Never ending Aerophagia, please help!

[sarahfv]

Hi! My husband has sleep apnea and an auto c-pap. About twice a week he wakes up so bloated he can't get out of bed for at least a half hour, until after it moves through his system and he has lots and lots of gas. 

I have read a lot about it. Here are the suggestions that didn't work-

1. This is common with new machines and will pass. ---he has had the machine and same settings for over a year, and had the same problems with the old machine he had for 7 years.

2. Sleep on your back with head tilted back.  ---he can't sleep on his back or he will snore (loudly) for some reason. He has a cpap pillow so side sleeping works.

3.Lower the max air pressure ---Looking at data, the machine frequently needs the max pressure often. When we had it turned lower he had many more instances of apneas.

The doctors have not been any use on this subject. Or really at all, besides being a gateway to getting the equipment he needs.

[Gideon]

Post charts from days where this occurs.  Pay attention to organization.  Your settings should show up on the lower of the screenprint.
The data will always help us to see what is going on, otherwise we can just say in general what to do.

Add a space as follows to the URL until you have "member" status.  "htt p://IMGUR.com/xxxx.png"

Fred

[OpalRose]

Hi sarahfv,
Does you husband mouth breath?  He could try to control that by using a chin strap, or a soft cervical  collar which helps keep the mouth from dropping open.  

If you scroll to the bottom of the page, under “related threads” there are other folks experiences that you could read.

As bonjour stated, we would be better able to advise when we can see some data.  Sometimes it’s just a matter of lowering pressure to see what works at the lowest possible pressure and still be treated for Apnea events, but we can’t really say without seeing what is going on.

If you could update his profile with machine name, mask and current pressure settings, that would be helpful.

[Sleepster]

3.Lower the max air pressure ---Looking at data, the machine frequently needs the max pressure often. When we had it turned lower he had many more instances of apneas.

For me the solution to this problem is bi-level therapy. This is commonly called BiPAP because one of the major CPAP manufacturers, Philips Respironics, calls their bi-level machines BiPAP instead of CPAP. Another popular manufacturer is ResMed, and theirs is called VPAP.

The machine you see listed in my profile is such a machine, with the added ability to auto-adjust pressure.

The strategy is to keep the pressure low. Bi-level machines lower the pressure on exhale, auto-adjusting machines keep the pressure low at times when higher pressures are not needed. Having both capabilities is the solution that worked for me.

A doctor put me on bi-level therapy at fixed pressure and this helped a bit. Then I bought an auto-adjusting bi-level machine on craigslist. Later I told my doctor how much better it was working for me, asked her to write a prescription for a new one, and she did. I used to have pain from gas every day. I now have a little extra flatulence on some days but never any pain; as opposed to the pain I used to have every day along with flatulence and lots of burping.

[sarahfv]

Hi guys.

Yes he mouth breathes often but has a full face masks.

Here's some data from last night. We were up at 4 with a sick baby, so we know the aerophagia happened between 4:30-7am.

[attachment=3922][attachment=3923]

[Gideon]

Your settings.
Min 9, Max 15, EPR 0 (off), No Ramp.
Device Resmed, either an S9 or an Airsense 10 Autoset.

Were my guesses correct?

The Apnea looks mostly positional. Try a loose fitting cervical collar to help with this.

For the Aerophagia I would suggest trying EPR,  That would leave the max pressure the same, so IPAP would be Max 15, but EPAP (exhale pressure) would be reduced by the amount of EPR (1, 2 or 3).


Chart organization   http://www.apneaboard.com/wiki/index.php...ganization
Organize your SleepyHead Charts
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• Flow Rate
  
  
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[pholynyk]

Sorry, Bonjour, with VS and VS2 flags, it must be some sort of Respironics machine. Also the spiky pressure pulses are Respironics.

I'm not sure that changes your advice any, but of course no EPR, and I'm not sure how AFlex will work to reduce aerophagia.

[Gideon]

And FL is showing as an event, I'm bad this is a PR machine.

My guesses were wrong. At least partially. Flex would lower exhale pressure, but differently than EPR and Resmed.

[pholynyk]

And I missed the FL as flag! My bad! Is it bedtime yet?

Those three event flags are the markers of a Respironics machine on a SleepyHead chart, as far as I can tell.

[Sleepster]

I'm not sure that changes your advice any, but of course no EPR, and I'm not sure how AFlex will work to reduce aerophagia.

It should be turned on to the maximum possible setting to help fight the aerophagia. If that doesn't work then I would recommend a BiPAP.