Urgent! Why is my CPAP therapy causing weird stomach pains, bloating, gas and IBS?

[WWu777]

Hi Everyone,
I got an important question and urgent problem. Last week I finally got my Z2 Auto CPAP device. It was great and all and looked brand new. I set it to auto cpap mode (apap 2) and set the range between 7 and 20, as someone here suggested before. The first night sleep was great. I felt more refreshed than usual, and best of all, I didn't feel drowsy during the day or doze off randomly when I am sitting like I always usually do, due to my apnea of course. So that was great. Excellent!

However, there was one unexpected problem. My stomach began feeling bloated the next day. Gas and flatulence followed too. Soon I felt stomach aches, as if I got an upset stomach. It was mild at first, but got worse as the night went on. I wondered if the CPAP caused it, but last year when I rented a CPAP device I didn't have this problem, so I thought maybe it was just a coincidence. Plus, sometimes during the Fall season when the temperature starts changing, my stomach will hurt for a while as it adjusts to the temperature change. But it's usually only for a day or two. As they say, "correlations is not always causation".

So I decided to continue the CPAP therapy and see. The 2nd day, the stomach pains got even worse, especially when I drank milk. It was ok in the day, but late at night it got more severe. I could not even sleep all night. I took all the remedies I had, such as Pepto Bismol, Alka Seltzer, and other stomach medicines. None of them helped. I was gonna come on this forum and post about it but I was too uncomfortable to type or sit at a computer. The pain finally got better in the morning after taking Advil. I was not able to sleep until the next morning. It was terrible.

The third night was better. But I still felt bloated and it also felt like something was "off" in my stomach. As though my intestines were twisting and a knot was being twisted inside my stomach. Are these called stomach muscle spasms? Or is this called an upset stomach? Or IBS (irritable bowel syndrome)? Either way, it felt icky. I felt like something was off in my stomach. The pain was mild but it just felt odd and off. I had a few upper abdominal pains. It felt like my stomach was sore and recovering from an injury or something. So I only ate light food throughout the day, to not give my stomach too much work. I also drank some baking soda to alleviate the pain, as a friend suggested. It did help, but something still felt off inside my stomach, like something wasn't right.

The fourth night was the same. Usually my stomach ache problems only last a day, so this was unusual. So I decided to stop my CPAP therapy for one night to see if my stomach would return to normal. Fortunately it did. Now my stomach feels normal again and I can sit in front of a computer and type, which I could not for the last few nights due to stomach pains.

What is going on here? Is this normal? Do people commonly experience stomach pains like this when they start CPAP therapy? If so, why? I imagine it would have something to do with the constant air blowing in from the CPAP which might disrupt something in my stomach right? What should I do? Any suggestions?

Some of my friends postulated that it may be due to bacteria entering my instestines from my body's immune system, because once I was able to finally get a good night's sleep without disruptions, my body went to work cleaning out toxins from my fat cells, and when it did, some extra toxins and bacteria were released, which caused an allergic reaction in my intestines. One of my alternative health lady friends suggested I drink a few drops of hydrogen peroxide in water to destroy the bacteria in my stomach or bloodstream. I tried that, along with some baking soda too, and it did alleviate the pain and allowed me to sleep, but the abdominal pains came back again the next night.

I have had irritable bowel syndrome before, long ago, about 10 years ago. But after I started taking fiber and Metamucil, it went away and never came back. Does IBS have anything to do with this? Does CPAP cause it?

Also, last year when I rented a CPAP machine, this didn't happen. So I don't get why it happens now? It seems inconsistent.

As of now, I've decided to take a break from CPAP so my stomach can rest and get back to normal, before trying again. What went wrong? Any idea? Should I put it on a milder pressure next time, like apap 1, which is below the default pressure of apap 2?

Any of you experience this before too? If so, what did you do about it?

Thanks in advance.

[Julie]

Do a forum search of 'aerophagia', it's common and there are various ways to deal with it... none of which are just stopping Cpap.

[WWu777]

Do a forum search of 'aerophagia', it's common and there are various ways to deal with it... none of which are just stopping Cpap.

Ok I will do that. Thank you. But why didn't this happen last year when I rented a CPAP machine? Does it come and go? Is it only temporary? Do you have any advice for preventing it?

I sure hope this is only temporary, because I was finally getting good sleep for once when I started using the CPAP. Darn.

[chunkyfrog]

You may need to relax.
Tension causes many unpleasant gastric symptoms--with or without cpap.
Do something that does not upset you.
Working, exercise, sports, taking a very long walk . . .
Avoid arguments and places (or forums) where there are people with whom you disagree.

[WWu777]

I called my CPAP equipment provider earlier. Apparently I have something called Aerophagia, it's common with CPAP users. Here are some links about it and how to treat it. I'm posting it here for my reference, and of course if anyone else is interested. However, I'm not sure if I should increase the pressure or decrease it. I guess I will have to try both and experiment and see.

https://www.alaskasleep.com/blog/common ... ap-therapy

https://www.cpap.com/blog/swallowing-ai ... erophagia/

https://www.sleepapnea.org/treat/cpap-t ... solutions/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525983/

http://www.apneaboard.com/wiki/index.php/Aerophagia

This is what AHI means btw.

https://www.sleepapnea.org/ufaqs/what-is-ahi-represent/

A document sent to me by my CPAP supplier in Word format about Aerophagia:

Aerophagia Causes and Resolutions
Tracy R. Nasca

CPAP users who experience excessive belching, stomach bloating, stomach distension and agonizing gas pains may be suffering from aerophagia. It’s the medical term for the phenomenon when air enters the esophagus, goes into the belly and causes bloating. Aerophagia can be caused by eating, drinking or even talking too fast. It can occur with hyperventilation from anxiety, from chewing gum, smoking cigarettes and even during strenuous exercising.
For the CPAP patient, aerophagia and stomach bloating is much more prevalent than you might think. It’s not a subject many feel comfortable talking about, but this side effect of CPAP use is an important issue to discuss and with proper changes to therapy, it can be resolved.
Aerophagia occurs when air from a CPAP enters the esophagus and goes into the belly, rather than the airway and into the lungs. This can cause gas pains and distension of the stomach. It is common and can happen to anyone who uses CPAP. But when it becomes chronic, it’s a red flag, a symptom that can be overcome when the cause is properly determined.

There are many possible causes; the following are provided:

1. Your CPAP pressure may be higher than you require. The extra air has nowhere else to go – thus, it is directed in to the esophagus and on to the belly.
2. Your pressure may be too low and inadequate to resolve your apnea event. In your effort to get more air into your lungs, you gulp air in quickly and it is forced into the esophagus instead.
3. You may have nasal congestion from a cold, flu or allergies. When your nose is stuffy, you may not be able to receive the CPAP air pressure you need, so you gulp air by mouth and down into the esophagus it goes.
4. You may be a mouth breather, who is wearing a traditional nasal mask. As your mouth falls open during sleep, the air that is delivered by CPAP and intended to enter the lungs may instead, escape via your mouth. Your apnea events are not being resolved and in your unconscious panic to breathe, you may suddenly have a choking sensation and gulp air in quickly, forcing it into the esophagus.
5. You may be having difficulty learning and adjusting to exhale over the constant pressure of the air delivered by CPAP. This is especially difficult for those patients on mid- to high-CPAP pressures. Inhalation of high pressures may be easy, but exhaling may cause anxiety, panic and a feeling of suffocation or choking. When this occurs, the patient may fall out of the natural rhythm of breathing and hyperventilation may occur. This can result in a quick sucking in or gulping of air, and that air may be forced into the esophagus rather than the lungs.

Here are a few suggestions:

1. If you suspect your CPAP machine air pressure might be inadequate for reasons mentioned above (too high or too low), discuss a pressure change with your doctor.
2. Confirm with your CPAP provider that your machine was indeed set correctly as prescribed by your doctor. On occasion, mistakes happen and CPAP may be set incorrectly.
3. Expiratory pressure relief features are available on most CPAP machines today. Depending on machine brand, it may be called CFLEX, AFLEX OR BIFLEX on Philips Respironics brands and EPR (expiratory pressure relief) on ResMed brands. This feature automatically reduces air pressure upon exhalation and can help reduce or eliminate aerophagia. Contact your CPAP provider and inquire if this feature is enabled and set on your machine. This is commonly a patient controlled feature, so ask to be shown how to use it.
4. Consider if the mask you are using is the best choice. You may be a mouth breather yet using a nasal mask. Your mask may not be the best size or style suited for your face. If you experience frequent mask leak, or pressure point soreness from over tightening straps to eliminate leak, consider choosing a different mask.
5. Make sure you know how to properly fit and adjust your mask for best seal. After you have chosen the best mask size and style for your face, you must adjust it properly before sleep. Sit on your bed, turn the machine on, and place mask on your face with straps loose. Lay down in your sleeping position with your head on your pillow as you would normally sleep. Slowly pull the straps JUST UNTIL you get a good seal. If your mask has a dual cushion, it will need to be “seated.” After you have fitted and adjusted your mask using the steps above, to “seat,” gently pull the mask straight out and away from your face to allow the dual cushions to inflate properly. Lay the mask gently back onto your face . You should know, by feel, that a good comfortable seal is achieved.
6. If you suspect your aerophagia is the result of hyperventilation caused from anxiety, consider utilizing Cognitive Behavioral Therapy provided by a sleep specialist. Ask your sleep doctor for a referral.
Learning the cause of aerophagia is key to resolving it. As always, discuss this issue with your sleep doctor and CPAP provider to help determine your causes and resolutions.

The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Contact your physician or health care provider when you have health related questions. Never disregard or delay medical advice because of information you have obtained on this site.

[WWu777]

You may need to relax.
Tension causes many unpleasant gastric symptoms--with or without cpap.
Do something that does not upset you.
Working, exercise, sports, taking a very long walk . . .
Avoid arguments and places (or forums) where there are people with whom you disagree.

Good advice. This world is toxic, and so is life, so we all need to take frequent breaks and time outs, especially if you are a sensitive type like I am.

I would also recommend daily meditation too, and some sort of spiritual practice that is simple (not fanatical) and involves "bending with the wind" and "going with the flow" such as Zen Buddhism or Taoism. Or Yoga if you are physically inclined for it. Also, listening to speeches by the late Zen teacher and author, Alan Watts on YouTube is also very therapeutic. His main motto is "Don't take life seriously. Nothing matters as much as you think it does. Just enjoy being alive. You don't have to do anything or accomplish anything." I agree. Following that motto from time to time (not all the time of course) has centered me and allowed me to cope with life. Otherwise I could have gone insane if I took everything seriously. Long ago I learned to stay in the eye of the hurricane.

[chunkyfrog]

I was hoping you might try the long walk--a very, very long one.
And silence, too.
Everyone would be less stressed.

[WWu777]

I was hoping you might try the long walk--a very, very long one.
And silence, too.
Everyone would be less stressed.

Good idea. I'll do a walking tour around America, for endless miles. Like Forrest Gump. lol. And update you on my progress with photos and postcards. lol

Wanna join me? I love hiking. Are the National Parks open yet? We could go hiking and talk for hours. lol Just kidding.

Hey, maybe during the long walk I'll lose weight and not even have apnea anymore and not even need CPAP anymore. lol. Thanks. Good advice.

Come on man. Lighten up. Try to be more positive please and see my posts in a more positive light. Remember, we can't control others, but we can control how we REACT and RESPOND to others and life events. Every self-help book emphasizes this point. So try to view my posts positively with enthusiasm. Some of my fans see my posts as "music to their ears", so why can't you? lol

[chunkyfrog]

I saw what you said before Pugsy zapped the nastiness/profanity.
My opinion of you remains unchanged, until I see a heartfelt apology.
Especially to Pugsy.

You are dead to me, and I am not alone.

[WWu777]

I saw what you said before Pugsy zapped the nastiness/profanity.
My opinion of you remains unchanged, until I see a heartfelt apology.
Especially to Pugsy.

You are dead to me, and I am not alone.

I don't understand what you are referring to. When was I nasty or used profanity here? Can you show me exactly? Did you get me mixed up with someone else?

If I do indeed owe you or Pugsy an apology, I would be happy to give you one, if you can show where I acted inappropriately. No problem. I am very civilized and fair.

As far as I know, all I did was explain why one should not trust authority and corrupt sources that are connected to cartels. Nothing new about that. Americans have always a tradition of not trusting authority ever since the time of Colonial America. I don't understand why that ruffled your feathers. Perhaps you can explain? Maybe we have some miscommunication here? Otherwise, it could be that some people just rub each other the wrong way without even meaning to, aka personality conflict in other words.

Opinion of me? You don't know me. If you watch my videos on YouTube you will see that I am very likable, down to earth, and authentic. PM me if you want me to send you links to my videos.

[WWu777]

Good news! This time my cpap therapy didnt give me any stomach cramps or bloating. Last night i talked to my cpap supplier. He told me to set a higher swing pressure and a higher minimum. So i set it to apap 3 instead of 2. And the range between 8 and 15. This time it felt much better. I was able to exhale properly and wake up without stomach cramps. Why is higher swing pressure better? Because it allows u to exhale better? What does swing pressure mean exactly? I would have thought that lower swing pressure was better but apparently its the opposite of what i think.

Wow my head feels so clear and alert and rejuvenated. I haven't felt this good way in a long time. I should have gotten this cpap thing years ago. If only someone told me about the supplier I found with low prices before. This cpap is definitely a life saver. I could kiss the machine. Lol. I feel like ive just done a long meditation and good workout or something. My body and mind feel very glad and rejuvenated.

[WWu777]

Btw bad news again. Last night i could not sleep at all. The stomachache happened again and lasted 6 hours. I tried every stomach remedy i had. Nothing worked. I couldn't sleep til morning and could not use CPAP.

Im pretty sure the CPAP causes it because when i don't use CPAP my stomach doesnt ache like that. However it doesnt make sense because if i had aerophagia the bloating would stop after i turned off the CPAP after waking up. However the strange part is that when I wake up i feel great and well rested. No stomachache. The stomachache doesnt happen until 6 to 12 hours later. Yesterday it didnt happen until 14 hours later. I thought it wouldnt happen at all and was relieved. But unfortunately it came 14 hrs later.

This makes no sense. Why would a cause and effect be delayed 14 hours like that? Yet im sure there has to be a connection because it only happens after i use CPAP. Also the stomachache is unusual because it doesnt respond to any treatment, not alka seltzer, not pepto bismol, not baking soda, not fiber capsules, not gas x, not the best Japanese stomach powder and tablets. Nothing. And it also happens on an empty stomach too. So its not caused by food.

This is a very mysterious and inconsistent stomach ache. It seems connected to CPAP. However i dont get why a stomach ache would be caused by something 6 to 12 hours prior. Usually something that causes a stomachache causes it right away in minutes. 14 hr delay in cause and effect is unusual.

Today i went to the stomach doctor in the hospital. He couldn't figure it out either. He thinks it might be related to my gallbladder which has some small stones and sludge in it. So he gave me some gas relief pills. He couldn't figure it out either. Because this stomach ache doesnt make sense and is not consistent or normal. Theres no clear cause. He did an ultrasound too but only found little stones and sludge in my gallbladder. Irritable bowel syndrome would happen in the lower part of the stomach, not the upper center part, he said. He doesn't know the cause either. He thinks it might be related to my gallbladder. However it only comes when i use CPAP. So that doesn't hold water.

Im not sure how i can continue CPAP therapy, even though its giving me great quality sleep and making me feel well rested and alert, if the price of it is that i have to suffer a 5 to 6 hour stomach ache everyday which cant be alleviated by any medicine or treatment and persistent and long. That really sucks. When a stomachache goes for 5 or 6 hours it feels like forever. Time slows down too. Feels endless. Can't think or type either.

Perhaps the CPAP causes a small imbalance in my stomach which causes a chain reaction of events that doesn't manifest until hours later, or half a day later in my case? Even if that's so, it's still odd and unusual because stomachaches usually happen fast, not after a 12 hour delay.

Should I lower the pressure to 5 to 12 and use apap 3 for stronger exhale? Maybe a lower pressure with a higher exhale relief would help?

[WearyOne]

IBS would not be caused by using CPAP. It's a functional gastrointestinal (GI) disorder. Stress can make it worse. It often originally starts from a bacterial problem in the intestines, but not always. I've had it for over 30 years. I've been on CPAP treatment for about 13 years. I've never seen a connection.

[Julie]

Wu you were advised at the beginning of this thread to read this forum's extensive notes on aerophagia, but apparently ignored that... so why should we plow thru all the other stuff you cited and then listen while you complain some more.

[chunkyfrog]

Or for schadenfreude . . .