Continuous Positive Airway Pressure (CPAP) therapy is a widely used treatment for sleep apnea, a condition characterized by breathing interruptions during sleep. While CPAP machines are effective at keeping airways open, some individuals may experience side effects. This article will explore the connection between CPAP use and nausea, common reasons for its occurrence, strategies for prevention and management, and when to seek professional medical advice.
Understanding CPAP-Related Nausea
CPAP therapy can cause nausea, often linked to a phenomenon called aerophagia, which is the excessive swallowing of air. When air from the CPAP machine is inadvertently swallowed instead of flowing directly into the lungs, it can accumulate in the stomach and intestines. This air buildup can lead to bloating, abdominal discomfort, belching, and in some cases, nausea or even vomiting.
Several factors contribute to aerophagia and subsequent nausea. High pressure settings on the CPAP machine can force air into the esophagus, making it easier to swallow. An ill-fitting mask can also contribute, as air leaks might disrupt proper airflow and pressure delivery, causing individuals to mouth breathe or gulp air to compensate. Additionally, sleeping on one’s back can make it easier for air to enter the digestive tract. Pre-existing conditions like Gastroesophageal Reflux Disease (GERD) can also be exacerbated by CPAP therapy, as the continuous air pressure might cause stomach contents to leak into the throat, leading to nausea and acid reflux.
Managing and Preventing Nausea
Adjusting CPAP pressure settings is a common approach to alleviate aerophagia and nausea. Collaborating with a healthcare provider to fine-tune the pressure can significantly reduce symptoms without compromising treatment effectiveness. Some machines offer an auto-adjusting positive airway pressure (APAP) mode, which automatically modifies air pressure based on breathing needs, potentially lowering the average pressure overnight and limiting air swallowing. A BiPAP (bilevel positive airway pressure) machine, which provides different pressures for inhalation and exhalation, can also make it easier to exhale comfortably and reduce swallowed air.
Improving mask fit is another solution. An improperly fitted mask can lead to air leaks, encouraging mouth breathing and air swallowing. Trying different mask styles, such as a nasal mask or nasal pillow mask, may reduce leaks and improve comfort, especially if mouth breathing is an issue. Using a chin strap with nasal masks can also help keep the mouth closed during sleep, preventing air from escaping and being swallowed.
Changing sleeping positions can also help. Sleeping on one’s side instead of the back may decrease aerophagia and reduce the pressure needed to keep the airway open. Elevating the head of the bed by 4 inches or more, or using a sleep wedge pillow, can also reduce acid reflux and the likelihood of air entering the stomach. Additionally, the ramp feature on a CPAP machine allows pressure to start lower and gradually increase as you fall asleep. This helps new users acclimate and reduces discomfort that might lead to air swallowing. Expiratory pressure relief (EPR) features, which lower pressure during exhalation, can also make breathing more comfortable and reduce air swallowing.
When to Consult a Healthcare Professional
If nausea persists or becomes severe despite adjustments, consult a healthcare professional. Indicators that warrant medical attention include persistent vomiting, significant discomfort, an inability to continue using CPAP therapy, or if symptoms worsen over time. A doctor can help diagnose any underlying medical conditions, such as GERD, which may be contributing to the nausea.
A medical professional can evaluate CPAP settings and make necessary adjustments, such as modifying pressure levels or recommending a different type of machine like an APAP or BiPAP. They can also assess mask fit and suggest alternative mask types. Discuss all symptoms with your doctor to ensure effective management and continued CPAP adherence.