Keep getting air bolus in mouth w nasal pillows

[Palmtrees]

I have been using the Brevida nasal pillows for almost a year with no real problems.  I use a chinstrap and put a strip of tape for sensitive skin over my mouth.  My numbers ( I have a Luna, so I can't use OSCAR) look very good.  Sometimes I have a dry mouth and sometimes a stuffy nose.  but it hasn't been too much of a problem.  However, the latest thing is that I wake up in the middle of the night with boluses of air accumulating in my mouth and I have to let them out of my mouth.  I have tried sleeping on my sides, using the technique of sticking my tongue to the palate, etc.  Nothing seems to help.  Any ideas of what is going on and what I can do.   I can't go to the full face mask because I have tried several and they all leak around the mouth.  Apparently, I have a rather narrow chin and lower face.  Even the small ones leak like crazy.

[Sleeprider]

I can relate to this problem, and it's not that hard to resolve. First of all, you need to be able to control the positive pressure enough to restore your mouth to an unpressurized state without breaking therapy. Since you've been at this for a while, I assume that is not a problem, and you are able to speak and even sip water while under pressure therapy. If not, those are good skills to master and we can talk about it. When I feel air leaking into my mouth and I'm having trouble resisting it, I find if I can support my jaw by pulling a corner of my pillow between my shoulder and the back of the jaw, that works to keep my mouth positioned where I can resist the air pressure. It's not that common I have the problem, but when I do, that gives me some relief.

[Palmtrees]

OK, thanks, I will try that.  I can, yes, sit up and sip water while the therapy is on.  Talking is not easy.  It shoots out of my mouth if I try to talk, but I can.  I also have an issue with air going down into my stomach.  any comments on that?  Thank you.

[Sleeprider]

Just practice with the talking. The flow of pressure from your airway or throat into your mouth is controlled by a combination of breath control and the back of the tongue. You should be able to open your mouth and still block off the pressure, or partially block off pressure. During inhale is easier, but during exhale is how you learn to control air pressure an speak. Eventually you will own the pressure rather than it owning you, usually with some comical noises. My wife and I both use nasal pillows and can talk under pressure, so if you live with an understanding person, use the opportunity to get good at it, and pretty soon you will talk normally by controlling the exhaled air with only a slightly nasal affect.

Aerophagia arises from a weakness in the lower esophageal sphincter (LES), and there is not much you can do with that other than keeping pressure below the threshold that forces that gate open. Aerophagia often improves as patients adapt to therapy, changes in head/neck position and learning to swallow without including air, and that is where sipping water through a straw while under pressure gives your conscious mind practice, that can transfer to the unconscious mind.

[Sleepy Quixote]

@Palmtrees

Just to add to what Sleeprider said, sleeping on your left side also reduces aerophagia due to how the stomach is oriented in the abdomen, works for me anyway. Another trick I used early on in therapy was to build a small incline with pillows from my midline up to my head so I slept in a comfortable slightly inclined position.
After a few months of adjustments/training and using Sleepriders straw sipping exercise daily for all beverages aerophagia is a thing of the past for me. I have to get really wonky in sleep position now to have it happen.

Good luck! Keep at it, that's how we get good at it.

[Deborah K.]

I tape too.  Air in the mouth does not happen to me often, but when it does I manage to remove it without removing the tape.  I push my tongue hard against the roof of my mouth and then exhale hard through my nose.  Try it next time it happens.  Hope it works for you too!  

[Palmtrees]

I'm going to try that!  I'm still trying to wrap my head around the sipping beverages and talking while the pressure is on.  Trying to figure out how that will help.  I do already sleep on my left side and on an incline.  What fun this all is!  Oy!

[Palmtrees]

I'm going to try that!  I'm still trying to wrap my head around the sipping beverages and talking while the pressure is on.  Trying to figure out how that will help.  I do already sleep on my left side and on an incline.  What fun this all is!  Oy!