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[Treatment] nose breather with open mouth issues
#1
Smile 
nose breather with open mouth issues
Hello. I'm new to the Board, but been using CPAP for nearly 5 years.  I have what can't be a unique issue . . . I am a nose breather but have a problem with my mouth constantly opening during sleep.  I have used a chin strap for years but finding I have to keep tightening and tightening it over the years to keep my mouth closed (no sarcastic comments please Smile). I have tried moving to a full and hybrid mask but since I'm breathing almost exclusively through my nose (with an open mouth) I find my API's are consistently high and I'm waking up constantly.  Has anyone else experienced this issue?  Would love to know if some particular mask or technique would help as this is getting pretty old, and frustrating.  Thank you!
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#2
RE: nose breather with open mouth issues
I can commiserate. with a beard the best mask of the few I've tried has been nasal pillows. unfortunately I get lip leaks (chipmunk cheeks leading to slight parting of lips to allow air to escape) and dry mouth. when I was on apap it often occurred when pressure would top 13cmw. with asv, I can't associate most leaks with pressure. instead I seem to get them mostly during longer sessions when sleep is deeper (my sleep is very fragmented).

in any event, the only thing I've found so far that helps me is wearing a soft cervical collar. in addition to reducing event clusters, it keeps enough pressure on my jaw and chin to keep my mouth closed. jaw drop isn't really my problem though; just lip leak, and for some reason I can't explain it also significantly reduces my lip leaks.

I've been wearing the collar for more than 2 years. when leaks rise, I find I have to tighten the collar more than the commonly recommended loose fit (this I think because of the way my neck and chin are formed), expand the collar with a couple of tops cut from athletic socks, or replace the collar after it becomes soft and compressed with wear.

other people have luck with a chin strap (for some, the strap pulls lower jaw back which is counterproductive) or mouth taping (which can be effective but unnerving to some). in addition to inexpensive full collars there are more expensive smaller 'wedges' to experiment with. I haven't tried them yet but suspect they can be less uncomfortable than a full collar. a rolled up towel, pillow or anything you can find to prop up the jaw and chin, keeping the mouth and lips closed will help.
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#3
RE: nose breather with open mouth issues
Very good insights. Thank you. Had not considered, or even heard of, using a C-collar. I pretty much lay flat on my back with little movement so the collar may be a good option. I recently shaved my beard and mustache to accommodate a full/hybrid mask without leaks, but my aforementioned mouth issue is now the problem. Thanks again for the collar idea.
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#4
RE: nose breather with open mouth issues
ahi, leaks, dry mouth... everything gets worse for me on my back so I try to stay on one side or the other. some folks have physical reasons that dictate sleep position but if you can manage a non supine position you might see some positive results.

in case I wasn't very clear: if you want to try it, make sure it's a soft cervical collar. $20 at many pharmacies, esp the big box variety.
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