Opening mouth with P10?

[rogerncormier74]

           

Can someone help me? I just started back on CPAP recently.  Using a Phillips DreamStation 1.

I am using a Resmed P10 mask.  I have attached 3 days from the Oscar software. Is there a way to see if I would open my mouth while sleeping?
When I started CPAP years ago I had eventually went to full face mask and it hurt me and that ended up stopping my therapy eventually.
Now, with the P10 I don't feel anything leaking, but I am questioning if I am still opening my mouth or not.

My AHI is better than it was, but not where I would like it to be. Under 5 every night.  I am wondering if its somehow because my mouth stays open and the therapy is not working as well as it should or maybe its because the pressure would need to be changed.

Is there anything on Oscar that would hint that I am opening my mouth? My dream station says 100% mask fit every night. Would it be leak rate Id be looking at and how would I tell if it was probably me opening my mouth or not? I don't feel that the mask itself is leaking.

Thanks.

[Crimson Nape]

For any mask other than an FFM, you can expand the Flow Rate chart graph. Mouth breathing will be displayed as an exhalation phase of a less magnitude (shorter downward spike or flatter) than the inhalation phase.  The inhale begins from the 0 (zero) line and above.  The exhale will be the portion of the graph that is below the 0 line.   If you haven't turned on the 0 reference line in OSCAR, right-click on the Flow Rate label next to the graph.  Select the Dotted Lines ⇾ Zero option.  This really helps.

[rogerncormier74]

How do I expand the graph?

[Crimson Nape]

Take your mouse pointer, select a point on the graph, hold down the left mouse button and drag the pointer in either direction. A box will appear that displays the time frame being selected. When you release the mouse button, the graphs, other than the Events graph, will display that zoomed image. To help in learning OSCAR, please see the links in my signature.

[rogerncormier74]

   

Do the leak rate and total leaks on the left side column give any sort of hints also?

I attached an expanded snippet of that flow rate thing.

I am really hoping its not mouth leaks.. Really don't want my therapy to fall apart again. Ive pretty much decided that for this to work for me I really have to try avoiding going back to a full face mask.
Full face mask really hurt me. Had tried chin strap before. Same deal, tension headaches, etc.

[Crimson Nape]

A quick review of all your graphs seems to show that your flow is equal distance on both sides of the zero line.   This tends to make me believe that you are not experiencing mouth leaks. What is leading you to ask this question?

[Crimson Nape]

In giving more thought to your problem, how long have you been using that particular P10 pillow? The first sign that the P10's pillow is starting to wear out, is having uncontrolled leaks. From my experience, the pillow loses linear resilience as it ages. This loses the needed pressure to maintain a seal. Being the tightwad that I am, I have successfully used little O-rings under the nasal pillow to provide additional tension. This provided a substantial longer useful life of the pillow.

[rogerncormier74]

The only reason I am wondering is because when I quit a couple years ago, I had stopped because I was wearing a full face mask.
I did know then that I did open my mouth at times when I slept.
It was pretty bad.  Swallowing air..  My stomach hurting because of that, etc.
The full face mask helped, however the straps always inflamed the back of my neck + hurt my head, so I eventually stopped.
This was back when I was mild sleep apnea 5ish AHI.  Fast forward to today and did I new sleep study because I questioned if it was ok for me to stop and I am at medium apnea.  15AHI.
But what I told myself is that to make this work I really needed to try to stay away from the full face masks.  This HAS to work now as I know I should not stop since I am at a medium.
My mouth IS very dry certain nights.  I have been taking xylimelts, so not really sure if my mouth is still dry or the Xylimelts are helping so I don't notice as much.


So I am using my old recalled Dreamstation 1 I had from before, with all the masks I had back then.  I had bough a new P10 a couple years ago right before I stopped and that is what I am using now.  So its a few years years old, but had been barely used before I decided to stop.
The sleep therapist also did not change my pressure after my recent sleep study.  She told me to keep it at the 8 I had from back then and then she would evaluate. After a week I had another appointment with her and she said 1 week still was not enough data for her to know what to do, so I have to wait another 1 1/2 weeks to see her recommendations.

[Crimson Nape]

Not all FFMs are designed the same.   I've had excellent results using the Fisher & Paykel (F&P) Simplus and Vitera masks.  These masks employee a roll fit seal that use the air pressure to complete the sealing process.  Less strap pressure is required with this design.   Another alternative is the hybrid mask that has a nasal pillow top with a mouth enclosure.  The two, that I'm aware of, currently being sold in the U.S., are the Resmed F30 (and "i" model) and the Philips Dreamwear.   F&P has one, the Evora full face mask, that is seeking (as I write this) FDA approval to be sold in the U.S.  It is currently available through Australian DMEs.


PS: You need to update your profile. SleepyHead??? Really?

[rogerncormier74]

Lol at the profile. I’m trying to find where to change that, but haven’t found it yet. 

As for full face masks, I had tried the F20, F30 and dreamwear FFM. I liked the dreamwear the best but they all had So much straps on those they are ended up hurting me eventually. If I did have to go full face, which would you recommend between the 2 F&P masks you mentioned? I haven’t tried those.