Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Setting up for success to eliminate aerophagia and mask leaks
#1
Setting up for success to eliminate aerophagia and mask leaks
I need help with figuring something out and the best course of action to minimize aerophagia and dry eyes when I get my new Resmed (transitioning from DS). My sleep doctor is MIA. 

- Untreated AHI 90.
- Fixed pressure of 6 using DS1 kept AHI below 3. 
- A lot of mask leaks, but even with that was still receiving therapy results per PA. Used Philips Respironics Dreamwear full face mask small size.
- I mentioned pressure felt like it was too much to PA, PA agreed to set the ceiling pressure from 20 to 10. This felt better, and was able to sleep longer with the mask on. Still woke up in the middle of the night, but longer therapy hours overall. Used ramped down button to be able to fall asleep (setting 4).
- To lessen air leaks Tech recommended a different mask to get a better seal. Tried Resmed Airfit F301 full face mask small size with Resmed tube standard size. The standard frame was a bit too large at the top. Tried between the two masks, ended up getting a better seal with the Dreamwear small size mask. The air volume coming from the Resmed tube felt larger too.
- Told PA felt like fixed pressure 6 was too much, she didn't want to lower it until after addressing the mask fit and leaks. Recall happened.

After discontinuing using the DS, I realized the CPAP had caused significant aerophagia. The bloating is all gone now. CPAP also caused dry eyes, those symptoms are gone now as welll. When I get the new machine, Resmed AirSense S10 Auto, I was thinking of trying the following to prevent aerophagia and dry eyes.

- Try what prescribed fixed pressure of 6 is like with Resmed.
- Use ramp feature to be able to fall asleep, start from 4 ramping up to 6.
- Use EPR 1-2 to make it easier to exhale. I found it difficult to exhale with DS1 with no exhale relief. Kept waking up in the middle of the night to ramp the pressure down to 4 and fall asleep again constantly.
- Maybe try a range of 5 - 6 or 5 - 7 with EPR on accordingly.
- Try without EPR on.
- Try another type of mask, air pillow mask with sleep collar.
- Analyze results using Oscar. Software already installed. (I don't like phone apps.)

The prescription says CPAP, ramp 6. I'll ask for the other records (sleep study and notes from visits) to get the information I need. I do recall that during the first month of CPAP trial when I think the 4-20 algorithm was running to find the optimal pressure setting that I woke up in the mornings and the pressure was at 5.3 and it felt very comfortable. In the middle of the night I woke up a lot at various pressure setting points, the highest I remember was 8.3 and that's when air was pouring out all around the mask seals and I had to pull the mask off, very uncomfortable. I was a mouth breather, with the full face mask learned to breathe through the nose. Breathing through the nose is no longer a problem.

What do you think?
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Setting up for success to eliminate aerophagia and mask leaks
As normal post OSCAR data. DS if you have that now and AS10 later. Then we can really see where you are.

Go to the wiki and read the Mask primer. Could be chin drop. Could be fit.

How long have you been on CPAP?
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
Post Reply Post Reply
#3
RE: Setting up for success to eliminate aerophagia and mask leaks
Thanks, very helpful article! I was on CPAP for five months; this coming Sat. will be two weeks off due to the DS recall. Ins. informed me that I'll be getting the new replacement machine AS10 within a week. (I have been checking the online suppliers too in case in-network DME route didn't work out and I would have to look for out-of-network.) I don't have Oscar data for the DS, I'll start using Oscar with the AS10 and will post the data.
Post Reply Post Reply
#4
RE: Setting up for success to eliminate aerophagia and mask leaks
You will like the RM AS10 better machine than the DS.

I am sure others will comment. Most likely will want Oscar data.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Setting up for success to eliminate aerophagia and mask leaks
My ophthalmologist suggested using Systane GEL drops when she found out I used a CPAP. She said it's not uncommon to have dry eyes if you use a CPAP. One drop in each eye before going to sleep.

If you read in bed before 'sleep' don't put them in until you are ready to go to sleep. The drops can make your vision slightly blurry.

I've not had a problem with dry eyes since I started using these drops.
Post Reply Post Reply
#6
RE: Setting up for success to eliminate aerophagia and mask leaks
Thanks for the tip to alleviate dry eyes, I'll try it!

On the aerophagia issue, looking at studies to find information. 'Aerophagia During CPAP for OSA: The Case for Auto-CPAP and Nasal Mask' (study from 2017) mentioned the following: "Few randomized controlled trials have been designed to address CPAP side effects. Aerophagia is one of the common side effects of CPAP that has not been adequately studied. Auto-CPAP significantly improved aerophagia symptoms. The results of this study provide clear evidence to switch treatment of patients experiencing aerophagia from fixed CPAP to auto-CPAP. Auto-CPAP may improve aerophagia symptoms by reducing mean overnight CPAP level. Aerophagia symptoms were significantly greater under oronasal fixed CPAP as compared to nasal fixed CPAP. There is growing evidence that oro-nasal CPAP may lead to higher unintentional leak, require higher therapeutic pressure level.”
Post Reply Post Reply
#7
RE: Setting up for success to eliminate aerophagia and mask leaks
Pardon me for hijacking this thread, but I just started having aerophagia, and I mean bad. I woke up with it at 6am this morning and as I write this it's 9pm, and I'm still burping and feeling bloated. I haven't eaten anything all day long except a decaf grande with cream, and several glasses of plain water, yet I threw up three times. A week ago I had the first episode of aerophagia, although it wasn't quite as bad as today. I've been on PAP since 2012 and I never had aerophagia before.

Both my machines are set at 15-25, one is a recalled Dreamstation BiPAP that I use when I sleep on my bed upstairs, and a Resmed S9 ASV sitting on a table next to my recliner downstairs. Both cases of aerophagia happened on the Dreamstation. I read that sleeping sitting up might provide relief, so tonight it's Resmed's turn in the recliner. For both machines I use a P10 mask, and OSCAR says my leaks are usually decent, although once in a while the mask and I need to talk. 

I can't understand this. Nine years of PAP, excellent control, and never a case of aerophagia.
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Setting up for success to eliminate aerophagia and mask leaks
(07-17-2021, 11:24 PM)JJJ Wrote: I just started having aerophagia, and I mean bad. I woke up with it at 6am this morning and as I write this it's 9pm, and I'm still burping and feeling bloated. I haven't eaten anything all day long except a decaf grande with cream, and several glasses of plain water, yet I threw up three times. A week ago I had the first episode of aerophagia, although it wasn't quite as bad as today. I've been on PAP since 2012 and I never had aerophagia before.

I can't understand this. Nine years of PAP, excellent control, and never a case of aerophagia.

Today I went to the urgent care people at my provide (Kaiser Permanent) and discovered that the problem is a gall bladder infection. I'm on my way to the hospital to have it removed.
Post Reply Post Reply
#9
RE: Setting up for success to eliminate aerophagia and mask leaks
I can't believe it took them four days to do it, after telling me at the beginning that I would have it out in the morning and be home in the afternoon.

But the crucial part for people here is that 'aerophagia' is also symptomatic of gall bladder failure, hence my initial pointing my diagnosis in the wrong direction. A diagnosis of PAP failure resulting in aerophagia could be the wrong cause of the aerophagia. And it may not even be aerophagia at all - it may be gases produced by the various pathogens that often infect the gall bladder. That's what caused what I was calling aerophagia.
Post Reply Post Reply
#10
RE: Setting up for success to eliminate aerophagia and mask leaks
Thanks JJJ. I have not heard of this before, but noted that sudden aerophagia may be an indication of a need for medical attention.
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.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Treatment] Koala1 - Moving to Resmed, aerophagia, please help with optimization koala1 89 1,642 6 hours ago
Last Post: koala1
Arrow Your Personal CPAP Success Story - Post Here SuperSleeper 1,212 506,848 7 hours ago
Last Post: S. Manz
  terrible aerophagia - please help gettingbetter 19 389 Yesterday, 01:02 PM
Last Post: Rice95
  OSCAR Questions - Leaks, Minimum Pressure and Central Apnea hookedonstitch 3 97 08-02-2021, 02:14 PM
Last Post: hookedonstitch
  Questions about TiMax setting on AirCurve 10 SakimaStorm 15 278 07-31-2021, 03:10 PM
Last Post: SakimaStorm
  Recommendations for aerophagia? always_tired 7 221 07-30-2021, 11:51 AM
Last Post: Cpapian
  Understanding leaks P30i cathyf 5 167 07-29-2021, 08:34 PM
Last Post: 2SleepBetta


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.