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Last night was my fourth night using a pap machine. But by 3AM I had swallowed so much air that I was in so much pain I was ready to call 911. It took over 1/2 hour to try and get comfortable. But I gave up using the machine because I was afraid I would be in pain again.

Is this normal? Is there anyway of stopping this from happening?

Thanks for all your help. I would have given up on night 1 without your support and encouragement.

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Some people do swallow air at first because anxiety about the new process is causing them to breathe unnaturally. If this is the case it may correct itself as the patient becomes more comfortable with the process.

However more common are the conditions known as aerophagia and the more severe condition gastric insufflation. These occur because the pressure of the CPAP is force air through the esophogeal sphincters.

For me the solution for both of these conditions is sleeping on my tummy. This however is not the solution for everyone and some struggle with the problem continually.

What is the exact model of your machine and what are the settings?
Rooster, I have a ResMedS9 and the pressure is set between 5 and 15. And unfortunately I cannot sleep on my tummy, hurts my back too much. And how would one do that with a mask on, I can't imagine. I am finding it hard enough to sleep on my back or side with a mask and still feel okay. The first 3 nights (I am new to all this), were mostly okay. I noticed some extra gas, but last night was awful. Thanks for your help.


Rooster said:
Some people do swallow air at first because anxiety about the new process is causing them to breathe unnaturally. If this is the case it may correct itself as the patient becomes more comfortable with the process.

However more common are the conditions known as aerophagia and the more severe condition gastric insufflation. These occur because the pressure of the CPAP is force air through the esophogeal sphincters.

For me the solution for both of these conditions is sleeping on my tummy. This however is not the solution for everyone and some struggle with the problem continually.

What is the exact model of your machine and what are the settings?
mARY,

I followed your Central apnea thread as well. And I'm curious. You are on a S-9 APAP. What else is going on besides the CSA and aerophagia? Are you experiencing sudden awakenings with the machine at really high flows or pressure? Do you have significant mask leak? Reason I ask is. Check your humidifier chamber. Make sure the water level is at or below the max fill line. If the water level is too high it will create a choppy airflow. The machine doesn't know the what the cause of the choppy airflow is and will assume it's you and will increase it's pressure to compensate or overcome the resistance.

What pressure range was your machine set to? 5-20? Or are you on a set pressure? What was the 95th percentile pressure recorded on your first download?
Neal, my humidifier level is find I keep it below the max. And I haven't done any downloads yet, as I have a mac and from what I understand the software is for PCs. My machine told me for a 3-day average I was at 9.4 pressure. And the machine is set from between 5-15. I wake up for who knows what, I have terrible insomnia as well. Actually my doc says I probably have UARS, and not really sleep apnea. My sleep study showed only 3 OSAs but 52 hypopneas. I also have fibromyalgia and have had insomnia just about my entire life. I no longer have trouble falling asleep (until this machine came along!), I usually have trouble staying asleep. I had been sleeping okay using Xyrem, or sodium oxybate. But it got too expensive for me to purchase as my insurance cut it off after 6 years of allowing it.

Thanks again for your help. Being new to this I just don't know what to do or expect.



Neal Buckner, LRCP said:
mARY,

I followed your Central apnea thread as well. And I'm curious. You are on a S-9 APAP. What else is going on besides the CSA and aerophagia? Are you experiencing sudden awakenings with the machine at really high flows or pressure? Do you have significant mask leak? Reason I ask is. Check your humidifier chamber. Make sure the water level is at or below the max fill line. If the water level is too high it will create a choppy airflow. The machine doesn't know the what the cause of the choppy airflow is and will assume it's you and will increase it's pressure to compensate or overcome the resistance.

What pressure range was your machine set to? 5-20? Or are you on a set pressure? What was the 95th percentile pressure recorded on your first download?
Call the doctors office and tell them you have gastric insufflation and also tell them about "AHI 13.4; Total AI 13.4; Central AI 11.1".

Do you think they will give you some decent support?
Does that machine give you a reading of your highest nightly pressure? Centrals and air swallowing together are signs of over titration.

Did you have a titration study? Are you using the same mask that was used in the study? Are you using pressure relief on your current machine such as EPR? Did they use pressure relief during your study?
No I did not have a titration study as I mentioned in the other discussion. Basically this machine is an at-home study for 30 days. So new machine, new mask, never used CPAP before. And yes, they are using EPR set at 3. But really have no idea what that is for. The RT said it would help me breath.

I think I might have breathing problems to begin with since I am a very shallow breather. I often have to take deep breaths while awake, and I find I have to do that with the mask on as well. Find it hard to breath against the wind tunnel. And need to take the mask off so I can breathe 'normally.' Do you know what I am saying? Again, much thanks.



Rock Hinkle said:
Does that machine give you a reading of your highest nightly pressure? Centrals and air swallowing together are signs of over titration.

Did you have a titration study? Are you using the same mask that was used in the study? Are you using pressure relief on your current machine such as EPR? Did they use pressure relief during your study?
Rooster, I will call tomorrow, but my doctor is generally in only on Mondays. But I am sure there will be some sort of an assistant there. I called on Monday after a lousy weekend, and all I got was the standard, "you need to get used to it." But I will try, that much I can do. Thanks!



Rooster said:
Call the doctors office and tell them you have gastric insufflation and also tell them about "AHI 13.4; Total AI 13.4; Central AI 11.1".

Do you think they will give you some decent support?
Mary, I am fairly new to this CPAP stuff too, I am going on my 3rd month of CPAP therapy. I can tell you that the first week I had my machine I would swallow so much air I felt like a float in a Macy's day parade. It scared me too, I asked the folks here and they offered me great advice. While everyone's condition is different and not all things work for all people what I have found works for me is:
I turn on my machine, get into bed and get comfortable, then I concentrate on my breathing and relax BEFORE I put my nasal mask on. I used to just put on the mask and then get into bed.(I was so exhausted I just wanted to go to sleep) I was more restless and anxious then, couldn't get my breathing regulated and it took longer to get to sleep. NOW, I get to sleep much faster and am much more comfortable with the whole thing. My hours used are increasing every week. (I keep a sleep journal too for my own record)

Also, I purchased the Contour Living pillow from my DME guy and I love it. It helps keep your mask in place when you turn over and has great neck and head support. (there is an ad on this page for it )

Don't give up Mary, it does get better, it just takes time. I am a happy sleeper now and soon you will be too !
Donna B.
Thanks, Donna. I felt like a blimp last night and thought if only I could poke a pin in my stomach! Actually someone suggested to me that I use some old stockings and tie up my chin so I might not be apt to keep my mouth open. Thought that might help tonight. Also trying some saline nose stuff too to see if that will help with the breathing. I don't have any mucous, just swollen turbinates.

Can't use the breathe rite strips as it pulls the skin of my face in the morning. But they did help me breathe. I am trying so hard to be 'compliant', but it is killing me in the process.


Donna B. said:
Mary, I am fairly new to this CPAP stuff too, I am going on my 3rd month of CPAP therapy. I can tell you that the first week I had my machine I would swallow so much air I felt like a float in a Macy's day parade. It scared me too, I asked the folks here and they offered me great advice. While everyone's condition is different and not all things work for all people what I have found works for me is:
I turn on my machine, get into bed and get comfortable, then I concentrate on my breathing and relax BEFORE I put my nasal mask on. I used to just put on the mask and then get into bed.(I was so exhausted I just wanted to go to sleep) I was more restless and anxious then, couldn't get my breathing regulated and it took longer to get to sleep. NOW, I get to sleep much faster and am much more comfortable with the whole thing. My hours used are increasing every week. (I keep a sleep journal too for my own record)

Also, I purchased the Contour Living pillow from my DME guy and I love it. It helps keep your mask in place when you turn over and has great neck and head support. (there is an ad on this page for it )

Don't give up Mary, it does get better, it just takes time. I am a happy sleeper now and soon you will be too !
Donna B.
Mary,
I put a little Vaseline in my nose and it has helped with the dryness. I use the breath right strips too. I take mine off in the shower after my face is good and wet, it comes off sooo much easier.

I use the saline nasal spray before I go to bed, it works great.

As far as the gas is concerned, yup, it hurts like hell and there are only so many places it can be expelled. Sometimes it would take me a whole day to get it all out. Thankfully my co-workers are very understanding, LOL.

I use a chin strap and that helps me from blowing bubbles and drooling all night. You should be able to get one from your DME provider.

Hope this helps :)
Donna B.



Mary Callahan said:
Thanks, Donna. I felt like a blimp last night and thought if only I could poke a pin in my stomach! Actually someone suggested to me that I use some old stockings and tie up my chin so I might not be apt to keep my mouth open. Thought that might help tonight. Also trying some saline nose stuff too to see if that will help with the breathing. I don't have any mucous, just swollen turbinates.

Can't use the breathe rite strips as it pulls the skin of my face in the morning. But they did help me breathe. I am trying so hard to be 'compliant', but it is killing me in the process.


Donna B. said:
Mary, I am fairly new to this CPAP stuff too, I am going on my 3rd month of CPAP therapy. I can tell you that the first week I had my machine I would swallow so much air I felt like a float in a Macy's day parade. It scared me too, I asked the folks here and they offered me great advice. While everyone's condition is different and not all things work for all people what I have found works for me is:
I turn on my machine, get into bed and get comfortable, then I concentrate on my breathing and relax BEFORE I put my nasal mask on. I used to just put on the mask and then get into bed.(I was so exhausted I just wanted to go to sleep) I was more restless and anxious then, couldn't get my breathing regulated and it took longer to get to sleep. NOW, I get to sleep much faster and am much more comfortable with the whole thing. My hours used are increasing every week. (I keep a sleep journal too for my own record)

Also, I purchased the Contour Living pillow from my DME guy and I love it. It helps keep your mask in place when you turn over and has great neck and head support. (there is an ad on this page for it )

Don't give up Mary, it does get better, it just takes time. I am a happy sleeper now and soon you will be too !
Donna B.
Thanks again, Donna! If I can remember I will call my DME guy and inquire about the chin strap. But he'll probably tell me to call the doctor again!

Don't like getting my face wet so I can't really work with those breath rite strips. Again, thanks for your concern and suggestions. Have a great night's sleep!



Donna B. said:
Mary,
I put a little Vaseline in my nose and it has helped with the dryness. I use the breath right strips too. I take mine off in the shower after my face is good and wet, it comes off sooo much easier.

I use the saline nasal spray before I go to bed, it works great.

As far as the gas is concerned, yup, it hurts like hell and there are only so many places it can be expelled. Sometimes it would take me a whole day to get it all out. Thankfully my co-workers are very understanding, LOL.

I use a chin strap and that helps me from blowing bubbles and drooling all night. You should be able to get one from your DME provider.

Hope this helps :)
Donna B.


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