Aerophagia or Swallowing Air with CPAP Use

Excessive CPAP Pressure or History of Heartburn May Contribute to Risk

Aerophagia, or air swallowing, occurs with CPAP due to excessive pressure or heartburn
Aerophagia, or air swallowing, occurs with CPAP due to excessive pressure or heartburn. Science Picture Co/Getty Images

Aerophagia may sound like something bizarre, but for those who use continuous positive airway pressure (CPAP) or bilevel to treat their sleep apnea, it may be all too familiar. What causes air swallowing with CPAP use? Learn about the roles of excessive pressure and heartburn in contributing to aerophagia and effective treatments that might provide relief from the resulting gas.

Definition of Aerophagia or Air Swallowing

Aerophagia can be defined from its word roots as "eating air." This may sound rather strange, but swallowing air is a common occurrence.

It is frequently associated with any sort of eating, especially when we eat too fast. Aerophagia often results from drinking carbonated beverages such as soda pop. It may also occur when chewing gum or even while smoking.

There are rare conditions that may be associated with aerophagia, such as an anxious behavior in those with a cognitive deficit from birth.

Aerophagia may also interestingly occur in the setting of CPAP or bilevel use if the treatment pressure is excessive. CPAP is the delivery of pressurized air through a face mask to support the upper airway and treat sleep apnea. The air enters the lungs through the trachea. If the air pressure is set too high, however, the air may travel into the stomach via the neighboring esophagus. Like a bellows, the machine may fill your stomach with air and this can lead to symptoms of aerophagia.

It seems that people with heartburn are more likely to swallow air with CPAP use.

This is due to the acid of the stomach causing the lower esophageal sphincter to relax. This opens the passage to the stomach and allows air to enter during PAP therapy.

Symptoms of Aerophagia Include Belching and Farting

The air that is swallowed with aerophagia enters the stomach and gastrointestinal tract.

This may cause bloating and abdominal discomfort or pain. If the air returns up the esophagus, it may cause belching or burping. It may also be passed as excessive gas by farting or flatulence.

How to Eliminate Aerophagia in CPAP Use

If aerophagia occurs in the setting of CPAP use, this can be corrected by making some changes to your CPAP pressure setting. In most cases, the pressure is too high and it must be reduced. It may also be necessary to change you to a different type of treatment, such as bilevel. If heartburn is present, treatment may be helpful. There are also other ways to reduce the effects of CPAP gas.

If you have concerns about experiencing aerophagia, start by speaking with your doctor.


Loening-Baucke, V. "Aerophagia as cause of gaseous abdominal distention in a toddler." J Pediatr Gastroenterol Nutr. 2000;31(2):204–7.

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