Engineering for your Face

[burtshulman]

    HI All,
I started cpap 5 years ago. Couldn't sleep with the screaming monkey jumping up and down on my face. I quit after the worst 4 months of sleep. Got 5 years older, apnea apparently got worst or less able to tolerate it, so I tried again. A Dreamstation  (Apap) and a Dreamwear nasal mask. Now the fun began.
Blowing in my nose is a good thing, because I have nighttime stuffiness, but the pressure keeps the nasal passages open.
I recommend the mask because it's so unobtrusive.
Now the bad things.
Air goes in my nose and out my mouth.
If I hold my mouth closed it burbles through my lips
If I tape my lips shut, it blows up my checks
and then blows off the lip bandage.
All of which either keep me from falling asleep or wake me up multiple times.

So all those ad pictures of the happy nasal mask wearers...I don't believe them.
The typical solutions of tape and chin straps don't work. Tape blows off and fabric straps, still allow the mouth to open. Full face masks don't work for me, nor an oral cpap mask.

I went to a dentist and I asked him to make a form fitting oral appliance, which is molded to my teeth and locks my jaws closed. You can see it in the center of the picture.
I found 3 X 4 inch waterproof bandages at Rite Aid 6 for $2.99. This keeps air from coming through my lips.
I made a Silence of the Lambs strap from a steel plate that covers my  lips and cheeks. Steel, because poofing cheeks require a lot of rigidity to keep them from poofing. The steel is covered by 2 inch duct tape and has a polyethylene foam liner around the lip area. A Velcro strap around the back of my neck holds it in place. This also keeps the bandage from blowing off. 
I ain't pretty at night, and will need a suitcase to carry all my parts, but at least I'm sleeping >6hrs a night, AHI about 3.5, 90% Pressure 12.5.
I believe the min Apap setting should be set .5 to 1 cm below the 90% pressure, to limit the number of events it takes to step up the pressure, to get to the 90% pressure.

Your thoughts?

[DeepBreathing]

Whatever it takes... I admire the ingenuity, but I can't believe this contraption is better than wearing a full face mask.

[srlevine1]

I use the ResMed Mirage Activa LT nasal mask which has a lip on the bottom of the cushion that keeps my mouth shut. My pressure is slightly higher than your pressure at 14.2. Keep experimenting. Best of luck.

[Cpapian]

You can fix your problem without any hardware and only willpower.

Tongue position.  Apparently, according to the powers that be, you tongue should be at the roof of your mouth, just behind the ridge of your teeth.  So test it out next time you strap up.  Put you tongue in position and open your mouth.  It's entirely possible that different people have different sizes and shapes so play with it a bit, pull your tongue further back until you can breathe through your nose, with you mouth open and zero air escaping your mouth.  It's like a brake.

That is the position you want for your tongue.  Easy, peasy right.

This is where the will power comes in ..... you have to practice, practice, practice throughout the day time and go to bed practicing until it becomes your habit.  Might take a while, but, as many here will confirm ..... it works.

I learned it here and did it.  Start easy ..... when you feel your cheeks puff out, put on the brake.  After a while you will start to believe it.

[multicast]

You can fix your problem without any hardware and only willpower.

Tongue position.  Apparently, according to the powers that be, you tongue should be at the roof of your mouth, just behind the ridge of your teeth. 

[...]

  Might take a while, but, as many here will confirm ..... it works.

Definitely right.  Be aware that the training might last a year or longer.
Mike

[burtshulman]

Hi,
A full face mask is great if you can take force against your nasal septum, I can't  because it becomes painful in 5 minutes. Also the full face causes mouth breathing (bad) because of my nasal stuffiness. Air pressure on the outside of the nose, with nasal passage congestion, causes my nasal passages to collapse.
Burt

---

Hi,
My will power only seems to work when I'm awake and not that well....he he

[burtshulman]

Hi,
Glad you can wear something that goes over your nasal septum, mine becomes painful after 5 minutes of wearing. I'm also glad that the mask's lip holds your mouth closed. My experience is that my mouth falls back and then down. If I tighten the straps to account for this, my mouth still opens and pulls the mask down, causing it to leak around both my nose and sides of my mouth.
Burt

[Codfish Joe]

You can fix your problem without any hardware and only willpower.

Tongue position.  Apparently, according to the powers that be, you tongue should be at the roof of your mouth, just behind the ridge of your teeth.  So test it out next time you strap up.  Put you tongue in position and open your mouth.  It's entirely possible that different people have different sizes and shapes so play with it a bit, pull your tongue further back until you can breathe through your nose, with you mouth open and zero air escaping your mouth.  It's like a brake.

That is the position you want for your tongue.  Easy, peasy right.

This is where the will power comes in ..... you have to practice, practice, practice throughout the day time and go to bed practicing until it becomes your habit.  Might take a while, but, as many here will confirm ..... it works.

I learned it here and did it.  Start easy ..... when you feel your cheeks puff out, put on the brake.  After a while you will start to believe it.

+1

For about my first few months on CPAP it was almost funny- if my lips opened at all I was like an untied balloon with all the air rushing out of my mouth.  I couldn't even close my mouth again until I turned off the machine.  
 
Eventually my body figured it out.  I can control it without trying to, and can even talk, although if I want to get more than a word or two out I just take off the mask.
 
It is doable.  You've just never done it before.

[70sSanO]

Good job. The nice thing is that you can always work on the tongue technique without having to lose on therapy... or not.

John

Edit Added: Instead of steel, you might be able to find rigid plastic flat bar and heat it up to bend it to the desired shape. Or even a hand lay-up of fiberglass or carbon fiber.

[Cpapian]

Burt

---

Hi,
My will power only seems to work when I'm awake and not that well....he he

To pharaphrase ........ if you practice it ....... it will come.