Breathing issues

[zeepac]

Hey all, newbie big time here, been using my Resmed S9 Elite now for a couple of weeks with all settings locked in. 8.5 cmH20, AHI between 2.1- 1.7 down from previous machine I was using, a Dreamstation Auto My concern is, I am using a nasal pillow medium size and I seem to be getting air coming back up through the throat (use a chin strap), having to make a small opening of mouth to expel the air, very annoying and I cant figure out what is causing it. Is there something I am missing in setting that can stop this. Have been searching forum with no luck, so any ideas or help please post away.

[DeepBreathing]

G'day Zeepac. Welcome to Apnea Board.

What you describe sounds like mouth leaking. The nasal passages and the mouth are all part of the same system, so any air pressure delivered via the nose will also put pressure on the mouth. Many people use the "tongue-stick method" to overcome this. The tongue is placed against the palate behind the teeth in south a way that the the back of the mouth is sealed, preventing the air escaping. You mention you're using a chin strap - other people use a soft cervical collar to support the jaw (and incidentally prevent chin-tucking) while others tape their lips.

My personal preference is to use a full face mask, which obviates the problem and means you don't have to resort to uncomfortable and potentially hazardous gimmicks like taping your lips.

[zeepac]

Hi DeepBreathing, thank you so kindly for your reply. Chin tuck, tongue stick method sounds pretty foreign to me but logical, as for the cervical collar I no what that is . From your comments I can now focus on my next step and hopefully my issues will be solved. There are plenty of full face masks on the market to choose from, so again will rely on other peoples experiences, there for and against.
Once again, thanks

[DeepBreathing]

I'll try to clarify...

Chin tuck is just your head falling forward so that your chin tucks down onto your chest. You can try it sitting up, and feel the difference it makes to ease of inhaling. In bed, it's preferable to have a pillow which cradles your head in a position so that the chin doesn't fall forwards and neck is extended slightly - this will help keep the airway open.

The cervical collar is basically just a soft neck brace which you can buy at a pharmacy. It helps keep the neck extended and prevents chin-tucking. If you decide to go this way, you need to choose one which is the right size (diameter and length) to gently support your neck without putting any stress on it.

The tongue-stick method is just a matter of placing your tongue behind your upper teeth to seal the mouth. It's easy enough to do while awake, the trick is to train yourself to keep it that way once you fall asleep.

If you decide to go for a full face mask it's almost a matter of trial and error to get one which is comfortable, fits properly and doesn't leak. Everybody's face is different, so what is great for one person will be terrible for another. Having said that the Fisher & Paykel Simplus and the Resmed F20 are both very popular.

[Sleep2Snore]

It is very difficult to stop air going out through the mouth if you are inclined to get this problem.
Try sucking and pushing your tongue onto the top of your mouth, works for some and not others.
Some stick tape over their mouths, however, I wouldn't recommend it.
I know of someone that couldn't get on with a Full-faced mask or a Hy-brid mask, so used one of those bands you get from a Physo to make a band to go round his head and keep his lips from opening and air escaping. Another found some soft silicone mouth thing somewhere (with he would tell me where he found it) I think it was either medical or something to do with diving? Anyway, it was soft enough to hold his lips closed and he held it in place with a chin strap he had modified with a vit of material that crossed his mouth from the chin strap.
All I do now is to keep the chin strap tight as I can, it is not perfect, I still get a slight leak now and again, but very little.#I know another guy that made a stretchy bandage into a head wrap that went round his mouth and the back of his head, he put a tab on the front so if he needed to remove the bandage he could grab the tab and rug the bandage off.
It is difficult to stop, the real answer is a Full-faced mask or a Hy-brid mask.
Some use a boil and bite gum shield that holds the teeth together, but if the air is escaping through your lips this will not work.
Sleeping on your side sometimes helps.

[trish6hundred]

Hi zeepac,
WELCOME! to the forum.!
Good luck with CPAP therapy, hang in there for more responses to your post.

[dracus]

I can say the simplus mask does work well. I did find it took a lot of tinkering to get the mask leaks taken care of. I also have a long beard. 

I prefer the nasal pillows I get much better AHI with them at a lower pressure. I do get some mouth leaks myself. Luckily mine are usually short and are below a level that triggers a sad face on sleep report. 

You'll get bit figured out...