Best solutions for reducing aerophagia?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
rainydaywoman
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Best solutions for reducing aerophagia?

Post by rainydaywoman » Thu Feb 07, 2013 4:17 pm

Hello, All. I hope I can get some help and useful advice. I just started using my machine and mask 3 nights ago and woke up several times with excruciating gas pains in my stomach chest and belching, etc, you get the idea. I feel at a loss because I was sent for a sleep study ( at my husband's insistence - he noticed the cessation of breath and heavy snoring and I noticed I sometimes awoke out of breath. ) I didn't have regular doctor, so this was requested from the clinic at my husband's job - from a nurse practicioner.

The night of the sleep study I only slept about 1 hour and according to the report never went into REM sleep. That was with a full face mask and my cheeks kept blowing out like a chipmunk. I didn'lt notice the gas that night - maybe just slightly uncomfortable the next morning, but not too bad.

I took my prescription to the DME place and they gave me a machine that is I guess straight CPAP - it doesn't titrate only monitors length of use. THe have me at a pressure of 9cm. It is a nasal mask pillow Swift for Her - I have a very small face. I asked to try this one because I found the full face mask so very uncomfortable.

Anyway, I will gladly go back to a full face mask if it will relieve these horrible air swallowing and pain. I saw on here where people say to get an Autotritrating machine.

Should i try to ask for that? What about masks? Any help would be greatly apppreciated because I feel so discouraged and don't even feel like going to sleep at night becasue of this.

herefishy
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Re: Best solutions for reducing aerophagia?

Post by herefishy » Thu Feb 07, 2013 4:35 pm

Do you have c-flex, a-flex, or EPR? These reduce the pressure that you breathe out against and helped me with the pain.

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rainydaywoman
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Re: Best solutions for reducing aerophagia?

Post by rainydaywoman » Thu Feb 07, 2013 5:04 pm

herefishy wrote:Do you have c-flex, a-flex, or EPR? These reduce the pressure that you breathe out against and helped me with the pain.

I don't know. I know it is a straight CPAP machine. I looked at it and it just says its Phillips Respironics Remstar.

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Always tired
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Re: Best solutions for reducing aerophagia?

Post by Always tired » Thu Feb 07, 2013 5:34 pm

rainydaywoman wrote:Hello, All. I hope I can get some help and useful advice. I just started using my machine and mask 3 nights ago and woke up several times with excruciating gas pains in my stomach chest and belching, etc, you get the idea. I feel at a loss because I was sent for a sleep study ( at my husband's insistence - he noticed the cessation of breath and heavy snoring and I noticed I sometimes awoke out of breath. ) I didn't have regular doctor, so this was requested from the clinic at my husband's job - from a nurse practicioner.

The night of the sleep study I only slept about 1 hour and according to the report never went into REM sleep. That was with a full face mask and my cheeks kept blowing out like a chipmunk. I didn'lt notice the gas that night - maybe just slightly uncomfortable the next morning, but not too bad.

I took my prescription to the DME place and they gave me a machine that is I guess straight CPAP - it doesn't titrate only monitors length of use. THe have me at a pressure of 9cm. It is a nasal mask pillow Swift for Her - I have a very small face. I asked to try this one because I found the full face mask so very uncomfortable.

Anyway, I will gladly go back to a full face mask if it will relieve these horrible air swallowing and pain. I saw on here where people say to get an Autotritrating machine.

Should i try to ask for that? What about masks? Any help would be greatly apppreciated because I feel so discouraged and don't even feel like going to sleep at night becasue of this.
Rainydaywoman,
There is good help available on this forum, hang in there. Things will get better--suggest you go into your profile and list (by text and not picture) the type of machine you have. There are lots of mask and nasal pillow options for you. Most members try many masks before finding the right one. Contact your DME and tell them you are not satisfied with your mask. Also you may be able to go to your sleep center and try some different ones out. Do you use a chin strap? If not you may want to try one. Is your machine data capable (is there an SD card in the back)? If so we can teach you how to look at and evaluate your sleep data. Lots to do at once and the frustraction factor is running high and you're tired. We have all been there. Try breaking it down one thing at a time. I am not knowledgeable about aerophagia, but others here are. Finally do you have a copy of your sleep report? If not request one. You will have to become your best advocate.
A T
12x35 and if you understand this we have a good guess at your musical likes and age

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Todzo
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Re: Best solutions for reducing aerophagia?

Post by Todzo » Thu Feb 07, 2013 6:28 pm

I seem to only have this during times of extreme stress from post traumatic stress.

I have not seen it since I moved to a small "less stress" town.

During anniversaries of the incident which precipitated the post traumatic stress I use EERS[1].

[1] :
Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741
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Re: Best solutions for reducing aerophagia?

Post by Cpap momma » Thu Feb 07, 2013 6:31 pm

Try taking a gas ex before bed. You may need a bipap.

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archangle
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Re: Best solutions for reducing aerophagia?

Post by archangle » Thu Feb 07, 2013 8:00 pm

rainydaywoman wrote:
herefishy wrote:Do you have c-flex, a-flex, or EPR? These reduce the pressure that you breathe out against and helped me with the pain.

I don't know. I know it is a straight CPAP machine. I looked at it and it just says its Phillips Respironics Remstar.
Take out the water tank from the humidifier. Then look on the bottom of the blower unit for label with a 3 digit number like 250P, 450, etc. The blower unit is the left hand part of the unit. The part where the water tank goes is the humidifier. Next to the display, it should say something like REMstar Plus.

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jweeks
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Re: Best solutions for reducing aerophagia?

Post by jweeks » Thu Feb 07, 2013 9:51 pm

rainydaywoman wrote:I just started using my machine and mask 3 nights ago and woke up several times with excruciating gas pains in my stomach chest and belching, etc, you get the idea.
Hi,

I can confirm that getting air into your system is very painful. I suffered with this for a few months as I was losing weight. It came on when I reached a certain weight, and then just went away at a lower weight. The only explanation that my RT could come up with is that it was a fluke of geometry in how the top of my airway and esophagus are oriented. I never did find a good way to cope with it, but I know that others here in the forum have battled and beaten air ingestion.

-john-

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Pugsy
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Re: Best solutions for reducing aerophagia?

Post by Pugsy » Thu Feb 07, 2013 10:11 pm

Check out this link for some ideas what you can do.
wiki/index.php/Aerophagia

You need to learn about your machine and the exhale features..adjustments might help.

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hyperlexis
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Re: Best solutions for reducing aerophagia?

Post by hyperlexis » Thu Feb 07, 2013 10:19 pm

jweeks wrote:
rainydaywoman wrote:I just started using my machine and mask 3 nights ago and woke up several times with excruciating gas pains in my stomach chest and belching, etc, you get the idea.


It's an issue of physiology. Air is getting into the esophagus and into the stomach. It can be very painful. I get it sometimes.

Try this:

https://www.youtube.com/watch?v=-65JWNBttnE

rainydaywoman
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Re: Best solutions for reducing aerophagia?

Post by rainydaywoman » Fri Feb 08, 2013 7:16 am

archangle wrote:
rainydaywoman wrote:
herefishy wrote:Do you have c-flex, a-flex, or EPR? These reduce the pressure that you breathe out against and helped me with the pain.

I don't know. I know it is a straight CPAP machine. I looked at it and it just says its Phillips Respironics Remstar.
Take out the water tank from the humidifier. Then look on the bottom of the blower unit for label with a 3 digit number like 250P, 450, etc. The blower unit is the left hand part of the unit. The part where the water tank goes is the humidifier. Next to the display, it should say something like REMstar Plus.
Okay, I looked at it. It says REMstar (not plus) and the 3 digit number is 150P.

Should I ask for an autopap or bipap? I just want something that can vary the pressure and make it easier to exhale.

herefishy
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Re: Best solutions for reducing aerophagia?

Post by herefishy » Fri Feb 08, 2013 8:02 am

You definitely need a machine that has "exhale relief" of some sort. Ask your therapist to show you how to turn this on, or to do it for you.

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Pugsy
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Re: Best solutions for reducing aerophagia?

Post by Pugsy » Fri Feb 08, 2013 8:15 am

The model 150 is the most basic plain machine...not even any exhale relief is available.
Bottom of the barrel model.
They supplied you with the cheapest that they had in terms of cost to them.

Read this...all the way to the bottom of the page.
http://maskarrayed.wordpress.com/
It explains data and what your options might be when you discover you have been given the most basic of machines.

You want at LEAST Remstar model 450 machine. That's the lowest model number that offers full data.

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DiverCTHunter
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Re: Best solutions for reducing aerophagia?

Post by DiverCTHunter » Fri Feb 08, 2013 8:48 am

Well, looking at the DS150, it's not a brick, but it's inexcusable for Phillips to have built it in the first place. Same hardware as the DS450, but extra-crippled firmware - no C-Flex, no A-Flex, no nothing.

If you're still in your rental period, I'd take it back to the DME and get your Dr. to prescribe either a DS450, DS460 or a DS560 with a "Dispense as Written".
When in doubt, open the case. Remember: If you can't open it, you don't own it!

Prescribed APAP range - 6-10 cm/H2O, titrated at 8.
Current range - 9.0-11.5 cm/H2O - still searching for the magic "zero night" but averaging 2.2 AHI

hyperlexis
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Re: Best solutions for reducing aerophagia?

Post by hyperlexis » Fri Feb 08, 2013 9:14 am

Listen -- they sell the freakin thing on cpap.com after all! In fact it gets 4.4 out of five stars from users! LOL https://www.cpap.com/productpage/respir ... chine.html. So I would say that for a CPAP, it's a pretty darned good machine. No it's not an APAP or whatnot, but it has an SD card for data, and rainout protection, and likely most of the same motor and control guts as the other System One machines. So if her MD prescribed "CPAP" and not "APAP", she got a pretty good machine.

The fact is there is still a case to be made for straight CPAPs in this world, and that's what her MD/nurse practitioner prescribed after all. I'm not going to second guess the treater, but perhaps a specialist would be warranted. To me that may be the biggest issue with her problem(s). She may have no insurance and is being treated in a company clinic or something by a nurse practitioner who can write a prescription. There may not be a specialized sleep doctor helping her.

Plus this aerophagia problem could well still remain regardless of CPAP or APAP. I have the top of the line PR APAP and I still, occasionally, get very painful aerophagia at higher pressures. And no, APAP machines have yet to include a tummy pain sensor. So they blow full tilt regardless of any air seeping into the esophagus or not.

Are there any resp therapists out there with any info on whether CPAPs cause more aerophagia than BIPAP or APAP? With or without exhalation relief options? Or is this all just conjecture or anectdote?

Because she may now be stuck with the CPAP machine and will have to deal with the aerophagia with changing position or possibly mask changes. It would be horrible for her to go drop hundreds of more dollars on a new APAP machine, on a guess, and still have the problem.