Events worse in the morning and events in general getting worse

[Elizabeth79]

Here are my last few nights' data. I changed the max pressure to 10.4, and that has reduced my events overall.  That said, I have been waking up with my mouth really dry- more dry than it ever was on CPAP.   I assume that is because of the increase in pressure, since no other variables have changed.   I continue to use the cervical collar, as I have found one that is very comfortable. Should I back off the pressure a little bit and see if maybe 10.2 or so works better?

[TechieHippie]

I'm new to reading these but it looks to me like the leaks are a problem, and that you are breathing through your mouth a lot which would explain the dryness, although why this would have changed, I don't know.... It might even be making the pressure less effective and masking events (making the AHI artificially low). You didn't have those big rounded leaks in your old CPAP graphs - maybe I'm just missing something when it comes to BPAP?

If they are mouth leaks, have you tried mouth tape? I like the Buteyko brand. I stopped using it for a while but even though I didn't have mouth leaks it seems to help me sleep better - maybe I can relax into better tongue posture. With the Buteyko you cut it to preferred size so it's easy to ramp up from a small piece to a larger one as you get used to it.

[Elizabeth79]

I didn't even notice how high my leak rate was, because I have been so focused on the other graphs. I actually do use mouth tape already- it's about 2 inches wide so it entirely covers my top and bottom lips.  Usually once a night I wake up and rip the tape off for a few seconds to a minute, which accounts for one of the "leaks," but I am not sure about the others. I may need to try to make it even tighter, I guess!

[TechieHippie]

I could be wrong about them being mouth leaks since you are using tape. I'm new to reading the graphs... The amplitude isn't so high.. Can anyone else comment?

If you don't already, try pursing your lips when you apply the tape. Also do you know if you need the tape so wide? Everyone is different; for me that would restrict movement of my face too much and feel claustrophobic. I use 1/2" to 3/4".

[Elizabeth79]

I’ll try pursing my lips. Maybe that’ll help! I actually used shorter width tape for almost a year, but it would always get moist and fall off. So I would like to stick with the wider width since it’s been sticking on very well

[TechieHippie]

Sure, that makes sense. When I sweat more I need wider tape. If the moisture is coming from saliva then if pursing works you can experiment with skinnier but it's all about what works for you.

[robbob2112]

My 2 cents and worth that -

You sleep mostly on your back, have you tried a full-face mask like the F20 or a half-face like the F30?

I was trying hard to use the N20 because I liked how small it was and I tried P10, P30i, and N30i masks because I liked not having my mouth covered, but none of those worked without mouth tape which became painful over time.

I switched to the F20 for a few months and it practically eliminated my leaks and took my scores to less than 1 on average. Sleeping on the side worked fine with that one but I also sleep on my stomach at times.

Currently I am on the F&P Evora (like the F30 but has a 'large' size which is basically a medium F30 with a little wider nose). I had eye surgery and can't have the F20 over the corner of the eye. With this one I have to put a line of tape on the bottom edge to keep it from leaking down there.

If you haven't tried one of those other masks several vendors do 30 day trials where you can either trade to another mask or get a refund if it doesn't work so there is no risk to you. Vendor #1 is who I have used for this.

I suspect a half mask would work well with or without the collar.

[Elizabeth79]

I tried a full face mask when I started CPAP therapy, but I really hated it.  For whatever reason, I am not comfortable with having the whole mask over my face. Kind of weird since I am fine with taping my mouth, but I think that a full face mask would be the last resort. Thank you for the suggestion though!

---

It looks like my events are now fairly well under control and I had minimal leaks last night (thanks for pursing my lips/rolling them) but I wonder if anyone can help me with the dry mouth. When I was using CPAP, I had both the heat and humidity on the highest settings, and that worked great (using a heated tube). Now that I am on Bipap, I am having trouble adjusting the settings so my mouth doesn't dry out. I had both the heat and humidity on the highest settings, but my mouth has been getting dry. Last night I reduced both moderately, and still have dry mouth. I have seen conflicting opinions on whether heat should be reduced, or humidity, or both. Any insight? I fear I will have to switch back to CPAP if this doesn't resolve, and don't want to do so since the Bipap is so much more comfortable for me

[Deborah K.]

You don't need to change any setting to deal with a dry mouth.  I put a Xylimelts Dry Mouth disc on my upper right gum (it will overlap a little on the adjacent teeth), and press it in place for about 15 seconds until it's fully stuck on.  It slowly melts as you sleep.  It works for me.  The bottle says to use two discs, but one is enough for me.  Good luck!

Agree on the two-inch tape, cut into a piece almost six inches long. Narrower or shorter just doesn't work for me.

[robbob2112]

Just trying to make sure - you tried something like this ?    Covers the mouth, but is a pillow below the nose?  Technically a full face mask but it allows you to wear glasses and doesn't feel confining like the over the nose style. 

I'll let others see what they can do.

https://www.fphcare.com/us/homecare/slee...vora-full/