Masks, mouth-breathing

[Dyssomniac]

After a little over six weeks with an AirSense 10 machine, I'm gradually getting things dialed in. AHI is usually in the 1 to 2 or 3 range, the events mostly being hypopneas and centrals. That might be the topic for another thread; right now I'm still working on getting things squared away with masks.

I've tried the DreamWear with cushions and with pillows, as well as the Brevida and an N30i. Overall the DreamWear with cushions has worked best for me; the Brevida and N30i are good masks, but I haven't figured out how to prevent them from leaking without tightening them excessively. (I should note that, yes, I've read the wiki article on mask fitting.)

However, it also emerged early on that I'm a mouth-breather. Mostly these are percussive exhalations on out-breaths. I tried a couple of chin straps, most of which were not successful in preventing the mouth-breathing. I also tried an Ultimate Chin Strap, but when I tightened it enough to work I got a significant pain the next day in the bone directly above the center of my mouth and below the nose. What has really worked best for preventing mouth-breathing has been 2-inch-wide 3M Micropore tape. I know that taping one's mouth shut is somewhat controversial, but it worked for me. On the other hand, it's caused some skin problems on my lip and face. I also have a goatee, which complicates things. (Yes, I've also read the wiki section on mouth-breathing.)

I also tried an F20 mask (with no taping or chin strap). This has worked out better than I expected. However, I have to tighten it a fair amount to seal well, and I found after a few nights that it is pushing up on the skin under my eyes that it causes prominent "bags" in the skin which persisted for longer than 24 hours. Thankfully these went away after a couple of days of not using the F20 mask. I wouldn't want to keep using the mask to the extent that these become more or less permanent.

(As an aside, I should also note that I use my cervical collar nightly, which seems to do a nice job of eliminating any possible obstructive events.)

So, like most of life, everything has its drawbacks. If anyone can recommend a full-face mask (really, just one that covers the nostrils and mouth) that doesn't extend up the face as far as the F20 does, I'd be interested to hear about it. Also if there are any interesting new ways to deal with mouth-breathing, that would be great to hear about too. (Yes, I know how to use the search feature! ;-) )

[snorybob]

Have a look at the Resmed Mirage Liberty or the Respironis Amara View.


    Bob.

[Melman]

The Amara View covers the mouth and the nostril openings but does not extend over the nose. it didn't work well for me but others like it.

[Dyssomniac]

The Amara View covers the mouth and the nostril openings but does not extend over the nose. it didn't work well for me but others like it.

Thanks. Just out of curiosity, in what way didn't it work? I completely realize that my experience may (or will very probably) be different from yours, but I'm just curious about what kind of issues can occur. Was it basically that it leaked?

I have a deviated septum so that my nostril on one side is bent from the usual shape. I've thus had problems using masks with pillows that enter the nostril very much.

[Gideon]

on taping, if I can successfully tape my lips with my beard, anyone can. It's just a question of finding the right tape, especially if you are sensitive to it.

[Coffee Man]

You can try the ResMed F30 as well. It is similar to the Amara View.

[snorybob]

If you look at the Amara View you will see that there are no prongs going in your nostrils. The silicone contours the bottom of your nose.   

Under your nose, is a flat section with 2 holes for the air. People have a tendency to overtighten the straps, thus leaks come out.

The mask comes with 3 size cushions (s-m-l). The best way for not having leaks with this mask is to let the strap a bit loose so that the air cushion will inflate to make a better seal. 

The other reason the mask wouldn't fit you would be the shape of your face. This mask is very smooth for your nose. 
  

   Bob.

[Dyssomniac]

on taping, if I can successfully tape my lips with my beard, anyone can.  It's just a question of finding the right tape, especially if you are sensitive to it.

Interesting, thanks. I just searched on "bonjour + tape" and have not found any posts that mention which specific tape you used (although in one post you suggested that "any medical tape should do"). Do you recall which one you used? As I mentioned, I've been using 3M Micropore, which is not as hard to remove as the previous tape I tried, but still causing some sore spots on my upper lip and skin adjacent to my mouth.

Also, I noticed that in one post last year you mentioned, "I used to use tape every night, finally I didn't need it." What there anything particular you did to get to the point where you didn't need it?

[Gideon]

I used a 1.5 inch medical tape of several brands, but I never had a sensitivity issue.  The tongue technique is what eventually eliminated my need for tape.  That took me 3 to 5 months of practice.  Placing the tongue on the roof of my mouth and breathing through my nose every time I noticed that I was mouth breathing during the day.  Duck tape would meet the sealing requirements but I don't recommend any tape that is not intended to be applied to human skin and duck tape does not meet that criteria.

[Dyssomniac]

The tongue technique is what eventually eliminated my need for tape.  That took me 3 to 5 months of practice.  Placing the tongue on the roof of my mouth and breathing through my nose every time I noticed that I was mouth breathing during the day.

A few times when going to bed with PAP gear on, I've tried moving my tongue to the roof of my mouth. While the machine is running, this seems to open some nasal-to-mouth passage, and very abruptly my mouth inflates with pressurized air, kind of like a blowfish. I'm going to speculate that's not the desired effect. The Mouth Breathing section of the wiki doesn't say much more than a very brief reference. Is there more to it than that?

Also, do you find that your mouth breathing is 100% gone, or does it ever manifest occasionally even now? I thought it interesting that I didn't mouth-breathe when I first started using a nasal cushion mask -- it only started a couple of weeks later, and intensified until it was pretty constant.