[CPAP] In the beginning, mouth breathing

[dan76]

So, my first night with CPAP is now behind me. Just want to share my experience and ask some advise to some problems.

I think the outcome is good and bad. I actually was not bothered by the mask itself (nasal pillows) at all (well some, but nothing to mention). In the beginning it took some time to get accustomed with the pressure when breathing out, but I think I got a hang of that. Noises didn't bother me either.

I went to bed early to get myself accustomed with the setup before even trying to get sleep. but after hour or so laying flat I started to feel like the sleep is moving in. But then the problems started. When I am just about to doze off, air gets into my mouth and my cheeks get blown out and finally the air is released between the lips. Naturally this cancels the dozing off and I need to start from the beginning.

I think this was also the main reason why I kept on waking up several times after finally falling in to some deeper sleep. Especially when the pressure went up my mouth would open. This is at least my interpretation - difficult to say for sure because of the half-sleep state in which I spent quite a long times during the night.

I didn't know much about the physiology of my mouth before, but I figured out I could block the airflow to my mouth using two different methods. One is to use my tongue as a hatch by keeping it pushed against the top of my mouth. This seemed to be the natural way to do it for me, but seemed like my tongue would relax when falling asleep and the air would break lose.

The other way to accomplish the blockade is to do it in the back of my mouth. This didn't come naturally at first, but I figured it out during the course of the night. It seemed like this worked better.

Any comments about this issue with opening my mouth? I don't think a chin strap would do any difference because my chin hardly moves. My lips would just open marginally and the air starts to escape through there. Will I learn to keep my mouth shut? Or learn not to wake up even this happens? I would not like to consider the full face mask because the nasal pillow version feels rather comfy.

And, how an earth do you yawn with this thing without choking?

Anyway, I still have two nights to try it out and on Friday morning I will head back to the sleep clinic to discuss about my experiences.

[zonk]

Hi dan76, welcome aboard
when air goes up the nose and route into the mouth instead going down the airways can cause the cheeks to balloon until it pops open and air exit between closed lips. we need to block the air escaping, some people taught themselves to use the tongue as a door stopper, placing the tongue at the roof of the mouth just behind the front teeth. if you use ramp (say 30 minutes) pressure start at 4 and stay at 4 for 30 minutes and as you start drift into sleep, machine increase pressure to treatment level and causes cheeks to balloon and therapy air escape thru the mouth
talk to the people at clinic about reducing ramp and adjust pressure range, or even set the machine at fixed pressure so pressure stay constant all night, you can play with auto range when clocked up more hours on the machine and have gained enough experience
don,t worry about data at this stage, concentrate getting the mask right and good night sleep

[dan76]

If I did understood correctly the machine is currently setup to operate automatically between pressures 4 and 20 without any ramps etc... So it is already at pressure 4 when I have difficulties opening my mouth and sleeping at the same time due to the airflow from nose to mouth. Hard for me to imagine that some here manage to sleep their mouth wide open with CPAP. Well... I may learn.

[zonk]

Hard for me to imagine that some here manage to sleep their mouth wide open with CPAP. Well... I may learn.

It essential to keep mouth closed while using nasal or nasal pillows masks otherwise escape air through mouth compromise the therapy and disturb your sleep. Full face mask offer the choice to breathe through the nose or mouth so opening your mouth does not matter much as full face mask cover the nose and mouth

[JimZZZ]

dan76, Welcome to the quest. Having been through the same "in the nose, out the mouth" struggle over the past three months, I can tell you I finally gave up on the nasal mask. With the full face mask, I continue to work on preventing air from leaking into my mouth but have discovered that if I stay off my back the problem goes away. When I roll on my back, my relaxed jaw moves back and down allowing airflow from my nose into my mouth. Then the resulting lip flutter awakens me, I roll over to my side and go back to sleep. It's not perfect, but it seems to be getting better.

[dan76]

...I can tell you I finally gave up on the nasal mask. With the full face mask, I continue to work on preventing air from leaking into my mouth...

Which one do you prefer, because seems that the problem wasn't solved by switching to full face mask?

If I cannot figure this out during next 2 nights, I probably need to make a call on Friday whether I want to trade to full face mask or not. From many aspects I would like the nasal version to work out, but if the sleeping is as ridiculous as last night, I don't know if I should try the full face mask.

Well I guess it's better to wait and see until Friday.

Thinking of taping my mouth doesn't seem like any kind of solution because that would not prevent the air flowing into my mouth and balloon my cheeks. Feels like that would wake me up with greater probability than air just flowing out of my mouth.

[trish6hundred]

Hi dan76,
WELCOME! to the forum.!
Don't be shy about trying different mask. This is the hardest part of the therapy. Just keep trying different ones 'till you find what works for you.
Hang in there for more suggestions and best of luck.

[me50]

Before giving up on a nasal mask/pillows, I would suggest you try a chin strap. We really don't know what our chin does when we are asleep unless we video ourselves sleeping. Also, one can open their mouth without their chin dropping; sometimes there can be leaking from the corner of your mouth. I wouldn't recommend taping as some have tried. They are fairly inexpensive considering the alternative and ffm are more expensive as a whole than nasal masks/pillows. If it still doesn't work, then consider a new mask. JMHO. YMMV.

[retired_guy]

A chin strap will help the balloon mouth thing. So will experience. You will probably discover you're better at keeping this from happening tonight than you were last night. Often we're not at our best during our first night with a new mask.

I believe we should work with our masks for awhile before we decide if we're compatible or not. I worked with my pillows mask for awhile then made the decision (because I'm a notorious mouth breather) that it just would not work out between us. My pillows mask moved into the closet and I moved on to my full face mask. We're still getting to know each other. But that's another story.

So give your little mask some more time. Good relationships require a little give and take on both sides. So maybe your little mask will have to learn to share your head space with a chin strap. That's ok too.

If the day comes that you just know it's over, then move on knowing each of you tried your best.

[Peter_C]

I've been on CPAP for many years now, and I have fought the battle against wearing a Full face Mask (FFM), until recently. Regardless of what I have tried, from chin straps (no good) to self-talk (works here and there) to the tennis ball in the shirt thing (I still hiss on my side) - it is with great sadness that for me at least, I must use a FFM.

On the plus side, I've never seen such great numbers~! Low leak rate, low AHI, and am feeling better - the hitch is, I have yet to find a mask that doesn't screw-up in at least one area; farting, air in the eyes, pain due to how tight I must make the straps, etc...