This topic is about finding ways to manage the uncomfortable side effects of using a CPAP machine for sleep apnea, especially for someone with an ileostomy. The person in question has been struggling with severe sleep apnea and the use of a CPAP machine, which causes air to fill their stomach and pouch, leading to discomfort and bloating. They are seeking solutions to continue using CPAP or another device without these issues. Here are some suggestions and insights that might help:

1. Consider using an oral appliance, which is a custom mouthpiece or mandibular advancement device.
- There are commercial options available, such as PureSleep and devices listed on SleepApnea.org.
- Dentists can create fully customized units, though insurance coverage may be limited or unavailable.

2. Switch from a full-face mask to nasal pillows combined with a chin strap to prevent mouth leaks, which can reduce swallowed air.
- An example is the ResMed Swift FX Nasal Pillow System, which comes with three pillow sizes.
- Chin straps can be purchased from CPAP suppliers and on Amazon.

3. Discuss alternative interfaces directly with manufacturers and your sleep clinician, as nurses might not always suggest more expensive but suitable components.

4. Explore DIY approaches that have worked for others:
- A homemade copper "nose-only" tube with a separate chin strap.
- Custom intra-nasal inserts made with plaster-of-Paris or silicone for a tight, leak-free nasal fit.

5. Keep in mind some general precautions and reminders:
- Do not stop using CPAP without consulting a medical professional, as untreated sleep apnea can increase the risk of hypertension, diabetes, and cognitive issues.
- Ensure the CPAP device is delivering adequate oxygen; incorrect settings or malfunctions can be dangerous.
- Try to minimize other sources of swallowed air, such as chewing gum or drinking through straws.

6. For purchasing accessories:
- ResMed products can be found at www.resmed.com.
- Chin straps and "nose pillow" interfaces are available from various CPAP web-shops and Amazon.

These strategies, particularly focusing on eliminating mouth leaks with nasal-only delivery or using an oral appliance, have helped others reduce bloating while maintaining effective sleep apnea therapy.