How to Reduce CPAP

Continuous positive airway pressure (CPAP) is a highly effective treatment for obstructive sleep apnea. But you can expect some side effects.

One of the most common complaints is CPAP-related gas. As excess air enters the stomach, it can lead to burping, belching, farting, and bloating.

This article will explain how to treat these symptoms and what you can do to reduce the amount of air you swallow in the first place.

Sleep apnea is a serious disorder that causes pauses in breathing during sleep. It could happen anywhere between 5 times per hour to hundreds of times per hour of sleep. Left untreated, sleep apnea can cause tiredness and irritability during the day. It can also contribute to the risk of eye problems, high blood pressure, heart disease, stroke, or diabetes.

One way to treat sleep apnea is with a CPAP machine—a mask and hose that is worn over the nose and/or mouth. An air blower gently forces air through the nose and/or mouth. The air pressure is set to prevent the upper airway tissues from collapsing during sleep. This treatment works, with very few side effects.

A downside is that the pumped air can enter the stomach, leading to a few common complaints.

These include:

These symptoms often are minor and tolerable. For many people, these side effects resolve within the first hour of the next day by simply passing the pent-up gas.

Fortunately, the extra gas poses no danger to your body. But, for some people, the symptoms can be severe and bothersome. If it continues, you'll probably want to find ways to manage it.

When air is pumped into the digestive tract, it is called aerophagia, which literally means "air swallowing" or "air eating." What causes this air swallowing to occur?

CPAP works by providing a constant flow of air that keeps the upper airway open. The airflow prevents waking episodes during sleep, which occur when oxygen levels drop.

Sleep apnea is common. Seventeen percent of women and 34% of men have the condition.

The airway includes the trachea, which leads to the bronchi and lungs. The opening that leads to the esophagus and stomach sits near the entrance to the trachea. When the air is pushed into the mouth or nose, you can also get excess air into your esophagus, and your stomach may fill with air. This doesn't interfere with how effectively your CPAP machine is working to treat your sleep apnea. But it can lead to gassiness.

You may experience aerophagia in other ways in your daily life. Drinking fizzy, carbonated beverages can cause you to swallow too much air. So can eating too fast, chewing gum, and smoking.

There are ways to decrease CPAP gas. Consider these options:

Sleeping at an incline may help. You may find it helpful to sleep with your head up at an angle of about 30 degrees. A wedge pillow can be placed on top of or under the mattress, depending on its design.

Some people opt for an adjustable bed, but this option can be expensive. Another idea: Raise the head of the bed with blocks placed under the mattress.

Whatever you do, make sure to fully support your head, neck, shoulders, and upper body.

Consider the possibility that you may have untreated heartburn, or gastroesophageal reflux disease (GERD).

The lower part of the esophagus has a muscular ring called the lower esophageal sphincter. This ring closes off the esophagus from the stomach, preventing the contents of the stomach, including stomach acid, from creeping up into the esophagus. If the sphincter becomes weak, it can cause reflux of stomach acid into the esophagus, with symptoms of heartburn.

The weak sphincter can also allow air to get into the stomach when you use a CPAP machine.

Some over-the-counter heartburn remedies can provide relief of heartburn and other gas symptoms:

Speak with your healthcare provider first. None of these options is meant for long-term use.

Your provider may recommend an over-the-counter (OTC) remedy such as Gas-X (simethicone).

In the end, you may find the greatest relief after resigning yourself to spending a little more time in the bathroom each morning. Passing gas naturally (through burping or farting) often solves the issue.

People who undergo CPAP therapy often ask if the type of mask they use plays a role in the amount of air they swallow. They want to know: Does it make a difference if the mask covers only my nose instead of both my nose and mouth?

The short answer is no. Whether the pressurized air is sent through the nose or mouth, it ultimately comes into contact with the same passage at the back of the throat—and can flow to your stomach and intestines.

For many people, CPAP therapy can help relieve sleep apnea. However, it can pump air into the stomach, which is called aerophagia. This literally means "air swallowing" or "air eating."

This extra air must go somewhere, and it usually escapes through burping, belching, or passing gas. If these symptoms are bothersome, consult your healthcare provider for guidance on how to manage them. They may recommend that you sleep at an incline, treat your acid reflux, or take OTC medications for relief.

When you're using a CPAP, you can experience some discomfort from swallowing air. Consult your sleep healthcare provider to discuss ways to minimize this CPAP side effect.

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By Brandon Peters, MDBrandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.