Dealing with Hiatal Hernias and CPAP Treatments: What’s Important to Know

Obstructive sleep apnea (OSA) is a relatively common condition and many individuals experience the associated symptoms on a nightly basis. In fact, many moderate cases are left undiagnosed for years at a time until problems begin to develop. 

Considering the fact that OSA can have a profound effect on numerous body processes, it only stands to reason that physical issues can sometimes emerge. One hypothesis claims that hiatal hernias may sometimes be caused by sleep apnea and this subject is worth a closer look.

Let's see what medical science has to say on the matter. 

What is a Hiatal Hernia?

A hernia is defined as any type of gap within the abdominal wall that allows internal organs to slightly protrude. Umbilical hernias and inguinal hernias are two examples. 

Hiatal hernias are yet another variant. In this case, a portion of the stomach may begin to "poke through" a gap within the diaphragm (an organ that separates the abdomen from the lower chest). 

These are some of the most common types of hernias and they can be caused by a number of factors including:

  • Smoking.
  • Age (individuals over 50 years old are at an increased risk).
  • Obesity.
  • Injury.
  • Weakness in nearby connective tissues

It is also interesting to note that hiatal hernias may sometimes be linked to other chronic conditions such as gastroesophageal reflux disease (GERD) and everyday acid reflux (heartburn). Scientists also believe that a genetic component exists, as some children are born with existing hiatal hernias. 

What are the Symptoms of a Hiatal Hernia?

Although it is always important to obtain a professional diagnosis, there are several symptoms which could indicate that a problem exists. Some examples include:

  • Heartburn after consuming a large meal.
  • Bad breath.
  • Cramps or bloating in or around the upper abdomen.
  • Sensations of nausea.
  • It is difficult or painful to swallow.

The good news is that most hiatal hernias are mild in nature and will not pose a profound health risk. There are nonetheless certain instances when medical intervention (such as laparoscopic surgery) might be required to physically repair detached tissue. This is once again why obtaining an expert diagnosis is always a good idea. 

Is There a Link Between Obstructive Sleep Apnea and Hiatal Hernias?

This question is currently being examined by medical experts in detail and the verdict is still out. However, some feel that there is indeed a relationship. 

This is due in large part to the negative pressure exerted upon the chest cavity during an apnea episode (when you momentarily stop breathing). It has been proposed that this pressure forcibly pulls the diaphragm down into the abdominal cavity -- and could cause a portion of the stomach to enter the subsequent void within the chest cavity. 

It is still important to mention that research is ongoing and that no firm conclusions have been drawn. Furthermore, not everyone who has been diagnosed with obstructive sleep apnea will develop a hiatal hernia. It seems that other factors might come into play to result in this condition. 

PAP-related Hiatal Hernia Suggestions

The following advice applies to individuals who are currently using a PAP device -- as well as those who might currently be dealing with the side effects of a hiatal hernia. 

Perhaps the most important takeaway point here is that your sleeping position can and will have a massive impact upon your levels of comfort during sleep. 

Those who are already using a PAP device are likely aware that it is best to sleep on their backs, as this helps to decrease the effort required to breathe. This is equally true in regard to hiatal hernias. 

However, simply stacking pillows may cause more harm than good. This method can actually place a great deal of mechanical strain upon the neck and shoulders, leading to stiffness and cramping. It is much better to position the entire bed at an incline. 

This can be accomplished through the use of several strategies. For example, you might simply choose to place a few bricks below the top of the bed; causing the frame to rest at an incline. 

There are also plenty of beds that have a built-in mechanism which allows the user to manually adjust their inclination. Above all, those who have been diagnosed with a hiatal hernia should avoid sleeping on their stomach. This can place even more pressure upon the abdominal cavity and exacerbate the existing symptoms. 

Can You Use a PAP Immediately Following Hiatal Hernia Surgery?

Let's now take a moment to imagine that you have recently undergone surgery to repair a more severe hiatal hernia. Should you immediately return using a PAP? 

We need to remember that PAP devices provide your lungs with air at a slightly higher pressure than normal. This increase in pressure may place additional strain upon the site of surgery during the healing process. 

It is therefore essential to consult with a primary care physician, a sleep specialist or the doctor who performed the surgery to appreciate your options. 

Ultimately, hiatal hernias can be managed by those who are also dealing with the effects of sleep apnea. The severity of the symptoms is perhaps the most relevant variable to take into account. There are many targeted solutions at your disposal and modern medical science is able to provide a host of unique strategies.