Mouth leaks - best solution

[fstrife]

I'm also using 3M Transpore tape.  
I'm still trying out different placements.  
Even when I tape across my mouth, I can breathe through the tape (with some effort).

[cathyf]

The best solution is a full face mask. Even if your past experiences with
one didn't go well, it's worth trying again because designs have improved and you are now better-adapted to CPAP therapy than you were in the past.

In my case, it turns out that the mouth breathing is a fundamental part of the disorder in my sleep-disordered breathing.

I was an adult before I realized that there were people who could sleep with their mouths closed.

With me it's not even fully-asleep -- I'm fine with mouth shut while awake, but once I get to "drowsy" I feel like I can't get enough air and I've got to open my mouth. And when I get to the forced-to-open-mouth stage it's always accompanied by a giant exhale, not inhale.

When the RT at the DME showed me how to use the CPAP in 2014, she had it all set up with nasal pillows. I put the mask on and had an immediate panic attack! I sat there for a few seconds thinking what the heck just happened?!?!? but then the RT came back with a full-face mask -- F10 -- and I concluded that I just needed to use an FFM.

Fast forward 6.5 years of cpap adventures, struggling with masks that seem to come in only 3 sizes: too big, way too big, absolutely enormous. But the machine worked well in keeping AHI below one, and mostly I could keep the masks from leaking. I came here because I have arthritis and carpal tunnel and had discovered that I really need to sleep on my back. I've always been a side sleeper, and was told after my sleep study not to sleep on my back, so deliberately trying to sleep on my back was a new thing. That was when I connected the dots -- every once in a while I would have a "spell" during a night where I would just be slammed with apnea after apnea, long events, with short segments of breathing in between. It might last for 10-15 minutes, maybe an hour or two, then back to my normal uneventful continuous flow limitations but no events. I would go weeks or months between these curious clusters. I finally connected the dots when I realized that this is what happens when I sleep on my back.

I came here with my story, and the experts here immediately saw that I was describing positional apnea -- chin tucking -- and they told me to get a cervical collar.

It was life changing.

Without the cervical collar, on my back, I can easily produce a short-term AHI in the 70s-80s, with 40-50% of that time slice not breathing. With the cervical collar, no events, I just continue breathing.

I quickly realized that with the collar on I can easily fall asleep with my mouth closed and not feel at all suffocated. So I've been experimenting with both a nasal mask and with nasal pillows.

I'm still not sure how to control leaks reliably, and still not sure how to interpret some of my data during various leaking scenarios, but I think that something that I am seeing is that with nasal pillows if I can control the leaks and keep my mouth shut and keep my chin up with the cervical collar, I can dramatically cut down my flow limitations.

In my case, if I'm able to get away from the full face mask reliably, it's a huge win for me!

[fstrife]

I should add that mouth taping is pretty controversial because it comes with some dangers.
It's also not so great with nasal congestion.
I hope to move away from it once my treatment is "dialed in".

[SleepFoo]

I also use the 3m Micropore Surgical Tape 2" x 10 Yards with Dispenser. I tape about 3/4 of my mouth but not completely.
I too used to have nasal congestion problems so I never could tape my entire mouth shut as it was just too dangerous.
If you tape 3/4 of it at the center, you can get some air in from the sides if needed.
This tape works with my facial hair and it doesn't hurt to pull it off.

[Sleepster]

In my case, it turns out that the mouth breathing is a fundamental part of the disorder in my sleep-disordered breathing.

I was an adult before I realized that there were people who could sleep with their mouths closed.

So you were a mouth-breather all your life. It may be worth your while to get an examination from a good ENT. It could be tonsils or adenoids. I wouldn't let them do surgery to attempt to treat the sleep apnea, though. I've heard too many horror stories about that.

Before I had my first sinus surgery I became a mouth-breather within minutes of lying down. This was way before I was diagnosed with obstructive sleep apnea.

[cathyf]

In my case, it turns out that the mouth breathing is a fundamental part of the disorder in my sleep-disordered breathing.

I was an adult before I realized that there were people who could sleep with their mouths closed.

So you were a mouth-breather all your life. It may be worth your while to get an examination from a good ENT. It could be tonsils or adenoids. I wouldn't let them do surgery to attempt to treat the sleep apnea, though. I've heard too many horror stories about that.

Before I had my first sinus surgery I became a mouth-breather within minutes of lying down. This was way before I was diagnosed with obstructive sleep apnea.

With the cervical collar on, I can sleep the whole night with my mouth closed. Using both a nasal mask and nasal pillows I can get a whole night leak free sometimes, and I certainly can sleep for hours punctuated with an occasional short little leak, too.

And, yeah, tonsils and adenoids are enlarged. I saw an ENT last fall, and they seemed to think it wasn't too bad.

[DaveL]

Knightsbridge Dual Strap.

I bought 2 of them. importing to Canada made them expensive.
I've had good results. Sometimes. And bad results sometimes. It varies night to night. My fault? probably.

It's really well made compared to the PapStrap I used before.

Oh...I had interference problems with the mask I use. ResMed N20. nasal mask. I had to increase the size of the headgear (buy a new mask) and that was expensive too.

Good customer support from the owner, who designed them.

[ICEMAN]

Try

•  Position top surface tongue up on Mouth roof, and pushing up against pressure behind 2 Front teeth
  
•   This generally works oh , well mostly improves  but wont happen over night but will happen if persist eventually do automatically.
  

Use in conjunction with the Cervical collar will help stop chin dropping, while also assist positional Apneas and dual assist hold mouth closed? 


What do you have to loose ?

[cathyf]

Try

•  Position top surface tongue up on Mouth roof, and pushing up against pressure behind 2 Front teeth
  
•   This generally works oh , well mostly improves  but wont happen over night but will happen if persist eventually do automatically.
  

What do you have to loose ?

When I do this I have a tendency to pull my chin back -- which is bad!

I'm one of the classic cases of narrow airway starting with a small mouth. I wore braces for 7 years after they pulled 4 permanent teeth -- it took a LOT of orthodontia to get my teeth to fit in my little mouth, LOL.

At the end of the orthodontia 40 years ago I had a retainer cemented in behind my lower teeth, and then a removable retainer on the uppers. For a year I wore the upper retainer at night, and it prevented my teeth from closing fully, and it closed the gap between my two front teeth. Then in the morning I would take the retainer out, and the bottom teeth now bumped the back of the top teeth and within about 20 minutes opened the gap back up. Of course I only went to the orthodontist during the day, and he couldn't understand why I showed up with a gap every time! So finally he decided that was as good as it was going to get, they finalized the treatment, and removed the lower retainer.

Within a few hours the pressure from my lips closed the gap between the two front teeth by caving in the bottom teeth slightly.

Anyway, be careful about pushing steadily on your teeth -- they will move!

[OpalRose]

cathyf is correct...  never push on your teeth with your tongue.  

Tongue Suck Technique:

Place your tongue to the roof of your mouth with tip of tongue resting behind front teeth.  (NOT PUSHING ON TEETH).
Gently suck upwards and back.
This places the tongue in a natural position, with the back of tongue sealing the back of the throat so that if your mouth/jaw drops open while sleeping, no air will escape.

Note:  This takes time and practice, but has worked for many.  You can practice this watching TV or reading, just about anywhere.  You may never get rid of taping, but this is worth mastering.