The air blows out my mouth!

[Leemax]

I started cpap not quite two weeks ago, and have been having what I assume are some of the usual adjustment issues. A couple of nights ago, however, I woke up at 0200 or so with the air rushing out of my mouth. The issue is not with my mouth coming open and letting the air escape, (I have a chin strap which prevents that) but rather with the air backing up through my nose, puffing my cheeks out, and pushing it out through my lips. The only way to stop that from happening is to actually tape my mouth shut, which I have done for two nights. I obviously don't want to continue with that. Last week, before this problem even started, I tried a FFM just to see if it was more comfortable or quieter, but realized after one night that the dimples at eh corners of my mouth completely prevent a seal, so FFM is not an option.

Any ideas about how to fix that problem?

[Gideon]

Pardon the generalities.

Getting the right mask is one of the hardest parts of PAP therapy.  as you have discovered each of us has a different facial structure.  This means that what works for me may or may not work for you, and what works for you may or may not work for me.  You have to TRY the masks to see what works for you.  You seem to be doing that part.

You have described the mask resting on your dimples, does a different size mask or a different mask miss this facial feature.

A mask pad (padacheek) rests between the mask seal and your face,  these can be made from old tee shirts.

Mouth breathing, what you are describing falls into this category is something many of us face.  Like you a chinstrap did not work for me, it has worked for others.  I solve mine with a P10 Nasal Pillows mask and taping.  The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing.  It is not to stop the mouth from opening.  I make sure that I can easily open my mouth, when taped, if I need to.  
Here is a bit on Mouth Breathing and mask leaks, maybe it will help.


 Mouth Breathing

Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy.  It is generally not good. The solution varies depending on the person

How to manage Mouth Breathing, not in any particular order.

Tongue Trick.  Place the tongue on the roof of the mouth, Practice during the daytime.  The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Chin Strap.  A chin strap is to manage mouth leaks from a variety of causes.  Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed.  If you have to crank it shut to make it work this is not the correct solution.  Note that your jaw is strong enough to open if it wants to.

Cervical collar.  A Cervical Collar may also be used to keep the jaw from dropping.

Mouth Guard.   The concept here is a closed mouth guard to keep the air from leaking out.

Taping.  The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing.  It is not to stop the mouth from opening.  I make sure that I can easily open my mouth, when taped, if I need to. 

FFM – Full Face Mask or Hybrid Mask.  This is a very traditional solution and it is generally effective. 

 

Mask Leak Prevention

There are, somewhat arbitrarily defined, three kinds of leaks.

1.      Mouth  Leaks.  These are addressed in Mouth Breathing, not here.

2.      Vent Leaks. This is a designed leak with the purpose of eliminating CO2 from the mask, it MUST be there.

3.      Mask Seal Leaks.  This is the purpose of this section

a.      incorrect adjustment

b.      incorrect assembly

c.      incorrect size

d.      your mask is worn out and needs replacement
e.      your hose pulled it to a side

[Leemax]

Thanks for the info, bonjour. The issue is really not mouth breathing, but the air being pushed out through my relaxed lips. It works to put my tongue on the roof of my mouth, but only until I relax and start to fall asleep, then it drops away and my mouth starts to fill with air again and the cycle repeats. I put paper tape on my mouth last night but after a couple of hours the moisture and pressure from my breath pushed it off.

I'll keep working on it! Maybe a mask with the padding could be an answer, but that seeks like it might be only marginally effective?

Onward!

[Gideon]

I understood the blowing out the lips.  But that is not leaking on the mask seal so I classify that as mouth breathing, that's all.

Try a different tape, a number of members here use 3M Micropore.  I use a cloth sports  tape, it has a fairly low stickiness, but it works.  

Don't know about the dimples, but otherwise many have had real good success with pads.

Try the tongue trick, it does work.  Maybe not instantly, but it does work.

[Amdx64]

I had the same problem with my cheeks puffing up and air escaping when I first started.  I used a chin strap and practiced on the tongue trick. Put your tongue behind your front teeth and on the roof of your mouth then gently suck you tongue back toward your throat creating a seal. It took about a week of practice now I do it naturally when I go to sleep and no longer need the chin strap.

[Leemax]

I'm glad to know the ways that other people have found to get past that particular problem. One of the great things about these forums is that you never have to "reinvent the wheel", so to speak. I will just use tape until I get my tongue accustomed to stay in place while I'm asleep.

[Geee]

I started cpap not quite two weeks ago, and have been having what I assume are some of the usual adjustment issues. A couple of nights ago, however, I woke up at 0200 or so with the air rushing out of my mouth. The issue is not with my mouth coming open and letting the air escape, (I have a chin strap which prevents that) but rather with the air backing up through my nose, puffing my cheeks out, and pushing it out through my lips. The only way to stop that from happening is to actually tape my mouth shut, which I have done for two nights. I obviously don't want to continue with that. Last week, before this problem even started, I tried a FFM just to see if it was more comfortable or quieter, but realized after one night that the dimples at eh corners of my mouth completely prevent a seal, so FFM is not an option.

Any ideas about how to fix that problem?

I had the same problem. I resolved it by using a full face mask instead of the nasal one. After switching I had no issue whatsoever in the last 5 years.
Best

[Leemax]

I ordered the Ultimate Chin Strap because the ads said that it would fix the problem. I got it yesterday and I'm happy to say that it works 100%! It's not uncomfortable at all, and it really holds my mouth and lips and cheeks in place so there's no chance of any air going anywhere it's not supposed to!

(Geee, I tried a FFM, but because of the shape of my mouth, and dimples, and whatever, I could not get a seal. Even the widest mask they had at my sleep place let the ends of my mouth stick out on either side. Oh well. I like my P10 nasal pillows. They're quite comfortable.)

[MitchS]

I ordered the Ultimate Chin Strap because the ads said that it would fix the problem.  I got it yesterday and I'm happy to say that it works 100%! It's not uncomfortable at all, and it really holds my mouth and lips and cheeks in place so there's no chance of any air going anywhere it's not supposed to!

(Geee, I tried a FFM, but because of the shape of my mouth, and dimples, and whatever, I could not get a seal. Even the widest mask they had at my sleep place let the ends of my mouth stick out on either side. Oh well. I like my P10 nasal pillows. They're quite comfortable.)

Let us know how this works out for you. I've been considering the Ultimate Chin Strap but have been hesitant to order it due to it's cost.

[Leemax]

Let us know how this works out for you. I've been considering the Ultimate Chin Strap but have been hesitant to order it due to it's cost.

I've only used it two nights so far, but I can tell you that it's working great. No mouth leaking at all. It takes a bit of tweaking to get the two straps adjusted just right so it's not too tight or too loose, but that's not a big deal. I don't think it would work with a FFM, but maybe mouth breathing isn't such an issue in that case. I have the ResMed p10, and a Dreamwear that I just got, and it seems to work just fine with both of those. In a couple of weeks I'll know more and I can give a better update.