Need Help???

I use a Restonics Dream Station BIpap auto tritrating. My problem is aerophagia. I have now been trying to use this machine for 4 weeks and have not had a single night of restfull sleep since. I have tried reclining, sitting up, and lying down on side or back. I have tried using machine while setting up reading before going to bed, but every night I end up with stomach problems, and unable to sleep. I have tried both nasal pillows and full face mask. My stomach aches constantly and I have constant bowel and oral gas problems. Before going on one of these machines I never had problem sleeping all night except when I drank to much caffeinated beverages during the afternoon or evening. I never had a problem of sleepiness and needing a nap during the day. Ever since being on this machine I do not sleep well, wake up very tired, and stay sleepy all the time. I have asked my Dr several times for some type of relief and have received none. I now have made an appointment with a ENT specialists and am ready to throw this damn machine against the wall and give up on my driving career. Any suggestions??????

Please go to Inspiresleep.com. There is good news for you.

Ditto - I have the Inspire device and am considering having my CPAP retrofitted as a boat anchor.

Hi @papawmedjic. BiPAP, along with other types of treatment, can take some time to get used to. I would encourage you to keep the appointment with the ENT to see what other options may be available to you, but I would also suggest having your machine checked to make sure the settings are all correct and you are not getting too much air. I'm sorry you are experienced such discomfort. Hopefully, some of our other members will chime in if they have had similar experiences.

Good day! I am seeking some advice. Background: I am a 65 year old male with congestive heart failure and an LV ejection fracture of 30%. I also have been diagnosed with both obstructive & central sleep apnea. I have been using a ResMed ASV machine for the last year, but a recall notice says that the ASV technology can cause sudden death in users who have an ejection fracture below 45%. I do not have much confidence in my current sleep doctor and I am trying to understand whether a CPAP or Bi-Pap works better for Central Apnea. Also, is there a best-in-class organization/place where I can speak to experts in this field? Thanks!

Dear Courageous-

The problem you described is a very real challenge, which unfortunately does not have a clear answer. The results of the ResMed study showing that there was an increase in mortality in patients with both central sleep apnea and low ejection fraction came as a surprise to many. This led to the strong recommendation that doctors contact patients with Central Sleep Apnea and heart failure with a low ejection fraction (<45%) who were prescribed ASV, discuss the risks of therapy, and consider stopping this treatment. Elsewhere on the forum we have discussed the results of the trial (see https://myapnea.org/forum/safety-alert-issued-for-asv-treatment-adaptive-servoventilation-asv-in-patients-with-heart-failure-and-central-sleep-apnea and https://myapnea.org/blog/complex-sleep-apnea). There are a number of experts who have pointed out that there may be various explanations for the results of this one large trial, and have argued that many patients appear to benefit from ASV despite the data reported in this published study. One issue that may be relevant to you is to understand how much of your sleep apnea is central versus obstructive. The findings from the ResMed trial were most specific for central sleep apnea. Making a decision of whether to continue ASV or not should be done by you and the doctor who understands your sleep apnea - the two of you together can evaluate whether you seem to have derived benefit from the ASV or whether the safest course is to discontinue this. Looping in a heart failure doctor may also be useful.

At this time, there is no evidence that CPAP or BIPAP is any safer than ASV for treatment of central sleep apnea and heart failure. In fact, an older study from Canada suggested that use of CPAP in patients with central sleep apnea and heart failure was associated with an early risk of increased mortality. There is another large multi-site study underway evaluating the Philips ASV device--however, only some of the patients in that trial have central sleep apnea. Those findings hopefully will be out in the next 2 years, and hopefully will shed more light on this question. Meanwhile, my colleagues in sleep medicine are working to better understand how to better treat patients with heart failure and central sleep apnea and even looking at the role of older treatments such as oxygen.

I am sorry we don't have better answers for you---but please continue to talk to your doctors and whatever decision you make, make sure that you and your doctors are closely monitoring your sleep and heart health.

It depends -- I find on occasion I have the same issue, and it is painful and - inconvenient, shall we say - but it seems to occur mostly on nights when I have caught myself sleeping on my back with my mouth open. Since that's suboptimal position for me, I do things to reduce the frequency, and find the aerophagia reduced as well. I don't know, but my guess is that when we are having an obstruction, the air has to go somewhere, and if the trachea is blocked, down the swallowing hatch it goes. One other thing I find helps it move on is gentle belly massage with both hands pressed against that whole area, something I learned in a Tai Chi class. My sympathies.

Hi there,

I wonder where a heading is for OROFACIAL MYOFUNCTIONAL THERAPY???

THANKS

I looked up this therapy and saw little relating to sleep apnea. Here is a quote from one site:

The goals of oral myology are.

Promoting a lip seal.
Promoting a palatal tongue rest position.
Promoting a posterior, tooth together swallow.i
Facilitating bi-lateral chewing and correct drinking.ii
Keeping hands and objectives away from the face.
Facilitating nasal breathing.
Developing a harmonious peri-oral muscle pattern.
Correcting dysfunctional habit patterns.

I am not sure what the medical implications of much of the list are but none seem to be sleep apnea. Can you explain?

Hi @ImaginativeScarletDolphin9830. Feel free to create a new topic here on the Forum! We really like reading about the experiences of our members!