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+--- Thread: [Treatment] Mouth filling from inside (/Thread-Treatment-Mouth-filling-from-inside)
Mouth filling from inside - mikeinstlouis - 08-10-2018
Hi all
I have been using my APAP for almost 2 weeks and wanted some feedback.
Using the sleepyhead program, I know that all of my AHIs are less than 5 but I wouldn't say that I have huge increases in energy but some!
I still have several hypopneic events and was advised to increase my baseline low pressure to at least 7.5 or 8
I did this hand had a miserable night!
Pretty much my only issue is with the higher pressure (which I know is not that high!).
I sleep on my side and when I start to fall asleep, I think my pharynx relaxes and I get a lot of air being redirected to my mouth which kind of blows up a little like a balloon and then releases pressure from my lips. That wakes me right back up again and it is a viscous cycle. I tried a chin strap but it seems to be from the air on the inside of my mouth, blowing on my lips from the inside. it is not my mouth opening as in people that sleep open-mouthed. I feel that this is bad so it makes me get frustrated and worry and then can't fall asleep. Dumb how the mind works.
When I do fall asleep and my apap responds to correct the apnea or the hypopnea, starting the whole process again and is more frequent with the higher pressure opening my mouth from the inside, releasing, making noise and waking me up.
I am a side sleeper and I am afraid the full face mask wont work. Currently using nasal pillows.
Has anyone ever heard of this? I read taping the mouth may help but the air is not coming from the outside, but the inside. Not sure how tape will help.
Just wanted your expert advice.
Thanks!
Mike
RE: Mouth filling from inside - Walla Walla - 08-10-2018
I use a full face mask. It's a Resmed F20 AirTouch mask and it works fine for side sleeping if you decide to go that route. Looking at your pressures you need to make some adjustments that would probably reduce the pressure surges your getting. Go ahead and post a sleepyhead chart here and someone will help you out. The links on how to arrange and post your charts are below.
RE: Mouth filling from inside - mikeinstlouis - 08-10-2018
I would post last night's data but I don't have access to a card reader at work.
I will get that up for you ASAP
RE: Mouth filling from inside - Cpapian - 08-10-2018
Really common problem for a new XPAPer. Some call it "chipmunk cheeks". Really bothersome.
I sleep in all four positions throughout the night and have used pillows, nasal and full face masks, doesn't matter which.
The secret is train your tongue to stay at the roof of your mouth. It closes the route between the nose and mouth and prevents air from going up your nose and into your mouth. Practice during the day so you can incorporate into your XPAP experience at night. It happens at the higher pressures, you wake slightly from an event, your body looses it's breathing rhythm, you get the chipmunk cheeks and you wake up more.
When this happens, think about where your tongue is and get it to the roof of your mouth, shut off the machine to bring the pressure down and go back to sleep with your tongue at the roof of your mouth.
I trained myself in one day, so its not hard to do.
The tape just helps to keep your lips together to prevent mouth breathing.
RE: Mouth filling from inside - OpalRose - 08-10-2018
mikeinstlouis,
Many folk here struggle with lip leaking, and many use tape. I personally don’t recommend it, but you have to do what works for you.
Have you tried a soft cervical collar? Many use this for mouth breathing, but it may help you due to the fact that it holds the chin up and may keep the lips together. Some also use a half type support under the chin like the Dr. Dakota collar, or even a neck cushion turned around.
I use the Tongue Suck Technique. This takes time and practice, but works for many.
It took me a couple weeks to master and I was able to get rid of the chin strap.
Occasionally, I use a small neck cushion turned around to help support my chin and it keep my lips sealed too.
Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front teeth. Slowly suck upwards and back.
This places the tongue in a natural position, with the back of tongue sealing the back of the throat so that if you open your mouth/jaw while sleeping, no air will escape.
Final word of advice...patience is the key! This stuff takes time to master and get used too. Once you are able to control your lip leaking and use the optimal pressure to take care of your Hypopneas, things will fall into place.
Post your data when you get a chance.
RE: Mouth filling from inside - mikeinstlouis - 08-10-2018
[attachment=7705][attachment=7706]
I have included both sleepyhead data from the last two nights. The first one is from 8/8/2018 and the second from 8/9/18
The first one is where I had my baseline pressure at 7.5 I believe . Bad night. Thought my mask was blowing off and bad exhaust from my mout!
The second one is baseline 4. Better night.
Hope this all makes sense and THANK YOU
Mike
RE: Mouth filling from inside - Walla Walla - 08-10-2018
If it were me I would set the minimum pressure at 7cm, the max pressure at 15cm. also I would increase the EPR from to2cm to 3cm. That should give you more comfort in breathing and help with the hypopnea your getting.
RE: Mouth filling from inside - mikeinstlouis - 08-10-2018
What is EPR and how do you change the setting in a Phillips Respironics machine?
Also, I tried to to the "tongue suck" but when I fall asleep, my tongue relaxes like it is supposed to I guess!
I can do that while I am awake but not asleep.
I like the advice to turn the machine off and restart rather than fighting the pressure.
When I turned up the machine to 7, that is when I had a horrible night. Chin strap just kept my mouth closed, not my lips.
I will try all the advice but patience is what I need to learn I guess.
So this is a problem that others suffer and eventually do OK or is a FFM the only answer?
Mike
RE: Mouth filling from inside - Crimson Nape - 08-10-2018
EPR is proprietary to Resmed machines. EPR stands for Expiratory Pressure Relief. It is a value from 1 to 3 and stands for the pressure reduction during exhale in units of centimetres H2O. The closest option on a Philips is the A-flex. There really isn't any direct option that matches either manufacturer.
RE: Mouth filling from inside - OpalRose - 08-10-2018
You don’t have EPR on your machine. Only ResMed uses EPR.
Respironics machines use FLex, which doesn’t work quite the same as EPR. The most expiatory relief you can receive from Flex is 2cm drop in pressure, where EPR will give you up to 3.
It looks like you are using a Flex setting of 3, which isn’t helping at all.
I would turn the Flex setting back to 1 or turn off completely. You can change the Flex setting on a 60 series machine from the display. Just click on the top right box on your machine display and change the Flex setting.
Order a Clinicians manual for your machine:
https://www.apneaboard.com/adjust-cpap-pressure/change-cpap-pressure-settings-adjusting-your-machine-with-a-clinician-setup-manual
A brief description of how Flex works:
Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief, which is flow based.
• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.