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Getting started -- waking up with horrible dry mouth
#1
Hey there, moderate OSA (like 25 AHI) sufferer just getting started with a bilevel auto machine here (I was prescribed this machine because I did very poorly in the sleep study, did not tolerate the CPAP well and they didn't get enough data).

The good news is I'm getting along with the treatment okay, keeping it on all night and sleeping less than I was before.

The bad news is that I'm still not sleeping through the night. Before treatment I tended to wake up quite a bit during the night and that was my primary driver to seek treatment. Now I'm waking up less, maybe 2-3 times a night but I have horrible, horrible dry mouth when I do. I go back to sleep pretty much immediately and always have. I've increased the humidity settings every night to no avail and it's now set to the max. After doing some reading on here, I'm suspecting it might be because I am breathing through my mouth. My studies did not indicate I am a mouth breather but I also didn't sleep very much in them, so I was given Swift FX nasal pillows which I actually quite like and would like to keep using if possible.

Looking at sleepyhead there's a fair amount of leakage -- I'm not really sure what to make of the data though. Tightening the mask reduced the severity of the leakage but did not stop them completely. Would breathing through the mouth even register as a leak?

Anyway my goal here is to stop waking up completely. I've been sleeping like this for years and I hate it. Based on what I've read I'm going to try to reduce the leaks and make sure I'm not breathing through my mouth and see if that helps. Any advice on this situation would be appreciated.

In the meantime I ordered a chinstrap and I'm going to try to fashion one out of stuff I have lying around the house for tonight.

Here is my stats in sleepyhead so far:

CPAP Statistics as of Wednesday, August 07, 2013
7 days of CPAP Data, between 8/1/2013 and 8/7/2013
AHI 4.17
Hours per Night 06:57
Min EPAP 4.00
95% EPAP 9.26
Max IPAP 15.00
95% IPAP 13.26
Average Leaks 16.73
95% Leaks 46.80

Would post some graphs from sleepyhead but apparently I am not allowed to post links or images yet.

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#2
Hi eviltim,
WELCOME! to the forum.!
You might try a chinstrap as you suggested in your post. I think you can make one out of ace bandages or something like that, 'til you get yours ordered
Hang in there for more suggestions and best of luck with your therapy. .
trish6hundred
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#3
Your leak rate doesn't seem that bad but dry mouth with a nasal mask almost always means mouth breathing while asleep.

You can try a home made chin strap then get a better one if it works. Take an Ace bandage and wrap it from chin to top of head a few times. You want it tight enough that, when you relax sitting up, the chin does not fall. But you do not want it so tight you cannot chew without effort. Some put their straps over the headgear of the mask (with the added benefit of it holds the mask on) and some put it under. All personal preference.

Try that a night or two and see if it helps. If it does, you'll want to look into the chin straps available. One of those would be cooler and stay in place better than the Ace will.
PaulaO2
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#4
Thanks for the replies guys. I tried it last night with an ice pack on a sling around my chin (without the ice bag in it obviously) and it seemed to help somewhat with the dry mouth but did not stop the leaks or the awakenings. I'm getting a real chinstrap in the mail today so maybe that will work better.
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#5
Got my chinstrap in the mail, let's hope that works. So about these leaks. I guess a leak under 24 are totally acceptable with this machine/mask? It does seem like, looking at the graphs, some of these leaks are associated with my awakenings, although obviously I have no way of knowing.
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#6
Try practicing to keep your tongue on the roof of your mouth during the day , it becomes a habit and helps stop mouth breathing .
It worked for me , it doesn't stop it entirely but it really helps .
I have to use the mirage quattro full face mask because of my mouth-breathing and I didn't like the nasal pillows on a hybrid . Dry mouth is a sign of mouth breathing , you might like the hybrid masks.
And yes with a swift fx your mouth-breathing is a large leak and you are not getting good therapy during that time. Pap pressure can't keep your airway open if its coming back out your mouth. Humidity setting isn't going to help your dry mouth with a nasal mask. It will if you use a ffm or a hybrid.
Only my opinion and i'm not medical .
Good luck to you . Sleep-well
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#7
Thanks for the advice. I actually don't mouth breathe at all during the day which is why I am pretty surprised at this. I have a followup appt in a week so I guess I will look into getting a different mask if it can't be fixed with a chinstrap.
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#8
(08-08-2013, 09:22 PM)eviltim Wrote: Thanks for the advice. I actually don't mouth breathe at all during the day which is why I am pretty surprised at this. I have a followup appt in a week so I guess I will look into getting a different mask if it can't be fixed with a chinstrap.
eviltim,
The elephant in the room is that you probably should just get a full face mask. May I suggest my current favorite mask, the Quattro FX Full Face. Also, one of the best chin straps available is the PapCap. I've had several. It's really the only one that works worth anything.

Full face masks aren't just for mouth breathing. They're really more about mouth leaking. The column of air between mouth and nose are equal when wearing a full face mask, hence making it easy for the wearer to simply breathe through the nose without having to worry about dry mouth. The PapCap chin strap allows you to reduce blowfish syndrome (ballooned-out cheeks) and keeps your lower teeth close enough to your upper teeth that your lips stay closed, thus eliminating dry mouth. It also reduces mask torque (when your head moves but your mask doesn't). The fact that you can also breathe through your mouth is basically only useful when you have a sinus cold. Most full-face mask users still breath mostly through their noses.

Dry mouth is a wake-trigger. Why not just eliminate it with a full face mask?

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#9
I'm certainly not opposed to getting a full face mask. Just trying to get some sleep for the time being.
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#10
DreamDiver , you make some very good points in your post. Sometimes I think the idea of a ffm puts people off just because it is bigger.
Society is in the smaller is better mind set . Phones etc. , but our eyes and fingers don't always like that .
I like your pressure equalization explanation. Mouth leaking is a good concept.
I am a terrible mouth breather during the day but I have gotten better since cpap and help from other posters to try and stop it. http://www.apneaboard.com/forums/images/...thanks.gif
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