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Reducing Air in Stomach from CPAP Use

CPAP stands for continuous positive airway pressure and is a therapy used to treat obstructive sleep apnea. This is the most common form of sleep apnea, a disorder that left untreated increases your risk of health conditions like heart disease, stroke, high blood pressure and diabetes.

A common side effect is air in the stomach from CPAP use. This can result in morning bloating as excessive air may be drawn down into the stomach. For most people, this problem is inconvenient, but potentially a little embarrassing when the trapped air is released! 

However, some people may experience more severe bloating and stomach discomfort.

Why Is Air in Stomach from CPAP?

CPAP treats obstructive sleep apnea by delivering a steady stream of pressurized air to a mask worn while you sleep. 

The pressurized air prevents the relaxed throat tissues from collapsing and blocking the airways. This in turn prevents the frequent “apneas” – pauses in breathing caused by blocked airways.

In everyday life, most of us will swallow some air, for example, if we are eating quickly or drinking fizzy drinks. However, the effect is generally negligible. 

Someone using a PAP device to treat sleep apnea will get air into the esophagus rather than the trachea. Therefore, this air reaches the stomach rather than the lungs.

This does not impact the treatment, and you should still reap the benefits of reducing your sleep apnea symptoms and receiving better quality sleep. 

However, air in the stomach can be frustrating; this excessive air swallowing is termed aerophagia.

What Is the Effect of Aerophagia?

The main impact of excessive air swallowing is morning bloating. This is a common side effect of a PAP device, but one which should soon pass. A stomach filled with excess air will expel that air naturally. 

This may be a little embarrassing at times -- and none too pleasant for anyone in the immediate vicinity -- but the effects of aerophagia should be gone within an hour or two after waking up.

Such a side effect may not be ideal but can be looked upon as a small price to pay for the benefits of the treatment. Sleep apnea increases your risk of serious health problems and compliance with the therapy is crucial in treating the disorder and reducing this risk.

Therefore, the main effects from excessive air in the stomach are as follows:

  • bloating
  • belching
  • flatulence
  • stomach discomfort

For most people, the side effects will be fairly minor and tolerable. However, for a few the impact may be more significant and threaten their compliance with the treatment course. 

As compliance is so important, any side effect that is making you consider sleeping without using your PAP device should be discussed with your health provider. They can work with you to provide options to help make the treatment more comfortable and therefore more likely for you to remain compliant.

Ways to Reduce Air in Stomach from CPAP

While bloating caused by excessive air swallowing will be tolerable for the majority, it can still be a little inconvenient. The following are three considerations that could help reduce air swallowing when using CPAP.

  1. Air Pressure

A sleep study is part of the process of diagnosing obstructive sleep apnea. The number of breathing pauses is measured during a sleep study, and this helps determine the air pressure setting required on your treatment device to keep your airways clear of obstruction.

However, a high-pressure setting can be hard to exhale against. This can increase the likelihood of aerophagia as more air is forced into the esophagus, leading to higher levels of bloating and general stomach discomfort.

Auto PAP therapy can also be helpful as the device will remain at lower pressures for approximately 80% of the night and only require higher pressures during REM sleep during 20% of the night.  Aerophagia is less severe when a patient is at lower pressures during a majority of the night.

You should never change the pressure setting of your treatment device. This should only be done in consultation with your health provider. If excessive air in the stomach is threatening your compliance with the treatment, chat with your health provider who may arrange a further sleep study.

If the pressure setting is too high, they can adjust it. However, for effective treatment of obstructive sleep apnea, the pressure of the air must be set at a point where the air prevents the collapse of the soft tissues in the airway to enable a clear flow of air through to the lungs while you sleep.

  1. Angle Your Head in Bed

Tilting your head up at an angle of around 30 degrees can also be a way to combat aerophagia and any resulting bloating. A wedge pillow can be a good way of achieving this, but always make sure your head and neck are properly supported.

The position in which you sleep is often considered when treating sleep apnea. Once you fall asleep gravity pulls the soft tissues of the throat down into the airways and this can create the obstruction that leads to breathing cessations associated with obstructive sleep apnea.

Sleeping on your side rather than your back can mitigate some of the effects of gravity and help prevent a complete blockage of the airways as you sleep.

  1. Treat Any Heartburn Issues

Heartburn can also result in air reaching the stomach. This can worsen any CPAP-related bloating issues. Therefore, addressing heartburn can ease your stomach discomfort by reducing the amount of air in the stomach.

You can consult with your healthcare provider, who may recommend over-the-counter medication to relieve heartburn. These medications may also be recommended for bloating caused by CPAP even if you are not experiencing heartburn.

Final Thoughts

Compliance with CPAP is important for the effective treatment of obstructive sleep apnea. Without treatment, this sleep disorder can increase the risk of serious health issues. 

Aerophagia can cause bloating and gassiness that, while tolerable for most, can threaten compliance for others. While some bloating is expected and soon passes, you should chat with your healthcare provider if bloating is threatening your compliance with your sleep apnea treatment.




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