A Continuous Positive Airway Pressure (CPAP) machine effectively treats sleep apnea by maintaining an open airway during sleep. While CPAP therapy improves breathing and sleep quality, some users experience gastrointestinal symptoms like gas, bloating, and abdominal discomfort. This common side effect often prompts users to seek solutions for more comfortable therapy.
Understanding Aerophagia and CPAP
The primary reason CPAP users experience gas is aerophagia, or “air swallowing.” While swallowing small amounts of air is normal, CPAP therapy can exacerbate it. A CPAP machine delivers a constant stream of pressurized air into the upper airway to keep it open during sleep.
The esophagus, which carries food to the stomach, lies close to the windpipe. During sleep, esophageal muscles can relax, allowing pressurized air from the CPAP machine to enter the stomach instead of the lungs. This trapped air leads to symptoms like belching, flatulence, bloating, and stomach discomfort. Around 16% of CPAP users experience aerophagia, affecting both adults and children.
Common Reasons for CPAP-Induced Gas
Several factors can contribute to aerophagia and the resulting gas when using a CPAP machine. An excessive pressure setting is one reason. If the air pressure delivered by the CPAP machine is too high for an individual’s needs, the excess air can be forced into the esophagus and stomach, making air swallowing more likely. Conversely, if the pressure is too low to effectively keep the airway open, a person might gasp or struggle to breathe, inadvertently swallowing more air.
Mask leaks or a poor mask fit also play a role. When air escapes from around the mask, the CPAP machine may compensate by increasing the pressure to maintain the prescribed level, which can then lead to more air being swallowed. A mask that is too loose or too tight can compromise the seal, allowing air to escape and contributing to this issue. Breathing through the mouth, especially when using a nasal mask, can also cause aerophagia, as the pressurized air can easily bypass the nasal passages and enter the digestive tract.
Some individuals naturally swallow more air during sleep, a tendency that CPAP therapy can intensify. Conditions like nasal congestion, often from allergies or colds, can make it difficult to breathe through the nose, leading to mouth breathing and increased air swallowing. Problems with exhaling against the continuous positive pressure can also cause users to gulp air.
Strategies to Minimize Gas
Several strategies can help minimize CPAP-induced gas. Optimizing CPAP pressure is key; work with a healthcare provider to adjust settings, as both high and low pressure contribute to aerophagia. An auto-adjusting positive airway pressure (APAP) machine, which automatically modifies air pressure throughout the night, may also reduce average pressure and limit air swallowing.
Ensuring a proper mask fit is another strategy. Users should regularly check for mask leaks and ensure the mask forms a secure, comfortable seal. Switching to a different mask type, such as a full-face mask for mouth breathers or a nasal mask with a chin strap, can help prevent air from being swallowed. Regular mask cleaning also prevents leaks caused by facial oils or dirt.
Lifestyle adjustments can offer relief. Avoid gas-producing foods or carbonated beverages before bedtime to reduce digestive gas. Elevating the head of the bed by sleeping on one’s side or using a wedge pillow can decrease aerophagia by altering body position relative to airflow. Over-the-counter remedies like simethicone (Gas-X) can temporarily relieve gas and bloating by breaking down gas bubbles.
When to Consult a Professional
Consult a healthcare professional if CPAP-induced gas symptoms persist or worsen despite self-management strategies. Seek medical advice for severe or persistent bloating, belching, flatulence, or abdominal pain that significantly impacts your comfort or CPAP compliance. Changes in bowel habits, such as new or worsening diarrhea or constipation, also warrant a medical consultation.
A doctor can evaluate your CPAP settings, including pressure levels and mask type, and make necessary adjustments to optimize therapy. They can also rule out other underlying medical conditions contributing to gastrointestinal symptoms, ensuring the gas relates to CPAP use and not another health issue. Working with your healthcare provider helps you maintain CPAP benefits while managing side effects.