144 days... and I seem to starting to mouth breathe

[SleepyDude]

The edema of soft tissue in our breathing apparatus goes down after successful xPAP therapy over 3-6 months. That may reduce your pressure needs (there is a paper in pubmed on this explaining how a 2nd titration after a few months of Cpap shows a lower required pressure).

My theory on mouth opening is that if the pressure applied is just a bit More than the critical pressure to keep the airway open, it blows open the mouth gate. In my case, I can even open my mouth while breathing nasally thru my P10 pillows and no air escapes thru the mouth.

You can try to correlate if the leak is happening at a higher pressure (and maybe that threshold has changed over time ). You may want to tighten your top end of the range a bit (if AHI permits) and evaluate.

And you can never leave the P10 cult once you join. Resistance is futile!!

Interesting about the pressure changing after a couple months of treatment. I wonder if the fact that I've lost 22 lb in the past couple of months has played into that as well. Perhaps I do need a lower starting pressure now.

My pressure band is pretty tight. I start at 10 and through the night can see myself work up to a max of about 11. I didn't see a lot of correlation between the pressure and the the starting of large mouth leaks.

I've definitely got room on the AHI front; I'm running at most 1.5.

I'll drop my sleep doctor an email and see what she thinks.

[SleepyDude]

Small update:
I've been using the chin strap now for a week and a few days. I'm finding my results with it are quite variable. Some nights I'm doing great (like last night; 0 95% leak!), but others I'm still getting woken up with a dry mouth or mouth leak (those nights my 95% leak averages around 10).

My snugglehose arrived the other day as well. So, comfort-wise using the machine I don't know why these things aren't standard. Usually when I wake up, I know exactly where my hose is because I've got hose-treads on my arm. With the snugglehose, it just blends in with the blankets. I used the climate control on manual -- 5 humidity, 82F hose. ZERO rainout, so the snugglehose seems to help keep things stable. I'm not sure if the much higher humidity is what helped me achieve 0 mouth leaks last night, but I'll try again tonight and see if I can get a repeat success.

[SleepyDude]

I think I've figure out the correct chin strap tension; that and the high humidity (made possible by the snugglehose cover) led me to a phenomenal night. 4 lps 95% leak, and 0 AHI. I'm going to keep up this combo!

Only downside is in a 7 hour night I burn through almost the entire humidifier worth of water.