Mouth leaks progress through night

[bamba415]

I have noticed that despite my AHI coming down to almost zero (typically less than one) when I manually remove all the false positives, I am still feeling tired.  The Oscar telemetry seems to point to mouth leaks being the culprit.  I see many many arousals (sometimes leading to full wake ups) that directly line up with large and small mouth leaks. I just picked up some mouth tape so I am hoping that mitigates them.  However, I am curious why the rate of leaks tends to increase throughout the night.  Usually the last couple hours before wake up is full of them.  Is that normal or maybe something specific to me?

[bamba415]

I noticed I titled the post "Mask leaks progress through night" but these are actually mouth leaks.

[Deborah K.]

It appears that you are already using Oscar.  It would help us help you if you post some Oscar charts.  The best way to set them up is to use the F12 button.  This generally sets them up so that we can see what we need.  

[bamba415]

Sure, this is a few days of data.  Almost all of the events are post arousal that occur upon mouth leaks.

           

[Sleepster]

However, I am curious why the rate of leaks tends to increase throughout the night.  Usually the last couple hours before wake up is full of them.  Is that normal or maybe something specific to me?

It could be that that is when your jaw-closing muscles are more relaxed. It could be because you are in a deeper state of sleep or it could be because those muscles are more fatigued.

Have you considered a full face mask. I had initially had trouble tolerating just a nasal mask and had to use nasal pillows. But after fighting mouth leaks for a couple of years I tried a full face mask and was surprised at how easily I adapted to it. Things that we are unable to tolerate can eventually become tolerable. It's simply the process of adaptation.

I think that the mouth leaks disturbed my sleep, even though they weren't big enough to interfere with my therapy. I started feeling much more rested after the switch. That was about 10 years ago and I've never looked back.

If a full face mask is absolutely out of the question try a soft cervical collar or a chin strap. Chin straps are available from your care providers. I don't recommend taping, although a lot of people have success with it.

[Deborah K.]

Your mouth leaks are not a problem. On the chart they look high, but they really are not. On two of the nights, your leaks registered as 0.0% on the left panel. On one night your leaks registered as 2.98%. SleepRider, our best expert, says anything up to 5.0% is nothing to worry about.

Also, for future reference, we need to see to the very bottom of the Flow Limits section, so apparently F12 alone does not set things up correctly for everyone.

[bamba415]

Thank you, that is good information. It definitely could be fatigue. That never occurred to me. I guess it is probably moot at this point. Since I posted the other day, I tried taping and it did help a lot. All of the larger leaks and the majority of the smaller ones are gone (as are their accompaning) arousals.  The progression of leaks throughout the night are also gone.  At this point I think I'm likely just dealing w/ small mask leaks.  Even when I see larger leaks, the size of them seems to affect me less than the frequency. Almost all the leaks (large and small) neatly align w/ arousals in the flow rate data. Maybe I am just more sensitive than most?
I attached the Oscar telemetry from last night and moved the flow limit into the view.     

A full face mask is definitely not out of the question.  I probably would have trouble going back to something front mounted (which is what I was originally was issued).  Even w/ a hose hook, I was constantly caught up in it since I'm a fairly active side sleeper. However, there seem to be some top mounted ones and I was already thinking about picking one up for when I am congested.