAP pressure.