Sleep Care

CPAP Induced Aerophagia: Tips to Prevent Swallowing Air While Using CPAP

Many things that are designed to make you “feel better” also have the ability to make you “feel worse” in other ways. Continuous Positive Airway Pressure (CPAP) is used to treat sleep apnea, a disorder that can leave a patient feeling as though they didn’t sleep at all. Obstructive sleep apnea is a condition in which the airway is slightly or completely obstructed by tissue in the throat causing a disruption in the flow of oxygen to the lungs. CPAP helps to correct sleep apnea by supplying a continuous flow of air to the lungs, which prevents the airway from closing.

Millions of people use CPAP nightly and have great success with it, leaving them feeling refreshed and ready to tackle the day ahead of them. Unfortunately, CPAP does have side effects that can cause other disruptions in your activities. Some patients report a sore throat, headaches, nausea, nasal congestion, sinus or ear infections, or dry mouth. Other problems include claustrophobia, feeling too much air pressure, and aerophagia.

The Greek meaning of Aerophagia is “eating air”, and often leaves you feeling like you need to belch or vomit, yet are unable to. Aerophagia happens when a person swallows too much air, causing abdominal bloating and belching. Aerophagia can be very painful and cause sleep disruption, sometime not allowing you to fall asleep at all.

Since CPAP provides a continuous flow of air to the body, it is not surprising to find that aerophagia is a common complaint for patients using CPAP therapy. CPAP induced aerophagia can be caused by a few different things. One of which is poor head positioning. Like CPR, the most amount of air can get to the lungs when the head is hilted back leaving the airway open for air to get to the lungs. CPAP users who sleep in a curled up position and/or with the head tilted slightly downward, may experience aerophagia because the position of the head is limiting the airway for the air to flow through and into the lungs. When the airway to the lungs is obstructed, the air forces its way into the esophagus and stomach. Aerophagia can also occur during CPAP therapy when the air pressure is too high, resulting in the air being forced into the stomach much like the previous example. Air leaks are another cause of aerophagia. CPAP air enters the body through the nose and for some patients may leak out the mouth causing unintentional swallowing of the air, leaving the patient feeling uncomfortable. Most patients, experiencing air leaks of this sort, will pull off the mask during the night without realizing it.

Fortunately, CPAP induced aerophagia is a side effect that can be eliminated. If you don’t already use the “Ramp” feature on your CPAP machine, you may want to try it. Instead of immediately supplying the full amount of your prescribed air pressure, the ramp feature will start at a lower pressure and gradually increase the pressure for up to 90 minutes, until your prescribed pressure is met.

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If that doesn’t correct the problem, try sleeping at a slight incline. For some CPAP users, sleeping at an incline will help to keep their head better positioned and let the airway remain open during the night. You should speak with your doctor if you are still experiencing problems with aerophagia and your CPAP. Your doctor may choose to lower your prescribed pressure for the CPAP or add C-Flex to the prescription if it isn’t already. C-Flex will allow the pressure to briefly reduce during the beginning of your exhale and go back to the prescribed pressure prior to inhaling. Not all brands of CPAP machines have a C-Flex capability, so your doctor may suggest that you change from CPAP therapy to BiPAP therapy. BiPAP machines will provide a certain pressure while you breathe air in and a lower pressure as you exhale, reducing the likelihood of swallowing excess air.

If you believe that you may be experiencing Aerophagia, please speak to your doctor regarding the best remedy for you.