Newbie struggling mask type

[sixfour]

Hi Everyone. I have just been diagnosed with mild sleep apnea with an AHI score of 14. So, on the upper end of mild. The diagnosis was a surprise because I wasn’t aware of any symptoms other than waking most nights to go for a pee, which I understand is common for many 58 year olds. I have a BMI of 25, exercise everyday, don’t drink and have a 16 inch collar (I’m 6ft 4in).

Anyway, I started CPAP a week ago with a Löwenstein machine and a nasal mask. Pressure is 8. The issue is, just as I start to go into sleep my jaw/mouth relaxes and I leak air from my lips. The pressure drops and I’m back awake. The result is next to zero sleep. Incidents are recorded as 1 or 2, with no mask leaks. The Löwenstein doesn’t tell you much but any data is almost worthless anyway because I’m wide awake all night.

I have tried a chinstrap but this doesn’t work, it just hurts my jaw joints. I can tighten it enough so my mouth doesn’t open but this doesn’t stop air leaking from my lips.

Should I consider a full face mask? I’m not a total mouth breather but then I’m not a total nose breather either.

Or will this just resolve eventually? I can’t exist with no sleep…

[Nightynite]

    


Welcome, That’s a problem for a lot of people including me. Using Lip tape is the solution. 
People use all different brands, size and technique on how to apply it and it’s just something that’s very individual and you’re going to have to experiment to find what works for you.

My method…….I just use Johnson & Johnson 1/2 wide medical tape, 3/4 long and only put in on the center of my mouth and lips.  That does the trick for me.  It also leaves a small open space at the corners of my mouth so I can sip water through a straw if needed.

I don’t miss a night and it makes a difference in my therapy.  

There’s all sorts of different techniques and I’m sure others will respond to help you also. Good luck!

[cberistain]

I had the same problem when I first started a little over a year ago.. nasal/pillows required either a chin strap or mouth tape but still had mouth leaks, so I switched to full face masks ... about a month ago, I tried the nasal mask again, with the chin strap & cervical collar and I no longer got mouth leaks .. so I assume that I've been "trained ", but must still use the chin strap, otherwise I have large mouth leaks that keep me awake all night and is ineffective in controlling apneas.

Charlie

[CorruptAlligator]

For me, mouth leaks happen rarely, and it depends on pressure. If set pressure higher than what I use now, mouth leaks can happen more frequently.

I believe the reason why mouth leaks do not happen currently is that my inner cheaks are kinda thick and blocks air from moving into my mouth. Combine that with my tongue placement on the back of the upper teeth, blocks the air from coming inside my mouth completely. I have to be sleeping on my side as well, since it causes pressure to the cheeks to block the air, and my other cheek is think enough to do that on it's own. If sleep the other way, I do on rare occasions get air leaking inside my mouth.

Even with this, if I raise my pressure a bit, the pressure can break through that barrier. Thankfully, my current pressure work just fine.

Even if I use tape, air can leak inside my mouth, and that in itself wakes me up. So, tape doesn't help much.

Also, if you use tape, since it's quite dangerous when the machine goes out, I recommend some kind of UPS device or battery backup just in cause there is a brownout or power goes out. I had issues with brown outs, and I wake up gasping for air, and rip my mask off.

I'm not sure how true this is, but I heard that tongue placement on the upper part of the mouth is the cause of air obstruction or apneas?

[sixfour]

Thanks for the great advice everyone, it’s much appreciated.

I’m not so keen on tape because I always seem to get an allergic skin reaction to tape, even the hypoallergenic stuff.

What are the disadvantages of a full face mask if I go down that route? I’ve heard that some people’ find them claustrophobic, others find them a bit scary due to suffocation concerns? I guess they’ll be heavier and more cumbersome.

I’ll also talk to my clinic about the pressure setting.

I do start the night with my tongue resting against the back of my top row front teeth, which provides a good seal. As I drift off though it relaxes to my bottom jaw, which I also think is where it should be. I was always taught that holding your tongue to your upper jaw promotes stress.

Thanks again everyone.

[CorruptAlligator]

Same happens to me with the tongue dropping on rare occactions, and I believe it's usually when I get on REM stage. When I sleep on the side, it doesn't happen for some reason. I think on back, the tongue is against the gravity?

[cberistain]

I've tried two different full face masks... resmed quattro & F30. The quattro fits on the bridge of the nose and the F30 fits under the nose. Neither caused me to feel uncomfortable. The quattro had more leaks for me (side sleeper) than the F30. If I'm having sinus issues, I will use the full face mask, otherwise I'm now using the N20 memory foam mask.

[RainbowFish]

Welcome!
Mask seal is critical to success with a CPAP, so hang in there! You will find a mask that works for you! And the fine people here have a huge amount of knowledge to help you.

Different people will have different solutions to mask management. Personally, I use a hybrid full face mask (ResMed F30i) and strap covers (to get rid of those unsightly lines and stabilize the mask) and get a great seal even side sleeping. If I try to use a nasal mask, I need chin straps and/or tape to prevent leaks with only variable success. And, by the time all that gear is in place, I find it more comfortable to just use a FF mask. For me, the hybrid rather than a traditional FF mask is nice as it does not obstruct the view and you can put on glasses without having to remove the mask.

My husband, by contrast, can't get a consistent nose seal with a hybrid and has had great success with a pillow mask (ResMed P30i). He seems to have minimal issues with mouth leaks waking him and seems a natural at getting a tongue seal. He also finds the nasal/pillow headgear more comfortable.

So, good luck on your own journey! You will get there. :-)

[sixfour]

Thanks so much everyone for your insights and encouragement.

I’m not giving up yet!