Why Does CPAP Make Me Burp? ENT Insights

If you use a CPAP machine to treat obstructive sleep apnea, you likely know it’s a true game-changer for achieving restful nights and improving your overall health. CPAP therapy helps keep your airway open in people with obstructive sleep apnea, reducing snoring and dangerous oxygen dips during sleep. However, for some users, CPAP brings along a surprising and sometimes frustrating side effect: excessive burping. You might be asking yourself, “Why does CPAP make me burp?” or wondering why you’re suddenly dealing with bloating, gas, or even worsening acid reflux after starting treatment.

Rest assured, you are not alone in this experience. Many patients report these symptoms, which often stem from a common but treatable condition known as aerophagia—the swallowing of excess air. In today’s article, we’ll dive into why CPAP makes me burp, how ENT expertise can help identify and manage this issue, and practical strategies to ease your discomfort. That way, you can fully enjoy the benefits of your therapy without unwanted digestive side effects.

What Does It Mean When CPAP Makes Me Burp? Understanding Aerophagia

What Is Aerophagia?

The term “aerophagia” might sound complex, but it simply means “swallowing air.” When using CPAP therapy, aerophagia occurs when pressurized air intended to open your airway may inadvertently enter your esophagus and stomach due to pressure and muscle relaxation during sleep. Sleeping with relaxed throat muscles makes this more likely.

One sleep apnea patient shared, “I woke up every morning burping and feeling like a balloon. I thought maybe I was using CPAP wrong, but my doctor explained it’s pretty common!” This swallowing of excess air leads to symptoms like frequent burping, abdominal bloating, and increased flatulence¹².

Though generally harmless, aerophagia can be uncomfortable enough to disrupt your sleep routine and even cause some users to discontinue CPAP therapy prematurely, missing out on its life-saving benefits.

Why Does CPAP Cause Swallowing of Air?

CPAP stands for Continuous Positive Airway Pressure. It works by gently blowing a steady stream of air to prevent your airway from collapsing during sleep. However, when the pressure is too high or the mask fit isn’t perfect, some of this air can escape the intended path and slip into the esophagus—the tube connecting your throat to your stomach³.

Think of it like inflating a balloon inside your stomach. The air gets trapped, creating that bloated, full feeling. At higher pressure settings, or if you breathe through your mouth while wearing a nasal mask, the likelihood of swallowing extra air increases. This is simply the physics of airflow meeting relaxed muscles during sleep.

Common Symptoms When CPAP Makes Me Burp

If your CPAP therapy leads to burping, you might notice related symptoms such as:

• Frequent burping or belching, especially upon waking up
• Abdominal bloating or cramping sensations
• Excessive flatulence or “gassy” feelings during the day
• Worsening of acid reflux or heartburn symptoms (GERD)⁴
• Disrupted sleep or discomfort that makes consistent CPAP use difficult

For many people, these side effects are mild and improve with time as the body adjusts. However, for others, the symptoms become significant obstacles to comfortable therapy, requiring targeted interventions.

Causes Behind CPAP-Induced Burping

So, what exactly makes CPAP makes me burp a common problem? Several connected factors contribute.

High CPAP Pressure Settings

The most frequent cause is that the machine’s pressure setting is simply too high for your unique needs. Excessively high pressure can force air past the upper esophageal sphincter—the muscle guarding your stomach—allowing air to enter and cause bloating²⁴.

One study showed that patients on pressures above 12 cm H2O tend to be more likely to experience aerophagia symptoms. Gradual and personalized pressure adjustment can help reduce swallowing of air without compromising apnea control.

Mask Type and Fit

Your mask choice plays a surprising role. Full-face masks cover your nose and mouth and are convenient for mouth breathers, but for some patients, they may increase air swallowing because you naturally breathe through your mouth more during sleep.

In contrast, nasal masks or nasal pillow masks with a mild chin strap encourage nose breathing and minimize aerophagia². A proper fit is essential too — masks with leaks or gaps can cause discomfort and airflow issues, which may trigger you to unconsciously gulp or swallow air as you try to maintain consistent airflow, much like how sipping from a leaky straw makes you swallow air alongside your drink.

Sleep Position and Its Impact

Believe it or not, how you sleep affects air swallowing. Sleeping on your back creates a more direct path for air into the esophagus, whereas side sleeping tends to reduce this risk. Many patients report less bloating and burping after switching to side-sleeping positions during CPAP use.

Try imagining your throat as a windy road: when you lie on your back, the road is straight and easy for air to take a wrong turn into the esophagus; on your side, the “road” curves, blocking easy air entry.

Gastroesophageal Reflux Disease (GERD) Link

Aerophagia and GERD often occur together. Swallowing excess air increases pressure in the stomach, which can push acid up into the esophagus, worsening reflux or heartburn symptoms⁴. In some individuals, CPAP-related aerophagia may amplify discomfort and lead to more frequent burping, especially if GERD is already present.

One ENT specialist notes, “Patients with reflux should have their symptoms monitored closely while starting CPAP, as aerophagia can exacerbate heartburn.”

How ENT Care Can Help Manage Burping from CPAP

ENT (Ear, Nose, and Throat) specialists bring valuable expertise in addressing why CPAP makes me burp and tailoring solutions to your needs.

Evaluating and Adjusting CPAP Settings

Your ENT or sleep apnea specialist can reevaluate your machine’s pressure settings to find the sweet spot that keeps your airway open without pushing excess air into your stomach. Sometimes switching from fixed pressure to an auto-adjusting CPAP device helps tremendously by only providing the pressure you need at that moment.

They will also carefully assess your mask fit and may recommend a mask style better suited to your breathing habits to reduce leaks and air swallowing.

Treating Underlying Conditions

Since aerophagia is often linked with esophageal or digestive issues, your ENT may work in concert with your gastroenterologist to treat GERD or other related conditions. Medication or dietary adjustments might reduce acid reflux, helping alleviate burping and associated discomfort.

Lifestyle and Behavioral Modifications

Simple but effective lifestyle tweaks can make a big difference. ENTs often suggest avoiding heavy or carbonated meals before bedtime (which increase stomach gas), using a chin strap to encourage nasal breathing, and experimenting with sleep positions. Relaxation techniques before sleep may also reduce nighttime swallowing.

Practical Tips to Reduce Burping When Using CPAP

Here are proven strategies to ease burping and maximize your comfort with CPAP:

• Increase pressure gradually: If you need higher pressure, ramp it up slowly over days or weeks to allow your body to adjust. (Ramp settings on some CPAP machines start pressure low and gradually increase to prescribed levels, easing this process.)
• Choose the right mask: Nasal masks or nasal pillow masks combined with a chin strap often help reduce air swallowing better than full-face masks for some patients.
• Avoid late, heavy, or carbonated meals: Eating lighter meals 2–3 hours before bed prevents excess gas buildup.
• Adopt side sleeping: Switching from back to side sleeping can reduce the potential for air entering the esophagus.
• Keep your equipment clean: Regular cleaning prevents leaks and optimizes airflow, minimizing compensatory swallowing.
• Consider new technology: Devices like bilevel PAP machines, which provide different pressures for inhaling and exhaling, can make breathing easier and reduce aerophagia, potentially lessening burping.

Remember, even small adjustments can dramatically improve your tolerability and the success of your therapy. Always discuss any changes with your sleep or ENT provider to ensure they fit your individual needs.

Frequently Asked Questions (FAQs)

Is Burping With CPAP Use Common?

Mild burping is relatively common, especially for new users adjusting to the therapy. However, if symptoms persist, worsen, or disrupt your sleep quality, it’s important to seek medical advice rather than ignore the problem.

Can Changing My CPAP Mask Help With Burping?

Absolutely! Switching to a nasal mask or nasal pillows, especially with a chin strap, can reduce air swallowing significantly. A well-fitted mask that minimizes leaks plays a crucial role. Your ENT or sleep provider can help determine the best mask type for you.

When Should I See an ENT Specialist?

If burping, bloating, or gas is frequent or seriously affects your sleep and daily life, seeing an ENT is advisable. Also, consult if you develop new acid reflux symptoms or find it increasingly difficult to adhere to your CPAP therapy.

Are There Devices or Accessories That Prevent Aerophagia?

Yes, options like chin straps, specialty masks designed for mouth breathers, and CPAP machines with auto-titrating pressure settings can reduce swallowing of air. Your ENT or sleep provider can guide you to effective solutions based on your individual needs.

Conclusion

If you ever find yourself asking, “Why does CPAP make me burp?” know that you are far from alone, and effective solutions exist. CPAP-induced burping, primarily caused by aerophagia or the swallowing of excess air, can be uncomfortable but is not something you must simply accept or endure silently.

With the right ENT care—including adjustments to pressure, finding the ideal mask fit, and implementing user-friendly comfort strategies—you can enjoy the full benefits of CPAP therapy without the unpleasant digestive side effects.

Stay patient and proactive with your CPAP use. If symptoms persist or worsen, don’t hesitate to reach out to a specialist. With proper evaluation and personalized care, you can breathe easier, sleep better, and wake refreshed—without the unwanted burps.

References

1. Verywell Health. The Causes and Treatment of CPAP Gas. 2025.
2. SleepApnea.org. Aerophagia and CPAP.
3. PubMed Central. Aerophagia Associated with CPAP Therapy. 2008.
4. Journal of Clinical Sleep Medicine. CPAP and Aerophagia: Impacts on GERD. 2013.

If you’re experiencing persistent symptoms or have questions about your CPAP therapy, consult your ENT or sleep care team for individualized advice and support. To find the right care and improve your comfort, book an appointment with our specialists today.

Disclaimer: This article is for educational purposes only and is not medical advice. Please consult a qualified healthcare provider for diagnosis and treatment.