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New Open Mouth Sleeping and Pressure?
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Maudessen Offline

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Machine: F&P Icon Plus Auto
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Post: #1
New Open Mouth Sleeping and Pressure?
Could there be a relationship between air pressure setting and starting to sleep open mouthed? Last night was my third night with the CPAP, and I woke up several times with a dry mouth! I have never slept with an open mouth...in fact, I grind my teeth when I sleep. Could this incident of starting to sleep with an open mouth have anything to do with the air pressure setting on my CPAP?
06-05-2015 09:47 PM
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TyroneShoes Offline

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Post: #2
RE: New Open Mouth Sleeping and Pressure?
Certainly there is. The pressure is considered pressure only when it is induced into a closed system (with venting, of course). The pressure is measured as a compared relative pressure, measured as continuous positive pressure relative to the atmospheric pressure outside the system.

If your mouth is open, the system is no longer closed, meaning that pressure just becomes airflow...out your mouth. This means that the pressure in the system equalizes to the pressure outside the system, meaning that you do not have any positive relative pressure inside the system relative to the pressure outside the system at all if all the air is leaking back out.

If you are asking whether the pressure is actually causing you to sleep open-mouthed, my guess would be no, although quite obviously if there is increased relative pressure in that system, it will have a greater tendency to try to push for an opening for release. I just don't think xPAP pressures, especially at 9 cm, would be anywhere close to enough to force your mouth open.

You may also sleep open-mouthed without xPAP and not even realize it. When you sleep open-mouthed with xPAP you will notice, because the airflow dries out your mouth pretty badly. So possibly it is evident now, while there but not evident before.
(This post was last modified: 06-06-2015 12:56 AM by TyroneShoes.)
06-06-2015 12:54 AM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
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Post: #3
RE: New Open Mouth Sleeping and Pressure?
(06-05-2015 09:47 PM)Maudessen Wrote:  Could there be a relationship between air pressure setting and starting to sleep open mouthed? Last night was my third night with the CPAP, and I woke up several times with a dry mouth! I have never slept with an open mouth...in fact, I grind my teeth when I sleep. Could this incident of starting to sleep with an open mouth have anything to do with the air pressure setting on my CPAP?


Hi Maudessen,
These are just my thoughts on this subject, a pressure of 9 may not bother one person while it could be a bit much for someone else.

Some of us are mouth breathers and don't realize it, but believe me if you are mouth breathing, the air will leave your mouth so dry that it will feel like someone stuffed your mouth with cotton. Unsure

I have learned to use the tongue to roof of mouth trick. I'm sure you have heard this before, but if you can master it, your mouth won't drop open. And if it does, the air won't come out. I have actually woke up in the middle of night with my mouth open and no air coming out, with my tongue still at the roof of my mouth, so I know it works. Or you can try a chin strap just to train yourself to keep mouth closed.

OpalRose
(This post was last modified: 06-06-2015 06:57 AM by OpalRose.)
06-06-2015 06:55 AM
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Maudessen Offline

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Posts: 35
Joined: Jun 2015

Machine: F&P Icon Plus Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10
Humidifier: Integrated in unit;set-at 1 of 7
CPAP Pressure: Was 9, now 7-10
CPAP Software: SleepyHead

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Sex: Undisclosed
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Post: #4
RE: New Open Mouth Sleeping and Pressure?
(06-06-2015 12:54 AM)TyroneShoes Wrote:  If you are asking whether the pressure is actually causing you to sleep open-mouthed, my guess would be no, although quite obviously if there is increased relative pressure in that system, it will have a greater tendency to try to push for an opening for release. I just don't think xPAP pressures, especially at 9 cm, would be anywhere close to enough to force your mouth open.

This morning I hit snooze and stayed on my side. In my drowsy state, I noticed a bubble forming at what would be the highest point in my closed mouth, and shortly thereafter a big bubble passed through my mouth and had to be expelled.

While this was a single incident, it may show that this is a positional/ structural issue. In my family we have very short palates, to the point that for one surgery an anesthesiologist found herself unable to intubate my mother and ended up ruining her vocal bands. Anyhow, with my congenitally short palate and my propensity to sleep on my side, I wonder if somehow a pocket of air starts to form near my palate instead of being passed down to my lungs. This could be structural, in that the inside of my airway may encourage the development of this bubble. Or it could be that the pressure is passing air to my lungs more quickly than my breathing rate can accommodate.

I can't do anything about the structure of my airway, but I should be able to adjust my CPAP setting of 9 to an Auto setting of 7 to 10, to see if that will help.

I haven't yet set up Sleepyhead because I don't have the sleep study data to fill in the form at the beginning. I have requested it from the sleep center but haven't received it yet.

However, when I manually review the data in the machine itself, it seems that at 9 my AHI is holding steady at 1.2 to 1.3. So it seems I may have room to lighten up the pressure.
06-06-2015 07:21 AM
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Maudessen Offline

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Machine: F&P Icon Plus Auto
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Humidifier: Integrated in unit;set-at 1 of 7
CPAP Pressure: Was 9, now 7-10
CPAP Software: SleepyHead

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Post: #5
RE: New Open Mouth Sleeping and Pressure?
(06-06-2015 06:55 AM)OpalRose Wrote:  I have learned to use the tongue to roof of mouth trick.

Actually, I believe I already sleep with my tongue on the roof of my mouth. With my bruxism (grinding of the teeth,) I sleep with retainers that act as mouth guards, and am in the habit of putting the tip of my tongue to the part of the top retainer that is nearest the top and front of my mouth.

At the sleep center they told me that I didn't open my mouth during the study, but of course that's a one-off and doesn't mean I don't open my mouth under normal circumstances.

I read on this board that it helps to such the air out of your mouth to create a little vacuum, and have begun trying to do that. But of course it's impossible to maintain the little vacuum after you fall asleep and relax.

Last night was my fourth night with the CPAP and second with the issue of my mouth opening while asleep. If I can't figure out how to prevent this by adjusting the pressure I will have to get a chin strap, because I'm allergic to the adhesive in most tapes.

Thanks for sharing your ideas!

Maud
06-06-2015 07:27 AM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
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CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
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Post: #6
RE: New Open Mouth Sleeping and Pressure?
Have you requested the clinicians manual for your machine? You can then change your machine to auto and set a range. The setting you mentioned of 7 -10 sounds about right, but as soon as you can, start looking at your data. Check the 90% pressure rate and set your staring pressure slightly below that number. Then look at your graphs and check to see how high your pressure is going. If it tops your setting of 10 quite a bit then raise it to 11. Once you make a change, watch your data for at least 10 days, before changing again. Now just so your are aware, if you have high leak rates, your AHI may not be correct. So the best thing to do is fix that issue first.
Good luck

OpalRose
06-06-2015 08:04 AM
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Maudessen Offline

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Posts: 35
Joined: Jun 2015

Machine: F&P Icon Plus Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Airfit P10
Humidifier: Integrated in unit;set-at 1 of 7
CPAP Pressure: Was 9, now 7-10
CPAP Software: SleepyHead

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Sex: Undisclosed
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Post: #7
RE: New Open Mouth Sleeping and Pressure?
(06-06-2015 08:04 AM)OpalRose Wrote:  Now just so your are aware, if you have high leak rates, your AHI may not be correct. So the best thing to do is fix that issue first.
Good luck

What is considered a high leak rate?
06-06-2015 08:46 AM
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OpalRose Offline

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Posts: 3,163
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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #8
RE: New Open Mouth Sleeping and Pressure?
(06-06-2015 08:46 AM)Maudessen Wrote:  
(06-06-2015 08:04 AM)OpalRose Wrote:  Now just so your are aware, if you have high leak rates, your AHI may not be correct. So the best thing to do is fix that issue first.
Good luck

What is considered a high leak rate?


I'm not familiar with your machine, but on mine, it will tell me on the screen if I've had high leaks during the night. Also, on Sleepyhead reports it will give you that same information. There is an acceptable leak rate that your CPAP can handle, but if you experience a lot of leaks, either from mask or mouth breathing, the machine wil try to compensate for that, and possibly miss an apnea. So your AHI reading could be off.
If I'm wrong, I'm sure someone will correct me, or elaborate on the subject. Smile

OpalRose
06-06-2015 10:08 AM
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trish6hundred Offline

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Post: #9
RE: New Open Mouth Sleeping and Pressure?
Hi Maudessen,
You might try a chinstrap and see if that helps.

trish6hundred
06-06-2015 04:26 PM
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Sharon1225 Offline

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Post: #10
RE: New Open Mouth Sleeping and Pressure?
(06-06-2015 06:55 AM)OpalRose Wrote:  
(06-05-2015 09:47 PM)Maudessen Wrote:  Could there be a relationship between air pressure setting and starting to sleep open mouthed? Last night was my third night with the CPAP, and I woke up several times with a dry mouth! I have never slept with an open mouth...in fact, I grind my teeth when I sleep. Could this incident of starting to sleep with an open mouth have anything to do with the air pressure setting on my CPAP?


Hi Maudessen,
These are just my thoughts on this subject, a pressure of 9 may not bother one person while it could be a bit much for someone else.

Some of us are mouth breathers and don't realize it, but believe me if you are mouth breathing, the air will leave your mouth so dry that it will feel like someone stuffed your mouth with cotton. Unsure

I have learned to use the tongue to roof of mouth trick. I'm sure you have heard this before, but if you can master it, your mouth won't drop open. And if it does, the air won't come out. I have actually woke up in the middle of night with my mouth open and no air coming out, with my tongue still at the roof of my mouth, so I know it works. Or you can try a chin strap just to train yourself to keep mouth closed.

I have 2 machines. One is set on 9 and the other adjusts according to need. If I get a leak, the pressure increases. When I open my mouth and my husband s wakes me up to tell me to close my mouth, the pressure is strong enough to force my mouth open.
06-06-2015 06:58 PM
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