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Struggling with Nasal Mask
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JimZZZ Offline

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Posts: 370
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: ResMed H5i (not using)
CPAP Pressure: 9 - 14
CPAP Software: ResScan SleepyHead

Other Comments: CareFusion PureSom Ultra Chinstrap

Sex: Male
Location: Western North Carolina

Post: #1
Struggling with Nasal Mask
Pardon me for whining but I'm still torn between loving my new nasal Wisp but spending the night with air blowing out of my mouth. Strangely, my numbers are good. Apparently the autoset increases the pressure to offset the air loss through the mouth? Maybe I should just let it blow?

I've tried several chin straps and various objects tucked under my chin to no avail. I have learned that no matter how tightly I strap my jaw closed, my lips are still able to part enough to allow air to gush out.

Regrettably, I'm on the verge of going back to my Quattro FX full face mask because the open mouth experience is waking me up a lot.

My clinician told me to train myself to keep my tongue against the roof of my mouth. I trained all last night but sadly this necessitated my remaining awake.

My question is; have any of you been successful in training yourself to keep your lips sealed? Is there really a learning curve?
01-03-2014 10:36 AM
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robysue Online
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Advisory Members

Posts: 1,225
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #2
RE: Struggling with Nasal Mask
(01-03-2014 10:36 AM)JimZZZ Wrote:  Is there really a learning curve?
Yes, there's a learning curve. For some folks, it's a pretty steep learning curve. Others take to this crazy therapy a lot more easily.

Quote:My clinician told me to train myself to keep my tongue against the roof of my mouth. I trained all last night but sadly this necessitated my remaining awake.
I'd suggest doing the tongue training in the daytime. When you're awake and not talking, try to keep the tongue up against the roof of the mouth. When the tongue is up there, it effectively blocks the oral cavity off from the upper airway. So keeping your tongue up there will force you to breath through your nose.

If you have serious nasal congestion problems or other problems that prevent you from easily breathing through your nose during the daytime, the exercise of trying to keep the tongue on the roof of your mouth will be difficult. But if you are just a mouth breather by habit and you actually can breathe effectively through your nose, the exercise of keeping your tongue on the roof of you mouth will help train you to favor nasal breathing over mouth breathing.

Once you are routinely keeping your tongue on the roof of your mouth during the daytime, you may find that it stays there during most of the night.

It's also important to understand that with CPAP pressure, how easy it will be to keep the tongue on the roof of the mouth may depend a bit on the pressure setting itself as well as the ability of the tongue to resist relaxing and allowing itself to be pushed down off the roof of the mouth.

Also note: For some people when the tongue is properly placed on the roof of the mouth, it is possible to open the lips and have very little or no air blown through the mouth. It all depends on just how well your tongue can seal off the oral cavity from the upper airway.

Quote:Pardon me for whining but I'm still torn between loving my new nasal Wisp but spending the night with air blowing out of my mouth. Strangely, my numbers are good. Apparently the autoset increases the pressure to offset the air loss through the mouth? Maybe I should just let it blow?
What do the leak numbers look like? The machine can compensate for some loss of pressure through the mouth by increasing the air blown through the system. But once the unitentional leak becomes too large, the machine has trouble compensating. And once you're in large leak territory for an extended period of time, the reliability of the recorded data goes way down.

Your profile shows that you are using a Resmed S9. The Resmed only records the unintentional leaks, and Resmed says that the Large Leak definition is anything over 24 L/min. As long as your leak rate remains below 24 L/min, the machine can compensate for the unintentional leaks. And then the question becomes: How much are the non-large leaks disturbing your sleep.
01-03-2014 11:13 AM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: Struggling with Nasal Mask
(01-03-2014 10:36 AM)JimZZZ Wrote:  Strangely, my numbers are good. Apparently the autoset increases the pressure to offset the air loss through the mouth? Maybe I should just let it blow?
Whats are the numbers? did you checked pressure and leak graph to see whether leaks coincide with the pressure increase
Resmed say to keep unintentional leak at or below 24 L/m (the red line, Resscan leak graph), above the red a line for brief period is not a big deal but whenever you see few spikes at times and non other times, that might indicate some mouth breathing. Chinstrap is not going prevent you from opening your mouth, more like bicycle training wheels so you learn keeping mouth closed. Its often said, practice makes perfect, anything the mind conceive can be achieved
01-03-2014 12:02 PM
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JimZZZ Offline

Advisory Members

Posts: 370
Joined: Dec 2013

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: ResMed H5i (not using)
CPAP Pressure: 9 - 14
CPAP Software: ResScan SleepyHead

Other Comments: CareFusion PureSom Ultra Chinstrap

Sex: Male
Location: Western North Carolina

Post: #4
RE: Struggling with Nasal Mask
Thanks to everyone for the information and encouragement. Here are the Sleepyhead numbers from last night that I referred to as good.
Presssure: Avg 10.57 Max 13.42
Leaks: Avg 7.33 Max 14.40
AHI Obstuctive 0.13
The leaks come in short duration spikes and do coincide with peaks in pressure. Strangly, the detailed statistics show a max leak of 14.40 but the leak graph shows a few leaks spiking between 16 and 24. But it's all good and the AHI is great! The only problem is being awake too much. Yawn....
01-03-2014 01:25 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #5
RE: Struggling with Nasal Mask
my chin strap is helping me keep my mouth closed when I am asleep. I have used a chin strap for a month and then every few nights, I sleep without it to see if I am keeping my mouth closed enough without it. some people cannot use chin straps no matter which kind they use. I am fortunate that the first chin strap I used worked but I started out with what the sleep lab calls a deluxe chin strap. Maybe you can try another type/brand of chin strap to see if it works better for you.
01-03-2014 03:09 PM
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chezdan9 Offline

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Posts: 22
Joined: Dec 2013

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed h5i
CPAP Pressure: 12
CPAP Software: ResScan SleepyHead

Other Comments: diagnosed AHI = 88

Sex: Male
Location: Massachusetts, USA

Post: #6
RE: Struggling with Nasal Mask
Yeah, I hate the chin strap myself, and it seems redundant to have two apparatuses (apparati?) on my head at the same time. Just like me50, I take it off every couple of nights as a test and my AHI usually goes from a .9 with the strap up to about a 2.5 without. I guess those are still pretty good numbers, but I notice more central apneas without the strap. When I'm wearing it, my obstructives and centrals are nearly zeros with just a handful of hypopnea events.

Just after a month, my cheap-o headstrap is wearing thin (I only paid $5 for it). Can anyone recommend a strap that they find comfortable, durable, and sexy?? (haha)
(This post was last modified: 01-03-2014 03:39 PM by chezdan9.)
01-03-2014 03:39 PM
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PaytonA Offline
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Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #7
RE: Struggling with Nasal Mask
(01-03-2014 10:36 AM)JimZZZ Wrote:  Pardon me for whining but I'm still torn between loving my new nasal Wisp but spending the night with air blowing out of my mouth. Strangely, my numbers are good. Apparently the autoset increases the pressure to offset the air loss through the mouth? Maybe I should just let it blow?

I've tried several chin straps and various objects tucked under my chin to no avail. I have learned that no matter how tightly I strap my jaw closed, my lips are still able to part enough to allow air to gush out.

Regrettably, I'm on the verge of going back to my Quattro FX full face mask because the open mouth experience is waking me up a lot.

My clinician told me to train myself to keep my tongue against the roof of my mouth. I trained all last night but sadly this necessitated my remaining awake.

My question is; have any of you been successful in training yourself to keep your lips sealed? Is there really a learning curve?

I have been able to train myself to make the seal with my tongue. I did so by practicing what your clinician recommended every night just before going to bed/sleep.

PaytonA
01-03-2014 08:23 PM
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Moriarty Offline

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Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #8
RE: Struggling with Nasal Mask
It can be done... this is my experience...

http://www.apneaboard.com/forums/Thread-CPAP-Anon

Not only do I breathe through my nose at night - the CPAP seems to have opened up my nasal airways so I can now breathe through my nose through most of the day - except during physical exertion..

Cheers
(This post was last modified: 01-04-2014 05:44 AM by Moriarty.)
01-04-2014 05:41 AM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #9
RE: Struggling with Nasal Mask
(01-03-2014 03:39 PM)chezdan9 Wrote:  Can anyone recommend a strap that they find comfortable, durable, and sexy?? (haha)

I use a carefusion adjustable chin strap.

SIDE NOTE: Sexy is in the eyes of the beholder! The chin strap can be made sexy according to your desires! lol
01-04-2014 10:51 AM
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drgrimes Offline

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Posts: 235
Joined: Sep 2013

Machine: S9 Resmed Autoset
Mask Type: Nasal pillows
Mask Make & Model: Philips Dreamwear
Humidifier: resmed
CPAP Pressure: 5-15
CPAP Software: ResScan

Other Comments:

Sex: Male
Location: Texas

Post: #10
RE: Struggling with Nasal Mask
Jim, yes you can eventually train yourself. I'm not sure "training" is the right word, but I had the same problem. I use a chin pad to keep my mouth closed, but like you, I would start blubbering out the lips...yeah REAL sexy. I didn't sleep well for a while. When I got to the point where it was p!ssing me off I would take it off and finish the night without

Somehow after persevering, it magically started to happen. Once in a while I still blow air out my mouth, but for the most part it worked. I hate full face masks, so I was motivated to make the nasal rig work. It's so much easier to control leaks once you get situated, AND lots more comfortable.

Like others I hate have a lot of "stuff" covering my face so I ditched the chin straps for a chin pad.
01-04-2014 11:39 AM
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