NEWBIE Intro | Side effects CPAP ? GERD & Apnea

[J3D]

Hello CPAPTALK ! Great site and has helped me out quite a bit on my new journey. I have a lot of questions & concerns.

MACHINE SUPPLIER: I do not trust the supplier settings. The supplier was not helpful Day 2 when I had questions on humidity settings because of throat dryness severity the 1st night.
My first night on machine was HORRIBLE. Only 2- 2.5 hrs sleep total !!! Dryness of throat was 1st major issue. And issue 2 was wrong size mask. That evening I didn't know the mask was wrong size. My nosie kept getting clogged and my dryness of throat was unbearable. I noticed day 2 when trying to nap that the small mask was pinching my noise when pressure increased on ramp up time.
So much for the 'fitting' with the supplier, they failed to get that right. Grossly wrong, I have a big head. LOL. The Supplier was non-responsive the 2nd day, i called many times, and I had to sic my insurance company on them to help to get a Large mask the next day.

SOOOOO needless to say this site was helpful immensely to get my machine setup better and get simple questions answered on settings.

I cant trust my supplier for info.

Machine settings now:
Ramp up time 45min. starting at pressure 4
ERP set at 3
Heat hose 82 degrees
Humidity level 8
Airplane Mode ON. I find it invasive I was not informed nor signed any paperwork re: data being collected. Waiting to see if someone calls me to ask about. They didnt inform me nor give me SD card. I do have to met 4hrs use per night for insurance to cover, so I think someone intended on pulling the information. I will take an SD card to the Pulmonary Dr myself.
Set to CPAP
Press, level: 12 (prescription from titration)

I am very interested in trying the autoset APAP. to get a sense of OSA vs. CSA and/or see if varying or lower pressures are more conducive to my situation.
1 study, 1 night, foreign place (lab) just may not capture the full situation of potentially varying events for myself - is what i am thinking ? your thoughts?

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About my situation.
APNEA: I have Sleep Apnea, supposedly OSA kind, moderate. I did 2 in lab sleep studies (intial study & the titration). Was having 21-28 apnea events an hour after asleep an hour.

I started noticing Drowsiness increasing the past 3 years, throughout the day and during certain activities. I just recieved a RESMED Airsense 10 autoset this past week, w/ built in humidifier.

GERD: At same time over past 3 years I also had GERD. I went to gastro doctor and had to get an endoscopy. Was told my esophagus is really bad. Biopsy no cancer thankfully

BOTH DOCTORS think the other condition caused it (Apnea caused GERD & GERD caused Apnea).
My Pulmonary doctor is waaaay more thorough in explanations & far better at communication so I tend to trust him more.
Gastro doctor just simply doesn't explain anything and does not want to really communicate and is quite crass. I feel like a number rather than a person for <5 min. pop in the room $$ charge. Thus, I am seeking another Dr. on the Gastro. BUT my GERD is real and the endoscopy did show it was bad or had some tissue damage.
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SIDE EFFECTS ?
Now I gave background above because as I am beginning my Apnea machine venture. 1 week prior, I started Omeprazole medicine for the GERD and have not had one episode of acid indigestion. Before I kept under control with Famotidine for about the last 2 of 3 years which always settled my stomach, which I needed it once a day on average when I started to feel the onset. The Omeprazole I simply haven't even had the onset of indigestion at all.

I have symptoms now of :
A. tightness in stomach. (1 week ago starting medicine)
B. burping a lot (everyday since Thurs. starting Apnea machine)
C. maybe bloating feeling? hard to describe. (everyday since Thurs. starting Apnea machine)
D. high level Dryness of throat (100% machine) builtin humidifier isn't helping to alleviate, I have on 82 heated hose and level 8 (highest) for humidity. Tonight I am putting
Thus dryness has caused me to wake up restless 1/2 dozen times a night and each night I must take mask off for a period unless I want to rip my throat apart from the dryness. I average so far 5.5. hrs with mask on a night)

It feels as if I have too much air in my stomach. AM I getting air bypass in my abdomen perhaps from the CPAP

These symptoms and conditions have been simultaneous, which makes it harder to isolate.

QUESTIONS:
Anyone similar situation with both conditions?
What are side effects of starting Apnea machine?

[dogsarelife]

Hi I had truly awful GERD from sleep disordered breathing. In my case it was Upper Airway Resistance Syndrome suctioning up my stomach contents. obviously I don't know if your GERD is from sleep apnea, but it is a possibility. In my case, I didn't get any relief from omeprazole or esomeprazole, zantac (ranitidine I believe is the generic name), or antacids like Tums.

This was the explanation I received from my doctor as to how my sleep disordered breathing contributed to my GERD:

When a person goes to sleep, the body's muscles become more relaxed, including those of the jaw, the tongue, and the throat. This leads to the jaw and tongue sliding back, and the throat becoming less rigid. These changes make the diameter of the top of the airway narrower, requiring more effort to pull air into the lungs. This can lead to airflow turbulence, creating vibration of the soft tissue in the airway. This sometimes produces sound (i.e., snoring) and can lead to mucosal irritation and mucous production during the night. The body compensates for this airway narrowing by increasing chest expansion, which generates a stronger vacuum force in the chest to pull the air into the lungs. In OSA, the soft tissue at the top of the throat may collapse due to this vacuum, closing the airway. In UARS, this does not happen, and the airway stays open. However, the relatively narrow opening leads to sustained increased effort to breathe during the night. The body sometimes thrusts the jaw forward and clenches it in place in order to keep the tongue forward to widen the diameter of the top of the airway. This thrusting is the source of teeth grinding, while the clenching can lead to significant muscle soreness and headaches.

Meanwhile, the sustained increased respiratory effort to pull air through a narrower opening is interpreted as abnormal by the peripheral nervous system, leading to strong signals being sent to the brain that cause brief disruptions in sleep. These disruptions interrupt the normal sleep cycle, reducing the efficiency of the brain's restorative process and therefore can lead to daytime sleepiness and fatigue, as well as impaired concentration and memory.

[...]
This vacuum pressure also can lead to acid being pulled up from the stomach and into the esophagus, leading to heartburn at night.

https://www.huffpost.com/entry/upper-ai ... _n_6649766

I think in those without a weak lower esophageal sphincter, they just get heartburn, but in those with a weak esophageal sphincter I think they get actual acid in their mouth? (not a doctor, so take what I say with a grain of salt).


I was at too low a pressure for a long time because my first sleep doctor didn't think it was necessary to mess with minimum pressure for an apap.

If you search "aerophagia" I found a thread where someone chose to lower their pressure from the titration encouraged by others that it's better to use your xpap at a less than ideal pressure rather than be in completely discomfort from it and having disturbed sleep all night long?

you can really only find that pressure that works for you with sleepyhead I think. good luck!

[Julie]

Do a forum search on Aerophagia and you'll see lots and lots of discussion about your 'tightness'.... which as previous poster said can often be relieved by just lowering min. pressure by 1-2 cms if it doesn't seriously impact your therapy otherwise. And lots of us have had GERD and treat it differently... I personally just take 1/2 a TUMs before bed and that works for me.

[dogsarelife]

I am very interested in trying the autoset APAP. to get a sense of OSA vs. CSA and/or see if varying or lower pressures are more conducive to my situation.
1 study, 1 night, foreign place (lab) just may not capture the full situation of potentially varying events for myself - is what i am thinking ? your thoughts?

oh sorry - I forgot to say, I think you have this part right. Setting your pressure, as far as I understand it, is an ongoing process.

and as for side effects of xpap - I got aerophagia some nights, but overall I also saw my GERD get much, much better. But I understand that may not be the case for everyone.

[J3D]

Dogsarelife and Julie, good feedback and thanks. I will begin research for the term you mentioned.

To clarify I started feeling a some 'tightness' when starting the omepraxole, which was 1 week before starting CPAP.
When starting the CPAP 3days ago I started feeling
A. even more 'tightness" in the intestinal area
B. bloating
C. And gradually increase amount of burping. I feel the small air pockets come from stomach. It is not uncomfortable and not acid indigestion. Weird air pockets feeling.

[Julie]

Also raising the head of your bed on 5" blocks can help depending on how you sleep otherwise... but I don't mean a mattress that folds, but a straight one.

[Janknitz]

You may be having dryness in your mouth because of mouth breathing. All the humidification in the world won't help that. Try training yourself, during the day, to breathe through your nose by placing your tongue on the roof of your mouth just behind the front teeth and sealing the lips. Do this all day unless you are talking or eating. With practice, this may become habit and carry over to night time. That will also reduce any aerophagia (swallowing air) you may have with CPAP.

GERD may be caused by OSA or OSA may be caused by GERD. It tends to be a viscous cycle. Aerophagia can exacerbate both conditions, because it increases abdominal pressure and causes more GERD. Ideally, if you can keep your mouth sealed with CPAP and stop swallowing air, this should improve.

Omeprezole and Famotidine were not meant for long term use. They suppress stomach acid and we NEED stomach acid. There are two really helpful books:
Fast Track Digestion: Heartburn by Norm Robillard https://www.amazon.com/Heartburn-Digest ... +heartburn

And Why Stomach Acid is Good for You by Jonathan Wright, MD https://www.amazon.com/Why-Stomach-Acid ... han+wright

Once you get the CPAP under control and stop the aerophagia, you will find these books helpful to address the GERD.

[TheDuke]

It does take a period of time to acclimate to CPAP/XPAP, good luck on your "Journey" toward control of apnea. By the way, My personal experience has been that I strongly prefer not to use the pressure ramp, and quite a few others on this site appear to feel the same way.

TheDuke

[Rainmom17]

The burping sounds like aerophagia as others have mentioned. But, I recently went on Prilosec (brand name of what you’re taking), and it’s causing all kinds of gurgling, burping, and just a lot of weird air in my upper digestive track. So maybe your burping is from the med.

[J3D]

Good points all...
I started omeprazole 1 week prior. I did not have burping on the med for that week, nor did I feel bloated. I started having these symptoms day after I started CPAP. Thus, I am leaning it is a CPAP side effect for me???

Only symptom(s) I had prior on omeprazole without CPAP, was tightness in abdomen area and upset stomach one day for the week.
However, I had the titration 2 days prior to starting omeprazole and it could have been tightness carried over from the titration session. I had severe muscle tightness the morning I last awoke from the titration, a very strong sensation pain I never felt before.

Has anyone had burping after they started CPAP anew?

It stinks I have this dual treatment stuff going on, but I really do think it is somewhat related to each other... One is exasperating or causing the other. I will be making calls to find a doctor that may be knowledgeable of both Gerd and Sleep Apnea at same time.

[nicholasjh1]

I did get some wierd effects from omprezole... It did seem to help healing my throat though. I also got an inclined pillow that seems to be helping. as for the dryness... I put the heat as low as possible... Just enough to stop condensation... of course that's effected by your local atmosphere. at 8 humidity I have it at 73 degrees... but I also live at 5280 feet above sea level.

[dogsarelife]

@J3D -

If I were you, then I would want to utilize this forum at what it does best- help making sure the xpap portion of things is optimized.

So if I were you, that would mean that I would start a new thread with a focus on posting my sleepyhead charts, with the images formatted as per the instructions on the main page of the forums. I would focus on - do I feel rested when I start the day, do I still feel foggy brained and tired, how do my flow rates look.

Once the sleep portion is sorted out, I think it will be easier to make decisions about other health issues. That is the advice I would give to myself a year ago, a friend or family member, or anyone else who is caught in a chicken and egg situation where they have a health problem that interrelates with sleep apnea. Sleep is the basis for a lot of bodily functions to work correctly in my experience.


good luck!

[J3D]

I agree with you dogsarelife.

I need to go get an SD card reader to xfer data. Have SW already loaded. Will start a log as well.

After going over all that s occurred the past 2 weeks, I do think I have mild case of air being pushed into stomach (aerophagia) root cause CPAP.

Last night I had episode a poor mask seal on the CPAP and evidently slept that way for a large portion of the 5 hrs total time I got to sleep.
I am tossing and turning with the CPAP, and wake up a lot from dry throat. vaporizer in the room did not help much it seemed, maybe intially and little better, buit not a total solution.

Anyways, with the mask seal leak I got the red gloom face report this a.m. LOL. SOOOOO I obviously was not receiving all the "12" pressure... and guess what .... I havent really been burping small air pockets today and do nto feel as bloated... as well the AHI are only 2.1 compared to 1.2 average couple night before.

------------->>>>>>>>>>>>>> So based on this, it would seem logical the controlled "12" pressure maybe a little high for me? Autoset may be a valuable course for me to try at this point ???

THOUGHTS???

[zoocrewphoto]

Auto mode is certainly worth a try. But it is hard for us to give much advice until you have data pasted. We don't want to make uninformed guesses.

[J3D]

Should I post graphs here? Or is there a section for members data posts?

Does Data indicate anything?

Should I increase max pressure since I hit the limit? Does it appear in graph I kept having OSA/hypopnea at 13?

.....
This is data from last night for a couple hours. It was rough and AHI was 12 during this period. I do not remember taking mask off . But when I woke in the a.m. I continued but I laid there 2 hrs and never could fully goto sleep so the AHI average went down to what is shown above.

I switched to Autoset 2 nights ago and it was much much better where I could sleep 2-2.5 hrs straight. I set 4 to 12 pressure first night and 4-13 last night.
1st night on Autoset was great 5 AHI events. Last night spiked much more.
Prior to that at constant 12 pressure I could only sleep 45min to 1.5 hrs at most straight.

Aerophagia I experienced for 3 days (burping most day) seems to have went away. Bloat feeling is gone as well.
Still no acidic stomach since starting omeprazole.

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