[CPAP] Need advice on ways to reduce AHI

[Juliez84]

    My husband got his machine a couple weeks ago after getting diagnosed with severe sleep apnea. We have tried 3 different masks so far, and each one came with a set of different issues. He tends to start breathing through his mouth with the nasal pillow mask, even with a tight chin strap. When he is on his back he still will snore sometimes, and I think its due to his tongue falling back and closing his throat off? So we tried two different styles and brands of full-face masks. While we thought that would be the solution for the mouth breathing, it obviously didn't solve his throat being closed off,it was sensitive to air leaks because of his beard, and he snored even more compared to the nasal pillow style. It seemed the air pressure wasn't as direct wearing the full face style compared to the nasal mask, even with a high pressure setting. So he is back wearing the nasal pillow style, and trying to just sleep on his side,which helps with his jaw falling back, but he still will have air leak through his lips at times, and his AHI is still not as low as we think it should be. On reddit I had a suggestion of using mouth tape/strips, and trying to use a better neck support pillow. Are there any other suggestions before I keep buying all these things on Amazon?ha! Maybe a different type of mask? We are super invested in finding a solution and appreciate any insight!  

[OpalRose]

Hi Juliez84,
Welcome to Apnea Board!

Your husband may benefit from wearing a soft cervical collar while sleeping.  This has helped many here that tend to mouth breath.  The collar can support the chin/jaw area and help keep the mouth closed.

Before buying one, measure the neck circumference and add a couple inches for comfort.  The collar should not be worn tight.  Also, be sure you don't buy one that is too tall, especially if he has a shorter neck.  

http://www.apneaboard.com/wiki/index.php...cal_Collar

Many here also use tape over their lips, someone else hopefully can address that and advise.

Also, read the mask primer to get some information on correct fitting of masks.

http://www.apneaboard.com/wiki/index.php...ask_Primer

[Gideon]

Also your obstructive events are clustered which tends to indicate your chin is tucking. No amount of pressure can correct this, but the collar suggested above can.

[Perkolater]

Also your obstructive events are clustered which tends to indicate your chin is tucking.  No amount of pressure can correct this, but the collar suggested above can.

I agree with the advice to get a collar.   I got one based on the recommendation of several people here (including Bonjour) and it made an incredible difference.  My AHI's dropped from an average of 5-6 to averaging in the 0.5 range, my snoring stopped and I sleep much better!   Give it a shot.  They are inexpensive and can make a huge difference!    Good luck!

[Dormeo]

To chime in about tape: I use Somnifix tape. It is gentle on the skin but gets the job done. There are people in the forum with beards who successfully use tape, though I imagine it takes some care in placing the strips.

One other thing your husband might try: teaching his tongue how to help prevent mouth breathing. The tip of the tongue goes behind the upper teeth, the rest of the tongue goes up against the roof of the mouth, and then a little suck or swallow creates a bit of suction. If he tries this during the day, he should be able to put his tongue in place and yet breathe only through his nose with his mouth wide open. The trick then is to train the tongue -- during the day, perhaps -- to do this effortlessly.

I need several solutions: the tape, the tongue thing, and sometimes a collar. So experimentation is good. But the collar is something your husband should try both for keeping his mouth closed and for avoiding the chin-tuck, as others are recommending, because that can contribute to obstructive events.

[SarcasticDave94]

Welcome to Apnea Board. Yes I agree the soft cervical collar would benefit. One other device, if you might be interested, there's a chin strap that is reported to be different than the others out there. Google Knightsbridge Dual Band. It's a skull cap device with 2 sets of Velcro straps that hold the jaw up only, with no backwards pulling by way of a unique design. The pulling back motion other straps typically cause can be a source of problems like pain or discomfort, along with being unable to provide the proper jaw placement. I do plan on buying one myself after I receive a new machine to enable me to try using my N/P30i.

[Juliez84]

Thank you everyone for your suggestions! I bought him a cervical collar and hoping that will do the trick! Im also going to get mouth tape incase his lips are still wanting to open a little.