What was your experience fighting mouth leaks?

[PersonInNY]

Thanks for the suggestion. I've been trying to self-titrate a fixed pressure that works well for me, looking at both EPAP and IPAP (so setting pressure and EPR on this machine). I don't trust any reactive algorithm, because I have REM-dependent breathing issues, so my pressure needs go up and down four or five times per night. The algorithm can't keep up. I tried the "For Her" algorithm, which also slows down pressure changes, and while the pressure curve looked a lot smoother, I felt a lot worse. As I mentioned previously, I'm not concerned about the centrals, since they were false positives while I was awake, and most nights I don't have any.

Here's an OSCAR chart from two nights ago. Setting the min EPAP to 9 or 10 seems to get rid of almost all hypopneas, and setting EPR to 1 helps with flow limitation, but I'm still running into flow limitation that seem to correlate with heart rate spikes. (My resting heart rate during the day is only 60, so it's much higher at night.) Based on data from the past, I think I'd do better with slightly higher exhale pressure and much higher inhale pressure, but if I increase pressure that extra air just seems to shoot out my mouth. The night in the screenshot was good but last night was bad.
   

I'm getting a Knightsbridge Dual Chin Strap soon, so hopefully that will help with the leaks, since tape and wedging my chin in a contour pillow aren't enough.

[cyberfiche]

The Knightsbridge was what finally completely fixed the mouth breathing and dry mouth problems. I absolutely love it! I hope it works for you!

[SeePak]

Person in ny
If you were awake for those CA events, i guess you were holding your breath? They totalled 1:19 min.

will be watching for the update on the chin strap.
Nothing kept my mouth closed.

My wife , no CPAP or sleep apnea,   but mouth breather, is using myotape ( chin strap hurt around the ears ) and i notice she is getting a lot quieter. Possibly starting to get control of her muscles around the mouth again. That's the theory of what should happen, watching for this.

I am going to try it again, doing some myo functional exercises and breathwork, but taping mouth for now closed.

i dont normally chase flow limits.

i have straight CPAP, never had any auto

Get rid of OA and hypopnea, i still get sleep, FL can be 0.2, no problem.

Then again, my events can go from 0 to crazy, maybe auto is in the cards for me?

but this full face mask setting seems to be working for me, for now.

Leaks down, and mine were already low.

Interesting.....

[OttSteve]

It may not be applicable to your situation, but I was having an increasing issue with mouth and other leaks.  I tried nasal cushions, nasal pillows, a full face mask, a cervical collar, tongue training, a rather expensive pillow, mouth taping and a chinstrap and I tried them in every combination I could think of.  Nothing significantly helped.  Then, on the advice of one of the sages of this forum, I bought a used BPAP machine (AirCurve 10 VAUTO) and switched from my AirSense 10 Autoset.

AHI has dropped from 1.26 to 0.61.  The average leaked has decreased from 9.33 to 5.20 and the 95% leak from 25.2 to 12.0.  The percentage of time above the leak threshold has reduced from 5.91 to 0.16 and the 95% flow limitation from 0.29 to 0.01.
I am definitely sleeping better.   I can't tell you if it might work for you as I really don't know why it worked for me, but it might be worth asking.

[PersonInNY]

SeePak: Yes, I think I sometimes hold my breath while half-awake and moving around in bed. I saw breath-holding during positional changes mentioned in another thread. Whenever I have a so-called central, my Apple Watch shows me as awake and my pulse oximeter shows me as moving. They usually look like this:

   

OttSteve: Very interesting that a different machine helped! Did your typical pressure go down a lot? Or maybe sleeping more soundly helped?

I learned a lesson the hard way last night: even though mouth tape that lets less air through stops leaks, it isn't necessarily better for keeping me asleep. Tape doesn't stop air from going into my mouth; it just stops it from going out.  I've had my worst nights of sleep with nasal CPAP with nonporous medical tape and with tape sealed over loose lips, and my best nights when the tape let a lot of air leak out.

[SeePak]

p in ny

try the Myotape, by Patrick McKeown.....breathwork too!

You get leak when you need to ( mouth puffing ), and get used to keeping lips together as well.

Also, think you were on another thread, VCOM device, sounds like that could work for you too!
gets rid of mouthbreathing for some people and leaks

i think u read the article, posted it...

[PersonInNY]

Oh, I just looked into Myotape and that sounds like exactly what I need -- it's supposed to keep your mouth closed but lets air out if need be. And just $5 for a sample pack! Thank you!! I'm about to order some.

I may be missing something, but I don't see VCom making sense for me, because I have EPR on. EPR lowers exhale pressure, and VCom lowers inhale pressure, so using both would just... lower pressure all the time?

[SeePak]

p in ny

A few reasons seem to me you could have good success with the VCOM......

1st....You dont breathe heavy, lower than most for median minute vent

So you have a chance right away with the VCOM as you will be relaxed and not fighting pressure when first laying down.

This is the state we should always be in when first putting on our mask for sleep.

15 min. breatwork goes a long way !


2nd....  you are fighting mouth breathing and sometimes leaks, this device can reverse that


3rd ....   Therapy results are not affected even though inhalation pressure is reduced, so if you think you need more pressure you could try to raise after using this device

4th  ....      Therapy induced CA events reduced

5th   ...      EPR not affected as per the paper you posted about the VCOM   "V̇-Com™ does not affect the operation of expiratory pressure reduction algorithms"

6th  ....     They mention REM sleep issues, i did not know if that was for you? sorry i lost the part, will keep looking, just want to give you a heads up in case it was pertinent

[PersonInNY]

Thanks for the thoughts. I don't want to discuss anything that affects the pressure I receive in this thread, since I don't think I've provided enough context, the OSCAR screenshots I've posted are not representative of the results I've been getting recently, and this thread will be most helpful to others struggling with mouth leaks if we don't get too into the weeds of my therapy. (Yes, I'm sorry, I know I asked for your thoughts on this! But now I'm realizing a full reply would be very long and drag this thread off topic...) But hopefully these thoughts on VCom will be helpful for others struggling with mouth leaks.

[SeePak]

p in ny

yes, good thought, thanx for that.

I have a few threads upcoming to trial.

would love to continue, and follow your trials.....and tribulations!?