Sudden onset of mouth breathing after heart attack

[Possum]

Dear all,

It’s been a long time since I’ve posted, because I have had several years of relatively uneventful (bad pun intended) years of using my machine. Well, things changed on 9/3, when I had a massive heart attack only 6 days before my 44th birthday. Needless to say, that was one hell of a wake up call. Since getting home from the hospital  I have made radical lifestyle changes and am already down 16 lbs. I have a long way to go but gotta start somewhere.

The reason I am writing is because since I got home I have noticed my leak numbers have gotten worse and worse. Now they are past the 24 L/min threshold, after which ResMed starts emailing you to tell you about it. The last week I have been waking up with a sore throat and dry mouth, which tells me that I have begun opening my mouth while sleeping, which I have NEVER done before. 

Does anyone know why, after years of sleeping with my mouth closed and having no issues with my nasal pillow mask, I would suddenly start sleeping with an open mouth and getting mouth leak? Are there any heart patients on here who have experienced something similar? I talked to my doctors about it and none of them had any ideas. It seems unlikely that it would have anything to do with my heart attack but it’s strange that it just started since then.

Most chin straps I’ve seen online get such bad reviews that I’m not sure I want to bother with one. I would be really bummed to have to switch to a full-face mask after so many years of comfort with my nasal pillow mask, but I suppose I’ll have to if I can’t relearn how to sleep with my mouth closed.

Thanks for reading.

[staceyburke]

2 things mentioned here a lot is mouth tapping and using a soft collar. The collar link is in my signature.

This may or may not be more attractive to you than a ffm

[Gideon]

Start with reading the Mouth Breathing section of the Mask Primer (link in my signature.
One possible and feasible reason you pointed out, your weight loss changing the geometry of your face.
If the P10 strap was stretched from your pre-weightloss face or you need a different pillow size.

I also suggest that you post nightly charts from OSCAR so we can see if there may be other adjustments that may be necessary.

[Sleeprider]

Some members have had good luck with the Knightsbridge dual chin strap Supplier #37. It takes a different approach and pulls up rather than back. There are reviews in the forum. http://www.apneaboard.com/forums/Thread-...-ChinStrap

Have you compared your respiratory statistics in Oscar from before and after the heart attack? Maybe there are changes there. Good luck with your recovery and new lease on life. I had friends that experienced a heart attack at your young age, and after making the kind of lifestyle changes you are making, it was their last. You will be monitored, and I'm sure you had some repairs made that should correct the problems in your heart and circulatory system, and are likely on some anti-clotting medications. It's a terrible thing to go through, but yours was a warning, and a second chance.

[Possum]

Thank you for your kind and thoughtful response, Sleeprider. Apparently I'm way behind on the CPAP data analysis scene. The last time I was concerned about my data, SleepyHead was still the software of choice.  I guess I need to download OSCAR and learn that now.

[Possum]

Start with reading the Mouth Breathing section of the Mask Primer (link in my signature.
One possible and feasible reason you pointed out, your weight loss changing the geometry of your face.
If the P10 strap was stretched from your pre-weightloss face or you need a different pillow size.

I also suggest that you post nightly charts from OSCAR so we can see if there may be other adjustments that may be necessary.

Thank you, bonjour. That's an interesting point that I actually hadn't thought of. I ran some basic regression analysis and my weight loss correlates with the leak rate with an R^2 around 0.98. Perhaps not all of the leak is attributable to mouth leak, but I do know that's at least a component.

Apparently I now need to download and learn OSCAR, since SleepyHead seems to be obsolete. Since my therapy has been relatively uneventful until now, I stopped looking at my data beyond what's provided in ResMed's basic report.

[Crimson Nape]

Possum,
If you are familiar with SleepyHead then you will not have a problem with OSCAR. OSCAR began as a fork of the abandoned SH code.  It is now its own entity with many improvements and bug fixes.   There is a download link at the top of the page and I have also listed it below.

https://www.sleepfiles.com/OSCAR/

[holden4th]

My apnea began after my bypass surgery (though I'm sure it was already in the background). Did you require surgery after your MI? You say it was massive and usually in cases like this they operate. If this was the case then I can add to the narrative. Did they stent or did they do a bypass? This will have nothing to do at this point with chinstraps etc but more about what happened to your body.

[Possum]

My apnea began after my bypass surgery (though I'm sure it was already in the background). Did you require surgery after your MI? You say it was massive and usually in cases like this they operate. If this was the case then I can add to the narrative. Did they stent or did they do a bypass? This will have nothing to do at this point with chinstraps etc but more about what happened to your body.

Yes, they stented the upper part of my LAD artery, with what I was told was the largest stent they had in stock. My cardiologist said the artery was almost completely blocked with clots, likely from a ruptured plaque.