APAP to relieve aerophagia

[Ferloft]

I have recently started feeling like a balloon that needs to be popped. This has been causing a lot of discomfort and had me worrying about my health. Come to find out, aerophagia is a common complication of CPAP use and exactly matches the symptoms I have been experiencing.

Reading through some of the recommendations for relieving aerophagia the one that seems easiest to me is reducing pressure. Since originally getting my setup over a year ago I have been using the default setting that was given to me of CPAP pressure 15. I think my best option is to transition to an APAP setup so that the pressure is lower during the times I don't need it. That being said, I am looking for some recommendations on what settings to use for switching to APAP, given that my recommended pressure was 15.

On a side note, my new computer does not have a microSD port. Is there any way to convert microSD to USB so I can get my data into OSCAR? Once I get APAP set up I would like some way to evaluate the results.

Thanks!

[Sleeprider]

We have several alternatives available to us to relieve aerophagia. A reduction in pressure, including the use of EPR on your CPAP machine may be possible without sacrificing much efficacy. You should post an Oscar chart if you want some specific suggestions so we can see what pressures and events look like specifically in your therapy. There are also fairly new devices sold that compress the upper esophageal sphincter to suppress reflux, which has the additional benefit of reducing aerophagia. I was not aware of the existence of a "Reflux Band" until recently. Easy to find with an internet search. This could help a lot of members with this difficult problem. Here is a study: Upper Esophageal Sphincter Compression Device as an Adjunct to Proton Pump Inhibition for Laryngopharyngeal Reflux
https://pmc.ncbi.nlm.nih.gov/articles/PMC8286644/

[Ferloft]

Thanks for the reply. I am really trying to avoid needing to wear anything else to resolve my issue. I am committed to wearing the mask every day but I fear adding more will make it difficult for me to sleep. Preferably I would like to find some degree of settings changes that will help mitigate.

I have attached some OSCAR screenshots from the past week, as well as last night where I tried APAP for the first time. Please let me know what you think.

[SarcasticDave94]

Of note your ResMed takes a standard SD card. Amazon and others sell an SD card reader that will then plug into a USB port on the computer.

[Sleeprider]

Ferloft, in the two charts posted, on Feb 11 you were using Autoset mode with pressure from 4.0 to 15.0 and EPR 3; and on Feb 8, you used CPAP mode at 15 with EPR 3.  There was a cluster of obstructive apnea on Feb 11 that was "positional", meaning your airway was obstructed by your sleeping position that resulted in chin-tucking or a bend in the neck that resulted in airway occlusion.  https://www.apneaboard.com/wiki/index.ph...onal_Apnea  This event cluster also coincides with a high leak rate, and that is pretty common when the sleeping position dislodges the mask seal. I most often see this when side-sleeping in a fetal position with the chin tucked.   On Feb 8, with fixed pressure of 15/12, the event rate is lower, but we see periods of high flow limitation that feature  RERA and obstructive apnea and hypopnea. Again, this is likely positional.

If you you can sort out how this positional obstruction occurs, and prevent it, you will likely tolerate much lower pressures with no increase in apnea events. This may also be a key to the aerophagia.  I think you could use fixed pressure at 11.0/8.0 (fixed 11.0 with EPR 3) if you avoid the position(s) that cause you to obstruct.

[lessgroggy]

I'm not clear on what exactly you're asking, but I use an old micro SD card in an adaptor case to make it standard SD card size for use in my ResMed machine. I stick the whole SD card assembly (micro SD in card adaptor) into a standard SD card to USB-A card reader to load my data onto my computer. I just happened to have all those parts from old digital cameras so ask an older person who has a lot of electronics and it's likely they have spare they don't need anymore they can give to you.

[ejbpesca]

I experience aerophagia concurrently with bouts of severe GERD/acid reflux.  I will be looking into the reflux band mentioned above.  I also can have clusters lasting an hour of areas at AHI 70. The clusters have been called "positional."  After raising my min. APAP pressure the positional apenas are disappearing from OSCAR reports.  I had tried other means to resolve positional apnea issues without success (collar, chin strap, taping, and devices to prevent rolling to my back during sleep). All failed.

My positional apneas occur when I roll to my back during sleep.  I do not chin tuck sleeping on my side or back, it is gravity at work on sagging tissues that causes high flow limitations and up to an apnea per minute.  Higher min. pressure has been working to prevent positional apneas but also increases the possibility of aerophagia.

Two weeks ago I experienced a bout with severe acid reflux and with it came aerophagia which exacerbated the acid reflux.  Now the acid reflux is back down, the aerophagia is gone.

[mswertfager]

Hi Ejbpesca, 

You mentioned, " I had tried other means to resolve positional apnea issues without success (collar, chin strap, taping, and devices to prevent rolling to my back during sleep). All failed.
My positional apneas occur when I roll to my back during sleep. "


I am curious, how did the devices to prevent you from rolling onto your back fail? Were they passive device like pillows/backpack, or was it an electronic device like a NightBalance or NightShift?

-Michael

[ejbpesca]

I tried passive methods of 1. stack of pillows, 2. special wedge pillow, and 3. tennis ball in a T-shirt pocket.  I have not tried any electronic device.  I have come to realize that due to my chronic pain, I must sleep in a supine position at times so I quit attempting to stop it and, like last night I purposely move to supine to relieve pain.