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How to Stop Swallowing Air (Aerophagia) During CPAP Therapy Key Takeaways - Aerophagia involves swallowing excessive air that collects in the gut. It can occur when using CPAP. - Excessive air swallowing from CPAP can occur due to incorrect pressure settings, sleep position, and mouth breathing. - Here are some solutions from a respiratory therapist to reduce air swallowing with CPAP. They include adjusting the AutoRamp and EPR settings, using a wedge CPAP pillow, and trying comfort accessories to reduce leaks.

One possible side effect that can occur when using CPAP is excess air swallowing. Swallowing small amounts of air when you eat is normal and helps with digestion. But swallowing too much can lead to discomfort. Learning why aerophagia occurs with CPAP can help you understand how to prevent it. While some air swallowing is normal throughout the day, the continuous stream of pressurized air from your CPAP machine can sometimes force excessive air into your stomach rather than your lungs.

It's not just annoying, aerophagia is a leading cause of people abandoning their life-saving sleep apnea therapy. But you don't have to quit CPAP to stop the bloat. Below, we break down why this happens and provide some solutions that can help. What is Aerophagia? Aerophagia is the medical term for excessive air swallowing that collects in the stomach. Habits that can lead to aerophagia include talking while eating, anxiety, and eating too fast. But the main cause of aerophagia is CPAP use.

Signs You May Be Swallowing Air You may not realize how much air you swallow with CPAP. But if it is in excess, you may develop certain signs. Symptoms of swallowing too much air include: - Morning bloating - Frequent burping - Heartburn - Stomach cramps or gas pains Why Swallowing Air Could Be Happening to You CPAP delivers pressurized air to the throat to prevent tissues from blocking the airway and causing apnea. But pressurized air from the CPAP can also enter the esophagus and then the stomach.

This may occur for a few reasons or a combination of those listed below. Incorrectly Prescribed Pressure Excessive air swallowing may occur if the CPAP pressure is too high for your needs. The pressure needs to be high enough to keep the airway open. But if the pressure exceeds the muscles' capacity in the throat, some of the air may be directed into the esophagus and the stomach. Mouth Breathing If you sleep with your mouth open, some of the air may leak out.

The machine compensates for the air leak by increasing the pressure. This can lead to excess pressure and subsequent air swallowing. The same thing can happen with a mask leak. Sleep Position Certain sleep positions make it easier for air to enter the stomach. For instance, when you sleep on your back, gravity allows the tongue and tissues in the back of the throat to relax back towards the airway. Furthermore, lying flat makes it easier for air to travel horizontally down the esophagus.

CPAP pressure may increase, and greater pressure may lead to more air swallowing. Also, when you sleep on your back, the horizontal alignment of the airway and the esophagus makes it easier for air to pass from the CPAP towards the esophagus. Actionable Solutions to Try to Help From a Respiratory Therapist As a respiratory therapist, I have found that excessive air swallowing is often fixable with a few changes. Below are some practical solutions to reduce swallowing air.

Adjust the Settings As mentioned above, if the pressure is higher than needed, it increases the risk of air entering the stomach. Talk to your healthcare provider about lowering your CPAP pressure. You may also be able to adjust settings such as: - AutoRamp: The AutoRamp starts at a lower pressure when you first fall asleep and increases throughout the night. However, if that pressure starts too high, it may lead to air swallowing.

Lowering the AutoRamp or starting pressure may make breathing feel more natural and reduce the risk of swallowing air while falling asleep. - Expiratory Pressure Relief (EPR): When you exhale against a constant high pressure, the air has nowhere to go but down your esophagus, causing discomfrot. Many CPAP machines have an expiratory pressure relief setting, allowing the pressure to drop slightly during exhalation. By adjusting the EPR level, you may reduce pressure and air swallowing. Use a Wedge CPAP Pillow A wedge CPAP pillow can help adjust sleeping position.

If you are using a wedge pillow, it elevates your head a few inches to prevent sleeping flat on your back. You can also try sleeping on your side to decrease the amount of air entering your stomach. Side sleeping helps keep the airway open, allowing you to use a lower, less-bloat-inducing CPAP pressure. Try Comfort Accessories In some cases, minor equipment changes may make a big difference in reducing air swallowing. For example, chin straps may help decrease mouth breathing.

Mask liners can improve the mask seal and reduce leaks, thereby reducing air swelling. CPAP accessories can improve airflow comfort, mask stability, and overall tolerance of CPAP therapy. Avoid Heavy Meals Before Bed Eating heavy meals before bed increases pressure on the esophageal sphincter, which may allow more air to enter the stomach. Consider avoiding large meals about 2 to 3 hours before bedtime, and skip carbonated drinks at night, as they can also increase pressure.

Additionally, avoid chewing gum a few hours before bed as that can force you to gulp ambient air before the machine even turns on. When to Seek Professional Help If you have tried adjusting your EPR, replacing a leaky mask cushion, and changing your sleep position, but the severe bloating continues, it's time to speak to your sleep doctor. They may recommend switching from a standard CPAP to a BiPAP (Bilevel Positive Airway Pressure) machine.

Unlike standard CPAPs, BiPAPs provide two distinct, prescribed pressures: a higher one for inhaling and a significantly lower one for exhaling, which is often the ultimate medical fix for severe, chronic aerophagia. Where to Find the Best CPAP Products If you're looking to troubleshoot issues such as air swallowing, getting the right equipment can make a significant difference. At The CPAP Shop, you'll find a wide variety of CPAP machines, comfort accessories, masks, and replacement parts designed to optimize comfort and therapy compliance.

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