Continuous positive airway pressure (CPAP) therapy is a common and effective treatment for obstructive sleep apnea, a condition characterized by periodic interruptions in breathing during sleep.
While CPAP machines are lifesaving for many, they can also bring about some unintended side effects, including the phenomenon of aerophagia—swallowing air during sleep—which leads to gas accumulation in the stomach and intestines.
This article explores how CPAP therapy can cause gas, the factors contributing to this discomforting side effect, and practical solutions to mitigate it.
Can CPAP Cause Gas?
Yes, continuous positive airway pressure (CPAP) machines can indeed cause gas in some people, a condition commonly referred to as “aerophagia.” This occurs when the air pressure from the CPAP machine causes a person to swallow air during sleep. The swallowed air then accumulates in the stomach and intestines, leading to discomfort, bloating, burping, or flatulence.
Aerophagia is more likely to occur if the CPAP pressure settings are too high or if the mask does not fit properly, allowing air to be pushed into the mouth and swallowed.
Adjusting the pressure settings or changing the mask type or fit can often help alleviate this issue. If the problem persists, it’s important to consult with a healthcare provider who can provide guidance on adjusting the equipment or exploring other treatment options.
What is Aerophagia?
Aerophagia is a condition where an individual swallows too much air, which can accumulate in the stomach and intestines, leading to symptoms like bloating, belching, abdominal discomfort, and sometimes pain. This swallowed air can also cause distension that might be uncomfortable or painful.
Aerophagia can occur in several contexts. It’s often seen in people who eat or drink too quickly, talk while eating, chew gum excessively, or smoke. In some cases, it can also be associated with certain medical devices like CPAP machines used for treating sleep apnea, where air pressure can cause the person to inadvertently swallow air.
Managing aerophagia typically involves lifestyle changes such as eating more slowly, avoiding carbonated beverages, and making sure any medical devices in use are correctly adjusted and fitted. In more persistent cases, consulting with a healthcare professional is advisable to rule out other underlying conditions or to adjust treatment strategies.
Causes of CPAP Gas
CPAP gas occurs when the air from the machine leads to an excessive swallowing of air. This can cause a variety of uncomfortable symptoms, including bloating, abdominal discomfort, and gas.
Several factors can contribute to the development of CPAP gas:
- High Pressure Settings: If the CPAP machine is set to a higher pressure than necessary, it can lead to more air being pushed into the lungs, which might then be swallowed into the stomach.
- Poor Mask Fit: A mask that doesn’t fit well can leak air into the mouth or cause the user to open their mouth during sleep, increasing the likelihood of swallowing air.
- Sleep Position: Certain sleeping positions, like sleeping on the back, can facilitate easier entry of air into the esophagus and stomach.
- Type of CPAP Mask: Full-face masks that cover both the nose and mouth can sometimes lead to more swallowed air compared to nasal masks or nasal pillows, especially if the mask is loose.
- Eating Close to Bedtime: Eating shortly before using a CPAP machine can increase the risk of aerophagia, as the digestive process may not be well suited to handle additional air.
- Underlying Health Issues: People with gastroesophageal reflux disease (GERD), hiatal hernias, or other gastrointestinal issues might be more susceptible to swallowing air.
Note: Addressing CPAP gas typically involves adjustments to the CPAP machine settings, changing the mask type or fit, or altering sleeping positions. If these measures do not alleviate the symptoms, it is important to consult with a healthcare provider who can further assess and adjust the treatment plan.
CPAP Air Swallowing Side Effects
Swallowing air while using a CPAP machine can lead to several uncomfortable side effects. These can affect both the quality of sleep and general well-being.
Some of the common side effects include:
- Bloating: Excess air swallowed into the gastrointestinal tract can lead to a feeling of being overly full or distended in the abdomen.
- Gas: Accumulation of air in the stomach and intestines can lead to increased flatulence.
- Belching: Swallowing air can cause frequent and sometimes uncontrollable burping as the air escapes back up the esophagus.
- Abdominal Discomfort or Pain: The pressure from the trapped air in the stomach and intestines can cause mild to severe discomfort or pain.
- Heartburn: For some, the influx of air can also exacerbate symptoms of acid reflux or heartburn by pushing stomach acids upwards into the esophagus.
- Disrupted Sleep: These discomforts can lead to frequent awakenings or difficulty falling asleep, reducing the overall effectiveness of CPAP therapy.
- Chest Discomfort: In some cases, the air can move into the digestive tract and create pressure that feels like chest pain or tightness, which can be distressing.
Note: Addressing these side effects often involves adjusting the CPAP settings, such as reducing the air pressure, changing the mask type or fit, or consulting with a healthcare provider for further evaluation and management. Sometimes, using anti-gas medications, adjusting meal times, and changing sleep positions can also help alleviate the symptoms.
How to Reduce Gas Caused by CPAP
To reduce gas caused by CPAP, you can take several steps to adjust your machine and lifestyle. Here are some effective strategies:
- Adjust CPAP Settings: Sometimes, the pressure settings on the CPAP machine might be too high, which can lead to more air being swallowed. Consulting with a sleep specialist to adjust the pressure settings can be beneficial.
- Check Mask Fit: A poorly fitting mask can lead to air leakage into the mouth, increasing the likelihood of swallowing air. Ensure your mask fits well and is properly sealed. If necessary, try different styles or sizes of masks.
- Switch Mask Type: If you are using a full-face mask, consider switching to a nasal mask or nasal pillows if you don’t have issues with nasal congestion. These types of masks are less likely to contribute to swallowing air.
- Use a Chin Strap: If you’re using a nasal mask or nasal pillows and find your mouth opening during sleep, a chin strap can help keep your mouth closed and reduce the risk of swallowing air.
- Change Sleeping Position: Sleeping on your back can sometimes increase the likelihood of air swallowing. Try sleeping on your side to see if it reduces symptoms.
- Avoid Eating Before Bed: Eating large meals or certain types of foods close to bedtime can increase the risk of aerophagia. Try to finish eating at least 2-3 hours before using the CPAP machine.
- Manage Heartburn or GERD: If you have gastroesophageal reflux disease (GERD) or frequent heartburn, managing these conditions can reduce the risk of swallowing air. Talk to your doctor about treatments that might help.
- CPAP Machine Features: Some CPAP machines come with features like Expiratory Pressure Relief (EPR) which lowers the pressure when you exhale, potentially reducing the amount of air swallowed.
- Regular Maintenance: Regularly checking and replacing CPAP components like hoses and filters can ensure the machine operates correctly and efficiently, reducing potential issues.
Note: If these adjustments don’t help, it’s important to revisit your healthcare provider or a sleep specialist. They might need to reassess your treatment, including potentially trying a different type of PAP therapy.
FAQs About Gas Caused by CPAP
Is CPAP Making You Gassy?
Yes, CPAP therapy can indeed make you gassy. This is due to a condition called aerophagia, where the user inadvertently swallows air while sleeping.
This swallowed air can accumulate in the stomach and intestines, leading to symptoms like bloating, discomfort, and gas.
Can My CPAP Cause Bloating?
Yes, your CPAP can cause bloating. Bloating is a common side effect experienced by users of CPAP machines and is primarily caused by aerophagia, where air is swallowed into the gastrointestinal tract.
This can lead to an uncomfortable feeling of fullness and distension in the abdomen.
How Do You Relieve Gas from a CPAP Machine?
Relieving gas caused by a CPAP machine involves several strategies: adjusting the pressure settings of the machine to ensure they are not too high, ensuring the mask fits properly without any leaks, and perhaps switching to a different type of mask, such as a nasal mask if you are using a full-face mask.
Additionally, using a chin strap can help keep the mouth closed to reduce air swallowing. It’s also beneficial to avoid eating right before bedtime and managing any underlying digestive issues.
Note: If these adjustments do not help, consulting with your healthcare provider is advisable.
How Do You Fix Aerophagia from CPAP?
Fixing aerophagia from CPAP involves several adjustments. First, consult with your healthcare provider to potentially adjust the pressure settings of your CPAP machine, as overly high pressures are a common cause.
Ensure that your mask fits properly to prevent air leakage that can lead to swallowing air. If you are using a full-face mask, consider switching to a nasal mask or nasal pillows, and consider using a chin strap if you find that your mouth opens during sleep.
Modifying sleep positions, such as sleeping on your side instead of your back, can also help reduce air swallowing.
What is CPAP Belly?
CPAP belly is a term used to describe the bloating and abdominal discomfort that some CPAP users experience as a result of aerophagia, where air is swallowed during sleep.
This swallowed air can lead to an increase in the volume of gas in the stomach and intestines, causing discomfort, bloating, and sometimes pain.
It is a common issue among those who are new to CPAP therapy or those whose machines are improperly calibrated or fitted.
How to Get Rid of CPAP Belly?
Getting rid of CPAP belly typically involves a few adjustments to your CPAP therapy and lifestyle habits. Ensure that your CPAP machine is correctly calibrated with the appropriate pressure settings and that your mask fits well.
Consider switching to a nasal mask or nasal pillows if you’re using a full-face mask. Using a chin strap to keep the mouth closed can also help. Avoid eating large meals close to bedtime, and manage any underlying digestive issues like acid reflux that might be exacerbated by the therapy.
Note: If these strategies don’t alleviate the problem, it’s important to consult with your healthcare provider for further assistance.
Can CPAP Cause Gastritis?
CPAP itself does not directly cause gastritis, which is inflammation of the stomach lining. However, the air swallowing associated with CPAP use can exacerbate symptoms of existing gastrointestinal conditions such as acid reflux or gastroesophageal reflux disease (GERD).
These conditions can sometimes lead to gastritis if stomach acid frequently comes into contact with the stomach lining.
If you are experiencing symptoms of gastritis while using CPAP, it is important to consult with a healthcare provider to manage these symptoms effectively.
How Do I Get Rid of Gas Pain from My CPAP Machine?
To alleviate gas pain caused by a CPAP machine, try adjusting the machine’s settings, such as reducing the pressure if it’s set too high. Ensure your mask fits correctly to minimize the amount of air you might be swallowing.
Consider switching to a different type of mask, like nasal pillows, which can reduce the risk of aerophagia. Using a chin strap to keep the mouth closed can also help.
Adjusting your sleep position, avoiding eating right before bedtime, and addressing any underlying digestive issues can also reduce discomfort. If these steps do not help, seek advice from your healthcare provider.
When to See a Doctor About CPAP Gas?
You should see a doctor about gas related to CPAP use if the home adjustments you make (like changing pressure settings, mask types, or sleeping positions) do not alleviate your symptoms, or if the gas and bloating are severe enough to impact your sleep or quality of life.
Additionally, if you experience other symptoms such as persistent abdominal pain, significant discomfort, nausea, or if you suspect your CPAP use is exacerbating underlying conditions like GERD, it is important to consult with a healthcare provider.
They can help determine if further adjustments or a different treatment approach is needed.
Final Thoughts
While CPAP therapy remains a cornerstone in the management of sleep apnea, it is not without its challenges, such as causing gas due to aerophagia.
Addressing this issue effectively requires a collaborative approach involving careful adjustments to the machine’s settings, proper mask fitting, and lifestyle modifications.
By understanding the underlying causes and implementing the appropriate remedies, patients can continue to benefit from CPAP therapy while minimizing its gastrointestinal side effects, thereby improving both their sleep quality and overall quality of life.
Written by:
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
References
- Pinto VL, Sharma S. Continuous Positive Airway Pressure. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
- Bredenoord AJ, Weusten BL, Sifrim D, Timmer R, Smout AJ. Aerophagia, gastric, and supragastric belching: a study using intraluminal electrical impedance monitoring. Gut. 2004.