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Cflex + Causing Mouth Breathing?
#1
I have been using straight Cpap for 20+ years with very little mouth breathing problems.  Last month my trusty Remstar LX machine died after 16+ years of faithful service.   Dielaughing   I picked up a used Remstar Auto M machine and have been trying the auto feature and Aflex, Cflex features with mixed results on Encore Basic.  I also ordered a Respironics System One 60 Auto Machine that came in last night.   So last night I set the new 60 series machine to simple Cpap with Cflex+ set at 1.  Of all the different settings I have tried Cflex+ seemed the most comfortable.  I had/have great hopes for using Cflex+.  It made things quieter (less air pressure noise) and felt the most comfortable of all the flex's I have tried.  But this morning I woke up after 5 hours with a very dry mouth.  If I'm correct, I think I have been so used to a steady 9.5 pressure for years and have trained myself to keep my mouth shut while I feel pressure.  Using the different Flex's with pressure relief cause me to mouth breath.  This explains the mixed results I get when using any setting with pressure relief. 

Am I correct?  I would really like to use Cflex+ daily.  Is there any tricks to stop the mouth breathing short of chin straps or tape?
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#2
if you left the pressure start at factory settings, it may be too low. what were the settings you are using?

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#3
I have been at 9.5 for years, but have lost 90lbs this year and what I have seen with the data from last month on the Respironics M & Encore Basic when set on auto the pressure was closer to 8.5 or 9.0.  So I set the machine last night to 9.0.  I'm new to reading these data readouts.  So I'm still trying to figure things out.  I did get a AHI of 3.56 but woke up with a very dry mouth and caught myself mouth breathing.  That was the Aha Ha moment.  That maybe not having a steady pressure, like I have been used to for years, is causing me to mouth breath. I will set to 9.5 with Cflex+ at 1 tonight and see if the increasing the pressure from 9 to 9.5 will make a difference.
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#4
The CFlex setting is a pressure relief feature on System one machines.  This doesn't change
during the night. It stays the same at whatever you have set it to: 1,2 or 3.

Are you confusing this with the Cpap Check feature?  If enabled, the machine would be in Auto mode for a set period of time to find the optimal pressure to use in Cpap mode.

For mouth breathing, try using a "soft" cervical collar.  This helps support and align the neck and keeps the jaw/mouth from dropping.

If you need the Clinicians manual for your machine, order here:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Just be sure to follow the directions and list your exact machine name.
OpalRose
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www.ApneaBoard.com

How to Organize and Post ScreenShots

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#5
What does your leak data look like? The number on the LCD is not very useful, but it's better than nothing. It would be best to download the data into Encore or SleepyHead and look at the leak graph, rather than just the leak numbers. That's the best way of trying to determine if mouth breathing is your current problem.
Questions about SleepyHead?
See my Guide to SleepyHead
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#6
(05-03-2017, 07:56 AM)redmed Wrote: Is there any tricks to stop the mouth breathing short of chin straps or tape?
From the Mask Primer, 
Mouth Breathing[edit]
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
With SleepyHead look at your Leak Rate graph where it is shaded (large leak/ LL), flat tops on this graph suggest mouth breathing. In SleepyHead right click on the left header of the Leak Rate graph and click on Dotted Lines then select "Leak Rate Upper Threshold" to get a line across the graph for ResMed. Manually set the value for Philips Respironics. Severity depends on how much over this threshold and for how long it is in the Large Leak territory.
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. There is one chinstrap that is notably different than others, the Ultimate Chinstrap, Search for it if you desire.
Cervical Collar. A "soft" Cervical Collar. This helps support and align the neck and keeps the jaw/mouth 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.
Dry mouth is a symptom mouth breathing that is uncomfortable. It can and does occur with some users of a Full Face Mask. Many users use a product called Biotene to get relief from this symptom.
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#7
Redmed, have a suggestion for you. Change the flex setting to CFlex rather than CFlex+. First here is the explanation of the two features.

[Image: AqJsMGL.jpg]

I have found that using the CFlex+/AFlex seems to create problems for some people because of the momentary relieve that occurs during inhalation which is when you need the support of your pressure. This quick drop in pressure may be causing your mouth to open in a natural response to get more air. Try switching to the straight CFlex and I would leave the level set at 1.

Let us know how it works.
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#8
You may just be one of those that don't tolerate pressure changes, although when using any of the flex settings won't give more than a pressure drop of 2cm.  

I recommend turning Flex off completely, and give this a few days to see if you feel better.

The flex feature doesn't have anything to do with mouth breathing.  The "soft" cervical collar will help.  See my post above.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#9
I have been using the "Tongue Trick" for years, but last night I had large leak warnings when using Cflex+ for the first time.

"You may just be one of those that don't tolerate pressure changes, although when using any of the flex settings won't give more than a pressure drop of 2cm.  "
I think I may be one of these people.
I'm trying to get my Sleepyhead data posted.  Maybe the next post since this is my 4th post.
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#10
Here is my Sleepyhead screenshot.


Attached Files Thumbnail(s)
   
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