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New CPAP User Questions (Icon Auto)
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ark Offline

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Mask Type: Nasal pillows
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Post: #1
New CPAP User Questions (Icon Auto)
Hi,
I'm a new CPAP user (1 week, ICON Auto at pressure 9). Would appreciate comments on two issues:

1. I'm currently using a nasal pillows type mask because a regular nasal mask killed the bridge of my nose after just 3 days. I noticed that if I open my mouth, the air entering my nose does not necessarily rush out my mouth unless I kind of relax. I've looked at some diagrams of nose/throat anatomy but still don't understand how I prevent the CPAP air from immediately exiting my open mouth. I'm asking because I'm concerned about leakage due to my mouth opening at night. I would assume air rushing out my mouth will wake me up so I know to close my mouth thus maintaining the effectivness of the CPAP. But if I open my mouth and air does not rush out, do I care? The CPAP effectiveness would seem to be maintained.

2. I obtained the setup manaul for the ICON Auto by email thru this Board (thank you!), but the displays on my machine don't seem to quite match the pictures in the manual. I have software version 1.05. Either the manual I received is based on a different Software version, or perhaps another possible explanation is that currently my DME has the USB drive that is usually in the machine. I wonder if certain setup options are only available when the USB drive is in the machine?

Thanks for any thoughts.
03-25-2012 11:35 AM
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greatunclebill Offline

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Machine: Respironics System one Auto A-Flex
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Post: #2
RE: New CPAP User Questions (Icon Auto)
(03-25-2012 11:35 AM)ark Wrote:  Hi,
I'm a new CPAP user (1 week, ICON Auto at pressure 9). Would appreciate comments on two issues:

1. I'm currently using a nasal pillows type mask because a regular nasal mask killed the bridge of my nose after just 3 days. I noticed that if I open my mouth, the air entering my nose does not necessarily rush out my mouth unless I kind of relax. I've looked at some diagrams of nose/throat anatomy but still don't understand how I prevent the CPAP air from immediately exiting my open mouth. I'm asking because I'm concerned about leakage due to my mouth opening at night. I would assume air rushing out my mouth will wake me up so I know to close my mouth thus maintaining the effectivness of the CPAP. But if I open my mouth and air does not rush out, do I care? The CPAP effectiveness would seem to be maintained.

2. I obtained the setup manaul for the ICON Auto by email thru this Board (thank you!), but the displays on my machine don't seem to quite match the pictures in the manual. I have software version 1.05. Either the manual I received is based on a different Software version, or perhaps another possible explanation is that currently my DME has the USB drive that is usually in the machine. I wonder if certain setup options are only available when the USB drive is in the machine?

Thanks for any thoughts.

welcome to the forum.

i doubt very seriously you can open your mouth when sleeping and air will not escape. i think you may need to consider a chin strap. be careful about ass-u-ming.
03-25-2012 11:50 AM
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JumpStart Offline

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Post: #3
RE: New CPAP User Questions (Icon Auto)
(03-25-2012 11:35 AM)ark Wrote:  Hi,
I'm a new CPAP user (1 week, ICON Auto at pressure 9). Would appreciate comments on two issues:

1. I'm currently using a nasal pillows type mask because a regular nasal mask killed the bridge of my nose after just 3 days. I noticed that if I open my mouth, the air entering my nose does not necessarily rush out my mouth unless I kind of relax. I've looked at some diagrams of nose/throat anatomy but still don't understand how I prevent the CPAP air from immediately exiting my open mouth. I'm asking because I'm concerned about leakage due to my mouth opening at night. I would assume air rushing out my mouth will wake me up so I know to close my mouth thus maintaining the effectivness of the CPAP. But if I open my mouth and air does not rush out, do I care? The CPAP effectiveness would seem to be maintained.

2. I obtained the setup manaul for the ICON Auto by email thru this Board (thank you!), but the displays on my machine don't seem to quite match the pictures in the manual. I have software version 1.05. Either the manual I received is based on a different Software version, or perhaps another possible explanation is that currently my DME has the USB drive that is usually in the machine. I wonder if certain setup options are only available when the USB drive is in the machine?

Welcome to the forum, ark. I don't believe that what you experience when awake will influence what occurs during sleep. You state that air doesn't "necessarily" exit via your mouth when it is open. During sleep, and particularly REM sleep, the majority of our muscles are non-functioning. Some sleep doctors describe them as "paralyzed". That being said, you will undoubtedly experience air loss through your mouth when asleep. Further, I doubt that you would wake up to deal with it. But even if you did, you would suffer the same type of interrupted sleep that OSA creates, leaving you without adequate rest. Do you wake up with a dry mouth? If so, that is from air loss.

You didn't mention a sleep study, or what kind of process led you to have a nasal mask. Some of us are simply "mouth breathers", and need a full face mask for effective CPAP therapy. If chin straps don't work for you, a full face mask may be the best choice. It appears you are within 30 days of acquiring your equipment - your DME, if you are using one, should be able to not only provide mask selection, but exchange any mask within that period.

I don't have any working knowledge of an Icon, so I can't help you on that. Maybe someone else here uses one and can chime in.

Good luck on CPAP. It will take perseverance to succeed in this therapy, but it is unquestionably worth the effort. Keep us updated.

Breathing keeps you alive. And PAP helps keep you breathing!
03-25-2012 12:37 PM
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ark Offline

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Posts: 13
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Post: #4
RE: New CPAP User Questions (Icon Auto)
(03-25-2012 11:50 AM)greatunclebill Wrote:  i doubt very seriously you can open your mouth when sleeping and air will not escape. i think you may need to consider a chin strap. be careful about ass-u-ming.

You are probably quite right that when sleeping and therefore relaxed, air will escape (with a rush) out my open mouth, which is good because I'd like to wake up if that is happening. However, I'm still trying to understand how I can manage to prevent that when awake. Somehow when awake I can control that, it feels almost like I am holding my breadth. There might be some way to use throat muscles to close off the connection between the nasal passage and the mouth when awake . Perhaps I'm not explaining this very well. I will demonstrate this to the DME clinician at my next appt and won't be surprised if she says something like, "Well of course (dummy), you are just ........
03-25-2012 12:48 PM
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ark Offline

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Posts: 13
Joined: Mar 2012

Machine: Icon Auto
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: Icon Auto
CPAP Pressure: 9
CPAP Software: Not using software

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Post: #5
RE: New CPAP User Questions (Icon Auto)
(03-25-2012 12:37 PM)JumpStart Wrote:  You didn't mention a sleep study, or what kind of process led you to have a nasal mask. Some of us are simply "mouth breathers", and need a full face mask for effective CPAP therapy. If chin straps don't work for you, a full face mask may be the best choice.

I did use a full face mask during my sleep study, but didn't have time to try anything else. I'm trying a nasal pillow approach now to avoid anything on the bridge of my nose. A chin strap trial may be next (or super glue on my lips. Unsure )
03-25-2012 01:01 PM
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zonk Offline

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Post: #6
RE: New CPAP User Questions (Icon Auto)
Hi
Go to Supplier #25 and look in the 'Education Videos' section for the Icon setup/info and masks.
I don,t use nasal pillows but it,s been mentioned that size of pillows is important as it suppose to rest at the nostrils not goes inside.

For me a chinstrap and keeping tongue at top of mouth against the front teeth helps with mouth leak and therapy air to go where it suppose to go.
03-25-2012 02:12 PM
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zimlich Offline

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Post: #7
RE: New CPAP User Questions (Icon Auto)
You can use painters tape, or a denture adhesive to seal your lips closed during the night. I have never used either one. I understand the denture adhesive is appled sparingly and that you can still open your mouth and lick your lips and it would re-adhere. It is generaly considered that when you open your mouth while using a nasal mask or pillows that the air escaping through your mouth decreases the pressure designed to keep the airway open. Why would you want to close the connection between your nose and your mouth while awake? We usually breathe through our noses- the nose wams, humidifies and removes particulates from the air. For whatever reason some of us are mouth breathers- I am sometimes during the night and chose a total face mask so as not to worry about losing pressure through my mouth. I know there are mechanisms in place to prevent us from breathing in our food when we eat which seal off the esophagus from the trachea.
03-25-2012 02:20 PM
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greatunclebill Offline

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Posts: 549
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Machine: Respironics System one Auto A-Flex
Mask Type: Full face mask
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CPAP Pressure: 8-12
CPAP Software: SleepyHead EncoreViewer

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Location: L.A. (Lower Alabama)

Post: #8
RE: New CPAP User Questions (Icon Auto)
(03-25-2012 12:48 PM)ark Wrote:  
(03-25-2012 11:50 AM)greatunclebill Wrote:  i doubt very seriously you can open your mouth when sleeping and air will not escape. i think you may need to consider a chin strap. be careful about ass-u-ming.

You are probably quite right that when sleeping and therefore relaxed, air will escape (with a rush) out my open mouth, which is good because I'd like to wake up if that is happening. However, I'm still trying to understand how I can manage to prevent that when awake. Somehow when awake I can control that, it feels almost like I am holding my breadth. There might be some way to use throat muscles to close off the connection between the nasal passage and the mouth when awake . Perhaps I'm not explaining this very well. I will demonstrate this to the DME clinician at my next appt and won't be surprised if she says something like, "Well of course (dummy), you are just ........

people say to place your tongue at the roof of your mouth by your teeth. what that does is tend to push the middle back of your tongue up at the roof of your mouth. i can stop the air by having the middle of my tongue up and the front of the tongue at the bottom of my mouth. so either way, however you understand it, thats what stops air from going out of your mouth. this is a conscious effort that may or may not work while completely relaxed. the only way to know for sure is by looking at data with a fully data capable machine.
03-25-2012 02:29 PM
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ark Offline

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Posts: 13
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Humidifier: Icon Auto
CPAP Pressure: 9
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Post: #9
RE: New CPAP User Questions (Icon Auto)
Thanks to everyone for your suggestions and ideas.

My AHI score last night (2nd time with the nasal pillows) was 9.8. Sleep study measured an AHI in the mid 50s without CPAP help. So while 9.8 is a definite improvement, it still is about twice the goal of being at 5 or below. I did wake up with a dry mouth so I'm sure there was some mouth breathing going on. I like the nasal pillow approach, so the addition of a chip strap, or perhaps going to a hybrid type mask might be the answer for me. I'll try anything to avoid having a mask across the bridge of my nose.
And just to clarify, the issue of somehow closing the airway between my nose and mouth when awake is just something I observed when using the nasal pillows for the first time. I woke up and realized my mouth was open but there was no rush of air coming out like it did at other times when I opened my mouth. It surprised me that it was happening (possible), and so I'm trying to understand what was going on. It is not something I'm trying to do or want to do.
03-25-2012 03:06 PM
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zonk Offline

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Machine: A10 AutoSet
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Post: #10
RE: New CPAP User Questions (Icon Auto)
Your profile indicate don,t use humidifier may be get the water chamber (if don,t have) adding some moisture might help with the dry mouth symptoms.
ResMed Mirage Liberty is a full face mask (nasal pillows cover the mouth as well)
(This post was last modified: 03-25-2012 03:25 PM by zonk.)
03-25-2012 03:21 PM
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