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Aerophagia

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Definition

The word "phage" in Greek means "to eat." Aerophagia is literally to eat air. In the modern context, it means swallowing too much air, a common cause of gas in the stomach and belching.

This is sometimes a result of CPAP Therapy. Unfortunately, the best solutions for this problem are not a catch all but instead an attempt to find the middle ground between needed CPAP pressures.

Note: The correct term for air in the digestive system due to the use of CPAP or ventilators is "gastric insufflation". However, the use of the term "aerophagia" is so ingrained in this forum that it is accepted as correct. When speaking with medical professionals, you should remember to say "gastric insufflation".

What You Can Do

1. Tell your CPAP prescribing physician. It may be better to decrease the CPAP level a bit and put up with some minor airway problems if we can significantly decrease the bloating. Sometimes this works great, sometimes not at all.

2. As the chin of a CPAP user nears the chest, air has a greater change of entering the digestive tract. Keep chin up so that the spine is erect. Also, do not position the head back beyond straight with the neck. Wearing a firm foam cervical collar will keep the neck in the best position for airway patency and help prevent the jaw from dropping.

3. Sleeping in a position different than normal helps keep the air out of the stomach. Try different sleeping positions. Left side, right side, inclined with pillows, or flat.

4. Try a bed wedge to sleep with the head elevated. Get a long wedge that extends from the head to below the hips. Shorter wedges cause the body to bend at the abdomen and may worsen the condition and cause other problems. Another option is placing the legs at the head of the bed on bed lifter blocks available at Bed, Bath and Beyond and other retailers.

5. Try a custom CPAP pillow, neck pillow or memory foam pillow.

6. Try an APAP machine. If already on APAP, reduce your top pressure, as long as your AHI (apnea hypopnea index) continues to remain low; or try the straight CPAP mode.

7. Try a BiPAP machine or auto BiPAP machine.

8. Have a gastroenterologist examine your lower esophageal sphincter -- it is this that is letting air into you stomach, and sometimes it needs medical or surgical intervention. Silent Gastroesophageal Reflux Disease (GERD) (a return of acid for you stomach to you nasal cavity that you don't even feel) is a known cause of congestion and sleep disruption, and having it properly treated helps in improving your sleep quality -- including a reduction of AHI.

CPAPTalk.com member Ozij has this to say about treating Aerophagia.

If these fail, It may be that you should consider a surgical alternative to CPAP. Many have tried all sorts of other solutions to this bloating problem with little success. Be aware that UPPP surgery has fallen out of favor with many surgeons because of the low success rate and irreversible side effects. Spend a long time studying the situation before deciding. Ask your surgeon how he determines whether your airway anatomy makes you a good candidate and what are the odds that you will be cured of sleep apnea.

This may be a temporary condition as you adjust to xPAP or a new mask, or it may be recurring or ongoing. Symptoms range from being painful to being merely socially embarrassing. See your doctor to rule out other related digestive disorders.

Coping With Aerophagia

1. Drink carbonated water or a fizzy beverage in the morning to help belch out gas.

2. Use wind-relieving yoga postures that compress your abdomen in the privacy of your bathroom or boudoir.

3. For digestive gas in the stomach, try over-the-counter simethicone products like Gas-X. Note that simethicone will not prevent digestive gas. Simethicone is a defoamer that will help break down many smaller bubble of gas to larger bubbles.

4. For digestive gas in the intestines, try over-the-counter activated charcoal tablets. Note that the science on charcoal tablets is inconsistent on whether they help with gas. Also note that there are side effects with chronic use. Consult your doctor if you intend to use the tablets for more than a few days.

5. Take steps to establish a regular early morning bowel habit to avoid flatulence after leaving home. Eating breakfast early and drinking a warm beverage such as coffee, tea or non-alcoholic cider helps to stimulate the bowel.