Swallowing air, also known as aerophagia, is one of the possible side effects that some people experience with CPAP therapy (continuous positive airway pressure). While a certain amount of aerophagia is considered normal, the stream of air flowing into your upper airway from a CPAP device can also lead to an uncomfortable gas buildup in the stomach and intestines.

For those who use a CPAP machine, it is helpful to understand aerophagia, including how it is connected to the CPAP therapy and tips on preventing it.

What is Aerophagia?

Aerophagia is a term used to describe the swallowing of air, which is the primary method of gas entering your stomach. Everyone experiences various levels of aerophagia from swallowing small amounts of air throughout the day, including when drinking and eating.

Causes of Aerophagia

If you utilize CPAP therapy for obstructive sleep apnea or other sleep issues, you may have experienced aerophagia symptoms. Many things can cause aerophagia, such as the following:

  • Chewing gum
  • Drinking or eating too quickly
  • Stress or anxiety
  • Smoking
  • Being nauseous
  • Laying on your back
  • Certain drugs or medications

Symptoms of Aerophagia

Depending on where the air becomes trapped, it can change the symptoms you may experience. The symptoms will vary if the air passes down through the intestines or stays higher up and may include the following:

  • Belching
  • Bloating
  • Flatulence
  • Gurgling stomach
  • Abdominal discomfort and pain
  • Distended belly

Less common symptoms include:

  • Diarrhea
  • Constipation
  • Decreased appetite
  • Nausea

Can Aerophagia Be Harmful?

Generally, it is not harmful to swallow small amounts of air. Most of the air will leave your stomach by burping, which keeps excess air from getting into the small intestines. However, if too much excess gas builds up in your stomach or enters your small intestines, it can become uncomfortable and produce large amounts of flatulence or burping. 

How CPAP Therapy Contributes to Aerophagia

When using a CPAP machine, some people experience aerophagia because of the consistent stream of pressurized air that the CPAP device pumps into the airway.

One of the most common issues that CPAP therapy treats is obstructive sleep apnea (OSA). Those with OSA have changes in their breathing because of a blockage of the airway by tissue in the throat and the mouth, causing frequent pauses or reductions in breathing during sleeping. 

CPAP machines are designed to send a consistent stream of pressurized air into your airway through a mask, which is intended to keep your airway open. When using a CPAP machine, many people swallow more air than usual because the muscles in the esophagus relax while sleeping, allowing the air from the CPAP to travel more easily into the esophagus.

However, sometimes, the air continues to travel into the stomach and the intestines. The causes of swallowing air with a CPAP machine include the following:

  • The pressure is too high, and you’re getting air in your belly and intestines.
  • Nasal congestion can lead to inadequate CPAP air pressure and gulping air into the mouth, pushing it into the esophagus. Nasal congestion can also lead to snoring, sleep apnea, and trouble sleeping. If you experience these symptoms, consider consulting a sleep specialist to participate in a sleep study or home sleep test.
  • Mouth breathing while on a CPAP machine results in unconscious mouth breathing, air escaping through the mouth and then gulping rapidly, forcing air into the esophagus. Mouth breathing can also lead to sleepiness, oral health issues and increases your risk of developing other medical problems.
  • Exhalation problems can occur for people who require higher levels of  CPAP pressures, which can cause anxiety or panic when exhaling, causing the individual to start hyperventilating or alter their normal breathing rhythm, which leads to sucking or coping in air and forcing air into the esophagus rather than lungs.                                               

How to Prevent Your CPAP Machine From Causing Aerophagia 

Here are tips to help reduce the risk of aerophagia from your CPAP. Remember to speak with your sleep specialist to ensure your CPAP therapy is effective and done correctly.

#1. Adjust CPAP Pressure

If your settings for your CPAP are not adequate, speak with your provider or sleep professional about changing the pressure on your machine. You should never adjust the pressure of your CPAP machine without first consulting with your sleep specialist.

#2. Consider Changing to a Different Type of Mask

Check your mask to see if it’s the proper size and style to fit your face. If you have any soreness or are experiencing frequent mask leaks, consider trying another type of mask until you find the ideal fit with a good seal. For example, a nasal mask is not the best choice if you are a mouth breather.

#3. Enable Expiratory Pressure Relief on Your CPAP

Many CPAP machines have what is called AFLEX or BiFLEX, an expiratory pressure relief feature that helps to reduce pressure upon exhalation automatically. 

#4. Sleep in a Different Position

You may need to change your sleeping position. Sleeping at an incline is better than sleeping on your back, as many people find sleeping at an angle helpful.

#5. Change to a BiPAP Machine

BiPAP machines (bilevel positive airway pressure machine) can help to alleviate aerophagia symptoms. Suppose you are experiencing aerophagia from your CPAP machine. In that case, the BiPAP machine’s bilevel delivery system will reduce the air being pushed in during exhalation, reducing the amount of air entering your esophagus instead of your windpipe.

#6. Change to an APAP Machine

APAP machines, or automated positive airway pressure, use a noninvasive mask that connects to a pressure generator that delivers air pressure to open your airways when sleeping.

Dreamzz Sleep Center Is Here to Help You Get the Sleep You Deserve!

CPAP therapy is highly effective For those with obstructive sleep apnea. Consult your healthcare provider or sleep specialist for guidance and evaluation to receive treatment tailored to your needs.

DreamZz Sleep Center specializes in helping patients get restful sleep even after their sleep study. We will help you choose the proper CPAP machine, headgear, mask, filters, hoses, and water chambers to give you an incredible night’s sleep. 

Contact us today and sleep better tomorrow.