What Is Aerophagia?

Last updated: July 2022

If you are a CPAP (continuous positive airway pressure) user, you probably have experienced this. So what is it? Have you woken up with your stomach hard as a rock and experiencing some pain? If you’ve answered yes then you have dealt with aerophagia. Will CPAP pressure settings help aerophagia?

What is aerophagia?

I found this definition online. “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.”

I have dealt with this for a long time. Now, I don’t recommend doing this without discussing it with your doctor. I like experimenting and tinkering with things. This includes my CPAP. With the power of the internet, I discovered how to get into the settings of my CPAP to adjust my pressure. Again I’m not advocating that anyone should do this. My old CPAP wasn’t connected to the internet so my doctor couldn’t see what I was doing.

CPAP pressure settings

When I got my new CPAP at the beginning of 2021, my pressure was set to the max. These newer CPAPs adjust the pressure automatically as needed throughout the night. After the first few nights using this new machine, I was waking up in the middle of the night with aerophagia.

It would take me about an hour to get rid of the extra air in my stomach. I turned to the internet and figured out how to dial back the max pressure on my new CPAP.

Over the course of the last year, my apneas per hour were hovering around 10. These new machines track usage, apneas, mask leaks, and how many times you take your mask off during the night. There is no hiding anything.

Coming clean with my doctor

Well, when I went in for my yearly checkup my sleep doctor noticed that my max pressure was turned down and that I was averaging about 10 apneas per hour. I had to come clean and told the doctor that I adjusted my max pressure due to aerophagia.

My doctor explained that averaging 10 apneas an hour is too high. They like to see that number no higher than 5. They wanted me to increase the max pressure, and if I was still having issues with aerophagia, I should switch to a BiPAP (bilevel positive airway pressure) machine. I asked about slowly increasing the pressure over time rather than just turning it back to the max. My doctor thought that might work but no guarantees.

Gradually increasing pressure

Over the course of the last few months, I have been slowly increasing the pressure. I have only had a few occasions where I was awakened with aerophagia. The good news is that my apneas are down to about 5 an hour.

I still haven’t worked up to the max pressure so I know that my apneas per hour can still improve as I raise the pressure. I really haven’t felt more rested per se. I haven’t had any issues since starting CPAP therapy over 20 years ago with feeling tired. However, knowing that my apneas are decreasing gives me peace knowing that I am helping my heart and well-being.

Please don’t do what I did. Always talk to your doctor about changing settings on your CPAP.

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