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New Machine Dry Mouth and Gas
#1
New Machine Dry Mouth and Gas
I just received a new CPAP (AirSense 10 AutoSet) since my old machine (REMstar Auto (System One 60 Series)) needed repair. I'm struggling with the new machine and can't figure out why. Can't seem to sleep more than 6 hours most nights and I wake up with a dry mouth and gas. I wear a well adjusted chin strap. The Respiratory Therapist prescribed a heated hose to relieve my dry mouth but it's not working. 

Posting Changes to Machine Settings for comparison and OSCAR screenshot. Thank you for any insight you might provide!

Jeff


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#2
RE: New Machine Dry Mouth and Gas
The machines have a different "feel" and your best all-time results were with your Autoset at a minimum pressure of 12, max 16 and EPR 3. Your recent chart at 10-16 EPR 3 is still a higher pressure than the highest setting with a Philips at 9-14 with A-Flex 2, and the Autoset pressure increases less than 1-cm pressure the whole night. I see no reason you can't reduce your minimum pressure. Since the Resmed is much more responsive to obstructive needs, you can probably reduce minimum pressure to 8.0, maximum 12.0 and then experiment with EPR at 2 and 3 to find the most comfortable setting. EPR 3 will provide the lowest exhale pressure. I'm certain that based on past results and pressures, your minimum is currently higher than necessary.
Sleeprider
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#3
RE: New Machine Dry Mouth and Gas
Hi Jeff J!  Welcome

Resmed CPAPs have a more aggressive algorithm.  For that reason you can set you starting pressure lower than you had for your Philips.   I would first turn the Ramp feature off, that is just delaying therapy.  I would try lowering your pressure range to 8 to 12 cm.   Let this run for a couple of days to see how you feel.  If you don't experience any hypopneas or OAs, you might then try lowering the pressure on down from 8 to 7 cm.  While you aren't having major leaks, you are still having some leakage.   You need to work on these.

Please report back and let us know how you feel.  Numbers are nice but feeling better trumps the numbers.
Crimson Nape
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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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#4
RE: New Machine Dry Mouth and Gas
Amazing, thank you both!

Am I correct in assuming that air leaving my mouth will register as a leak? I have not experienced dry mouth before.

I'll make the recommended changes and report back.
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#5
RE: New Machine Dry Mouth and Gas
Hi Jeff,
Yes, air leaving your mouth will register as a leak.  Although, your leak rate is low and is not affecting the machines ability to do its job.  

The bad part is that air leaking from your mouth over time will cause dry mouth.  This needs to be addressed for a couple reasons.  First, it can affect your gums and teeth and cause you some issues with that.  
Second, even minor leaks, not registering as over the leak line can disrupt your sleep.  

Finally, with a lower minimum pressure, you may have more control over mouth leaking.

Here is an exercise you can practice that has helped many of us with this problem:

Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front teeth. (Not pushing on 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.
OpalRose
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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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#6
RE: New Machine Dry Mouth and Gas
I know it's only one night but what a difference! Got 7 hours of sleep, no gas, no dry mouth and .58 AHI. Leake rate was much improved. The experience was much more like my trusty old CPAP rather than a fight.

Thank you so much for your suggestions! I wonder why the Respiratory Therapist got it so wrong...
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#7
RE: New Machine Dry Mouth and Gas
I am glad to hear the good news! Sleep-well

The reason your Respiratory Therapist didn't know, is probably they don't use a CPAP and are relying on what they were told or read. There are basic guidelines for setup and then there is intuition on actually using it properly. Big Grin
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

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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