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Training Yourself to stop Mouth Breathing?
#21
We are all different, and have had different experiences.

I have wasted a lot of time and hundreds of dollars trying to get nasal pillows or a nasal mask to work for me. I really thought I could get them to work because of the H5i. Even though I always had been a mouth breather, the humidifier helps my sinuses so much I always wake up with my mouth closed using my ffm.

A chin strap may keep my chin up, but it does not keep me from waking up to a sound reminiscent of a whoopie cushion and my lips flapping in the wind.

I've tried a chin strap in conjunction with "Chin-ups" and have found it very hard to stay asleep when my cheeks puff out like I'm playing a trumpet.

I've tried all of the tongue placement tricks and they work great...until I fall asleep. I seem to loose conscious muscle control when I fall asleep. The one that I found worked the best (for about an hour after falling asleep) is to close my mouth and slide my tongue forward against the the back of my teeth and flat against the top and bottom of my mouth, then (with mouth closed) try to suck in a little - creating some vacuum to hold the tongue in place and mouth closed.

With the humidifier my sinuses are not the problem - the pressure is the problem. Whenever I would waste money on some new product (chin-ups, new chin strap design etc.) that supposedly held the promise of making it so I wouldn't have to shave every night (yes, that would be the only benefit for me) I would go to sleep with such hope, such optimism; only to wake up with all hell breaking loose when the pressure hit about 19cm (about an hour after going to sleep).

I think everyone aught to give each type of mask a try, but avoid getting hung up on trying to make a type of mask work that just isn't as suited to you as another kind.



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#22
Good points, JG, I think your situation is a bit different. You have very high pressures plus you've already tried nasal masks extensively with no success.

That's not really what I'm concerned about - for you and folks like you, yes, FFMs can be a very viable solution and sometimes the only solution.

What concerns me is more of the lower pressure newbies who are given FFMs right from the start, when there is no prior history of nasal issues. I think DMEs, Docs & RTs who hand out FFMs willy-nilly to folks who don't really need one is a huge mistake and can lead to various FFM complications that could be avoided by simply trying a nasal mask first. Those patients have no opportunity to even try a nasal mask when they start off, because they are being pigeon-holed into a FFM by their provider.

That's really my point. I do realize that some folks are better served by using FFMs (due to issues such as you, Ren and others have shared).

The real issue is "what kind of mask should be given to the average new CPAP user-- Nasal mask or FFM?" I contend that (barring any nasal or other obvious issues), the majority of beginning CPAP users will be better served by a nasal mask or nasal pillows system as a starting point.

Starting off with a FFM first is to use generally less effective technology before giving the more effective technology (nasal masks) a chance to work.

Again, I'm talking as a general rule here - I know there are always exceptions to this rule.

Smile

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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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#23
Much to the sleep lab where I had both of my sleep studies credit, they started me out on a nasal mask, "The "respironics" "Comfort Jell Classic." The person who came out from the DME I'm with, told me that they were easier to work with. Right now, I'm not using a chinstrap but every once in a while I have to go back to using it to get my brain to connect, (Ha-Ha-Ha.) I have a love-hate with the chinstrap because they can get too bunchy on my face,, thus making me a bit clostraphobic, I have to psych myself up to use it, but I manage.
trish6hundred
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#24
(01-23-2013, 01:35 PM)SuperSleeper Wrote: Starting off with a FFM first is to use generally less effective technology before giving the more effective technology (nasal masks) a chance to work.


Well SS, I guess next you're going to try to get me to believe that DMEs give out PAP machines that aren't capable of measuring sleep quality data and can't adjust pressures to meet the changing needs of the user!


Laugh-a-lot



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#25
(01-23-2013, 01:10 AM)SuperSleeper Wrote: I realize that there are true mouth-breathers out there that have major issues with nasal passages, but that's not who I'm talking about. I'm talking about folks who have no serious nasal passage issues, but mistakenly think they're a "mouth-breather" simply because the untreated OSA gave them a tendency towards mouth-breathing before being diagnosed.

I would take your point and make it a bit stronger. Even folks who have nasal passage issues such as congestion or a deviated septum and so are true mouth-breathers may still be able to wear a nasal mask or nasal pillows.

There are two reasons for this. When we are lying in bed relaxed our breathing rate declines. We don't need to breathe in as much air because we are not exerting any effort. Therefore only a small amount of air needs to pass through the nose. When we are awake and moving around we need more air and if we can't get enough we may then have to mouth-breathe.

Secondly, the positive pressure from the CPAP machine forces the air through the nasal passages. This opens up the passages and makes it easier to breathe through the nose.

I used to have a deviated septum and serious nasal congestion issues. When I laid down the increased blood pressure to my head would cause my very narrow nasal passages to collapse and I would immediately begin to mouth-breathe. I has sinus surgery and when the packing came out two days later this problem went away and never came back. This was long before CPAP therapy so I don't know if any of it is relevant, but if you're a mouth-breather and are a candidate for endoscopic sinus surgery I say you should go for it. I'm really glad I did.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#26
(01-23-2013, 01:35 PM)SuperSleeper Wrote: I think DMEs, Docs & RTs who hand out FFMs willy-nilly to folks who don't really need one is a huge mistake and can lead to various FFM complications that could be avoided by simply trying a nasal mask first.

SS,

I understand your point but, just as many people have problems trying to acclimate to a nasal interface too, there's always potential for complications with any type of mask, not the least of which is trying to keep their mouth closed, which is critical to receiving ANY therapy at all.

I believe some RT's are simply trying to get a newbie accustomed to just using CPAP "regularly" without introducing them to the potential mouth leaking issues inherent with nasal-only interfaces.

If they then determine they don't need a FFM or that they do need one, then at least they're engaging with their therapy and are more likely to continue being a hosehead.Grin

It's funny (or sad), I've met 3 people in the last year that all have CPAP's but will not use it, two had nasal cushions and one had a nasal mask, all 3 of them refused to use their CPAP after less than a month of use, 1 guy only tried it for a week. Regardless of my success using CPAP, nothing I could say or do could convince them to try it again. My cousin is still the only other person I actually know that has CPAP and is 100% compliant like me. BTW, she has a nasal mask but has never been a mouth-breather.


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#27
(01-24-2013, 12:51 AM)Sleepster Wrote: I would take your point and make it a bit stronger. Even folks who have nasal passage issues such as congestion or a deviated septum and so are true mouth-breathers may still be able to wear a nasal mask or nasal pillows.

But there's still other obstacles that would prevent a nasal-only interface from working for some folks. I had forgotten about the 3 gigantic polyps I had removed from my sinus cavities back in 1990, back then I had about 5% airflow through my right nostril and about 60% airflow through my left nostril, having them removed made a huge difference but if I had been on CPAP back then (I wish) I don't believe it could have forced enough air into my nose to be able to adequately breathe through a nasal mask.

Then there's the folks with enlarged turbinates, I had a friend that could hardly breathe at all through his nose, there's no way CPAP is strong enough to blow enough air through his nose to breathe.

Now, thanks to a high humidity level without rainout, I breathe almost exclusively through my nose day and night but I still wake-up about half of the time with a semi-dry tongue or while drooling into my mask, if that's as bad as it gets - I'll take it! :grin:

Ren
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#28
What an interesting thread....

I am a bit surprised at the strength of feeling that seems to come across - it almost seems like the Ford <> GM-H debate amongst Australian motorists..

My Experience is here: http://www.apneaboard.com/forums/Thread-CPAP-Anon

I have found the change from the Hybrid mask to the Pilairo to be quite liberating. It is much lighter and quicker to disassemble and clean.

Cheers

David
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#29
When I returned to the sleep lab for the titration(?), the tech handled me the nasal mask while asking me if I had congestion and/or deviated septum issues. I do have them. Right away I cringed at the thought of using the nasal mask (the tech didn't seem to high on it)..tried if for about one minute and said it woundn't work. They put me on a FF mask and proceded with the sleep test. As I recall, the tech had said that the nasal device was something that was a very new design (sorry I don't remember the name of it) and they were learning about it in class. That was early fall last year.

I've been using the FF mask since. After reading a lot of the posts, there does seem to be talk that the nasal mask is the superior route to take. As for myself, I use the FF mask because the congestion I get in one or both nostrils. Sometimes both passages are clear and I'm not mouth breathing. I do try to breath through my nose whenever possible and must be doing it since I'm not waking up with a dry throat all that often.

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#30
Most people find nasal masks more comfortable and less prone to leaking. Of course, every individual's experience can be different so if a full face mask works for you it doesn't really matter if it doesn't work for other people.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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