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So, you nose breathers, either with assisting devices or not, how good is good?
#1
So, you nose breathers, either with assisting devices or not, how good is good?
While I've been moderately successful with both a cervical collar and the "dual strap chin strap" in controlling mouth leaks, I still have a few episodes per night of "large leaks," and maybe half of those are awakenings with the dry mouth thing.  With the FFM (F30), I never have awakening leaks (and hardly any leaks at all), but it's at the cost of increased events (nearly double, but still only puts me into the 1's) and some awakenings due to those, as well as the FFM morning "face" and the general confinement of face using it.

Can't help but be curious, though, when it comes to the mouth leaks.  Whether you use assistance or not, just how good is your leak rate while using a nasal/nasal pillow mask?
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#2
RE: So, you nose breathers, either with assisting devices or not, how good is good?
My leak rate got better when I learned to sleep with my mouth closed.  I concentrated during the day on keeping my tongue against the roof of my mouth until it became natural. Per SleepyHead, my average leak rate over the last 30 days is 2.97; 90% leak rate 10.0; percent of time above leak rate threshold .04%. I still have the occasional lip flutter, but am fine with my nasal pillows.
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#3
RE: So, you nose breathers, either with assisting devices or not, how good is good?
I use the N20, and that has been the extent of my experience to date.  I also open my jaw and air will escape.  That happened starting about six minutes into my very first PAP evening.  I haven't tried a collar, but would do so if I had to.  So far, taping works for me.  My annual AHI average is 0.5.  Leaks are minor to moderate at worst.
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#4
RE: So, you nose breathers, either with assisting devices or not, how good is good?
(11-07-2019, 01:04 PM)edfreeman Wrote: With the FFM (F30), I never have awakening leaks (and hardly any leaks at all), but it's at the cost of increased events (nearly double, but still only puts me into the 1's) and some awakenings due to those, as well as the FFM morning "face" and the general confinement of face using it.

Maybe try a different FFM? We are creatures who adapt well so we can get used to things that seem a bother. When you're mouth-leaking because you're wearing a nasal mask you're compromising your therapy.

Having a AHI in the 1's is awesome! It will likely come down a bit more as you adapt to a FFM, but even if you cut it in half that's not clinically significant.

The problem with taping IMHO is that you don't have an anti-asphyxiation valve.
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#5
RE: So, you nose breathers, either with assisting devices or not, how good is good?
Yeah, I hadn't mentioned taping, but I tried it in several forms, across the mouth, the lip things ("Somnifix?"), and the ones around the lower lip that use the jaw skin to hold up the chin. The latter made a rash on the skin, and the other 2 I either chipmonked during the night (very awakening) or would parse the lips and blow through the tape, also awakening. Taught me that the mouth breathing can be a lips thing or a jaw thing or both. With my lips taped, the jaw would still drop a bit and end whatever seal I had with the tongue, no matter what.

The F30 is the most comfortable FFM I've tried, but I have tried others. My nose bridge was irritated by the others in addition to the general FFM stiff of strap and mask seal marks on the face. The confinement comment was more a contrast with the "freedom" of the nasal masks.

Anyhow, thanks for the input so far.
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#6
RE: So, you nose breathers, either with assisting devices or not, how good is good?
My leak rates are so low, almost non existent with using a P10 nasal pillow mask.  

I also learned early on in my treatment to practice the tongue suck method to keep air from leaking from my mouth, should my jaw fall open at night.  

It’s second nature to me now.  My tongue knows what to do and I rarely mouth breath.  So rare, that I would wake up immediately should that happen.

Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front 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.
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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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#7
RE: So, you nose breathers, either with assisting devices or not, how good is good?
(11-07-2019, 05:15 PM)... Wrote: The problem with taping IMHO is that you don't have an anti-asphyxiation valve.

I have awakened two or three times at/near my normal awakening time to learn that my machine turned off during power outages.  This was prior to purchasing a Medistrom backup.  I wasn't getting PAP through my N20, but still managed to sleep okay and not suffocate.

Now, there was another horrible incident where both nasal passages swelled shut at about the same time.  I awakened in a panic, but had yet to learn to make that small folded-over EZ tab at one end of the tape.  I clawed at my face for about 6 seconds before I lifted the end of the tape.  THAT was a lesson!
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#8
RE: So, you nose breathers, either with assisting devices or not, how good is good?
I tried collars and everything but did not like the add ons over time I gradually learnt to keep my mouth shut, I was never at the red frowny face stage (large leaks for 30% of the night or more), but I did start at large leaks for 20% of the night, after the first few nights it dropped to 10% a night, tried a FFM leaks were good but the comfort and noise was a lot less with the Resmed P10. With about a month generally my leaks were less than 10% of time over the large leak threshold and became a non issue. Now a year in my large leaks due to mouth opening are less than 1% of the night.
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#9
RE: So, you nose breathers, either with assisting devices or not, how good is good?
I love my FFM (F30).   The design makes it easier for my mouth not to fly open during the night.   I no longer need to tape or use a chin strap.   The cushion covers my mouth in a way that makes it difficult to open my mouth.   I love the F30.   My numbers are great and I sleep well.   
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#10
RE: So, you nose breathers, either with assisting devices or not, how good is good?
(11-07-2019, 09:33 PM)OpalRose Wrote: My leak rates are so low, almost non existent with using a P10 nasal pillow mask.  

I also learned early on in my treatment to practice the tongue suck method to keep air from leaking from my mouth, should my jaw fall open at night.  

It’s second nature to me now.  My tongue knows what to do and I rarely mouth breath.  So rare, that I would wake up immediately should that happen.

Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front 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.

Yeah, I can do that, just haven’t been very successful while unconscious.  A few % of large leak wouldn’t be so bad, but when the jaw drops for multi-minutes, mouth glued dry-shut from the full flow air escaping, it is a very disruptive awakening.

Collar helps, that “dual band” strap helps, trade off of which discomfort will it be tonight?  

The information from everyone was great, thanks for that.  And Opel, you and others are my nose breathing idols with no/very rare leakage.
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