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Mouth leaks - can "training" help?
#1
I've got a mouth-leak issue, and I've tried a couple different ways to fix it. Lately, I've been thinking about "better" ways to deal with it.

Right up front, I know that the biggest, easiest way to solve the issue is to get a full face mask. I'm very hesitant. I tried on a nasal mask when I first got the PAP and hated it. The air blowing around my nose was terrible distracting. I went with a P10 nasal pillows, and then to a dreamwear which I like quite a lot. I really want to make it work.

Looking at my data, I first started therapy in December and had some small leaks - likely mouth leaks. I tried a chin strap with limited success. Then a mouthguard - which I HATEd - then back to a chinstrap. After about 5 chinstraps I found one that was decent and seemed to do a good job without being terrible uncomfortable.

After a couple of weeks, I found myself fighting it. I would put it on, and subconsciously I would push my jaw down against it, opening my mouth. At night, I would wake up with a dry mouth proving it wasn't real effective and i was opening my mouth anyways. Sometimes I would wake up with dry mouth/teeth, showing that my jaw was closed, but I was leaking out of my lips around my teeth anyway. VERY uncomfortable. I had it pretty tight - it would leave a mark under my chin - and if I went any tighter I would give myself a headache.

My latest thought was: Am I handicapping myself, and the chinstrap is just a crutch? In other words, am I becoming dependent on the chinstrap instead of "training" myself to keep my mouth closed in my sleep? Is training myself even possible? Other people can sleep with their mouths closed, can't they?

So a couple nights ago, I stopped using the chin strap. They've been really bad nights as far as leaks go. Not surprising. I've had a cold also, which of course complicates things. My AHI has remained consistently under 2 for a couple weeks, so therapy is technically going good. The last two nights the leaks have been bigger than they almost ever have been - to me this reinforces that i was becoming dependent on the chinstrap. Now that I don't have it, everything falls apart leak-wise.

What I'm going to try is continuing without the chinstrap, and trying to "catch" and train myself as I sleep to keep my mouth closed.

Is this even possible?
Does anyone have experience or advice?
Am I foolish to even try?

Dont-know
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#2
mchlwise,
Yes, it's possible, but takes time and perserverance.

Place your tongue to the roof of your mouth with tip of tongue behind front teeth, then suck upwards gently. This helps your tongue to create a seal at the back of your throat so that no air escapes.

It took me a few weeks to master this, but now it's second nature. At first, I used a chin strap along with practicing this technique, then after awhile was able to dump the chin strap. It's worth the time it takes to master this.
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#3
I agree with the above. To make sure you know what it feels like, put some water in you mouth, hold it there and breath through your nose-bingo this is what you need to do at night (without the water of course). This is very natural and you do it all the time throughout the day, without even thinking about it. We need to be able to shut off the mouth from the airway to keep things from our mouth from falling into our lungs. Now you need to do the same thing to keep air at night from getting into your mouth.

Something else I might suggest since you like the dreamwear mask. Take a good look at the are of air flow into you nose and then look at the same area on the Amara View mask. I think they are pretty much the same except that the Amara View also covers the mouth, incase in comes open.

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#4
Thanks for the responses so far.

I figured out pretty quick how to close off my mouth from my nose with what I think is my soft palette (something at the back of my mouth). I can have the PAP on and open my mouth with no air coming out. At some point when I'm sleeping, it must get tired and open up or something.

I'll try the tongue thing and see if it helps.
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#5
The graduate studies for learning control are the following:
Talk intelligibly with the cpap on.
Drink some water...beginners can use a straw.
Inhale at the mouth and exhale from the nose, then when you're good at that, reverse.

All of this can be done, and practicing it gives you REAL control and understanding of air pressure. You'll look pretty silly in the first attempts, so video is encouraged. I'm not kidding, it not only can be done, it can become easy.
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#6
mchlwise, As we've read, some folks have successfully trained themselves to keep their mouths closed during sleep while others have tried unsuccessfully. I'm in the latter group. I've been a mouth breather since childhood. When first becoming a CPAP pt., I used chin straps with first a nasal mask and later with a FFM, but to no avail. My jaw muscles must have been stronger than the strap material, and I tried more than one chinstrap before giving up on that idea.
Thought I'd add my two cents if for no other reason than to point out that not everybody is successful with chinstraps long term or for shorter training purposes.

David
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#7
One correction: no need to use a chinstrap with a FFM, so I didn't. In my case, it turned out that nose bridge damage was a problem for me with a FFM, but that's a different subject.

David
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#8
mchlwise,
Have you considered trying a Hybrid FFM? Has nose pillows & a smaller mouth seal area. Also, has a chin flap, so no chin strap is needed. Kit comes w/three sizes of cushions & nasal pillows. I find it much easier to maintain mask seal when side sleeping with this mask. Might be worth a look. Google Hybrid FFM. Hope you find what works for you.
Cheers,
otrpu
Love your family, treat your friend(s) well, and don't waste your time. Everything else is just so much BS. Sleep-well
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#9
Hi mchlwise,
I just recently switch to the F&P Simplus FFM and I really like it; and I don't have to use the cursed chinstrap; I could never get used to that extra thing on my head, even the minimalist version I made with some old P10 headgear. That one was better than the ones I tried but still, I just couldn't get used to it.
Of course, YMMV. Good luck to you in finding something that will work for you.
trish6hundred
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#10
(02-22-2016, 04:35 PM)Sleeprider Wrote: The graduate studies for learning control are the following:
Talk intelligibly with the cpap on.
Drink some water...beginners can use a straw.
Inhale at the mouth and exhale from the nose, then when you're good at that, reverse.

All of this can be done, and practicing it gives you REAL control and understanding of air pressure. You'll look pretty silly in the first attempts, so video is encouraged. I'm not kidding, it not only can be done, it can become easy.

Thanks. This was very helpful.

At some point in trying all of the above, I "discovered" something I hadn't been able to before and closed off whatever door it was that I was having trouble closing. At one point last night, I woke up and actually thought: "Is this thing on?" because I didn't notice it.

I'm sure I still need practice, but this was very helpful and reduced my mouth leaks considerably.
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