Complaints of Painful Gas/ Bloating After PAP Treatment?

Do you ever wake up with painful bloating after PAP(Positive Airway Pressure) treatment?

For many of you on PAP treatment, waking up with a small amount of gas is normal.  However, if you are waking up with persistent -painful bloating that interferes with your normal day, this should be addressed and eliminated as quickly as possible.  Bloating due to swallowing excessive amounts of air is called aerophagia.  According some research, aerophagia may be related or more prevalent in people who suffer from GERD (gastroesophageal reflux disease).  ( Watson and Mystkowski paper on CPAP Related- Aerophagia).

Here are a few techniques to try to reduce or eliminate  aerophagia:

Head Position

First and foremost try changing your sleep position.  Make sure that your head is tilted back in order to ensure that your trachea is open.  You might want to reduce the amount of pillows you sleep with or purchase a wedge pillow that automatically places your head and neck into this position.  Some research also suggests elevating the head of the bed may help as well.  You may need to try both positions and see if either one of these suggestions helps your case.

CPAP Pressure

Speak with your doctor or DME provider about lowering your pressures.  If you have an APAP- changing it to CPAP and reducing the pressure or narrowing the APAP pressures as well as lowering the pressures overall can help.  If your CPAP/APAP has an EPR (Expiratory Pressure Relief) option then have your clinician set it the highest level of exhalation relief.

When I work with a driver who is suffering from aerophagia, reducing the pressures for a period of time sometimes does the trick.  Once the discomfort has been reduced or eliminated then I slowly work to increase the pressure to the optimal titrated level.

Bilevel Unit

In some cases, if lowering the PAP pressures is only slightly effective, switching a driver to a bilevel unit can usually resolve the issue.  A Bilevel unit is a more sophisticated unit that has a separate exhalation pressure that can be reduced to help with aerophagia.



Avoid eating too soon prior to bedtime

Avoid caffeine and nicotine


It’s important to let your Doctor and DME provider-clinician know of your symptoms so that they can help you.

Safe Travels!