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Waking up to mouth leaks
#1
I am 3 days into this nighttime torture.  DME tried to talk me out of p10 pillows incase my pressure was too high for comfort.  Pssh.  My pressure won't be that high, I said.  And maybe my pressure shouldn't be very high.  Help my sleep-deprived brain understand this.  
I awaken several times a night to the sound of air rushing from my mouth.  Is this why my pressure goes higher and higher during the night?  If I use a chin strap early in the night, maybe the pressure won't become high enough to be uncomfortable?  It seems like the higher the pressure, the more likely my mouth will open?  Why doesn't this phenomenon show up on SleepyHead as a leak?


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#2
Hello ZombieMom,
It looks like you are mouth breathing, but the leaks are not bad enough to have any affect on the machines ability to do it’s job.  Although mouth breathing air leaks can be annoying as it can wake you up several times.  You may want to consider a soft cervical collar to help keep the chin up.  Also try the Tongue Suck Technique.  This takes time and practice.

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.


Now the real problem is that you are probably on the wrong machine.  You are suffering from Central Sleep Apnea.  Most of your chart show Clear Airway events and a few Hypopneas.  I would bet you will need an ASV machine in time.

Did you have a sleep study?  Did it show Central Sleep Apnea?

The first thing I would do is turn the EPR setting to 1 or off.  This may help with the CA’s.
OpalRose
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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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#3
(08-12-2018, 08:51 AM)ZombieMom Wrote: I awaken several times a night to the sound of air rushing from my mouth.  Is this why my pressure goes higher and higher during the night?

You need to fix the leak problem, so it doesn't really matter if it's causing the pressure to rise.

Quote:If I use a chin strap early in the night, maybe the pressure won't become high enough to be uncomfortable?

Maybe. That would be a nice bonus, but regardless fixing the leak issue is something you need to do anyway

Quote:It seems like the higher the pressure, the more likely my mouth will open?

Yes, this seems likely to me. As you fall into deeper levels of sleep the muscles used to keep your airway open relax even more. This limits the amount of air flowing through your airway, but it also alters the shape of the air flow graph, which your CPAP machine is designed to detect. In response, your machine raises the pressure.

The back of your tongue touches the roof of yor mouth, forming a seal. Think of it as a valve that you can open and close. The pressure behind the valve is higher than the pressure in your mouth, and this difference in pressure can cause this valve to leak. A full face mask fixes this problem by raising the pressure in your mouth, making it equal to the pressure behind the valve. Thus, the valve is less likely to open, but the thing is, it doesn't matter if it opens because even if it does there is no leak. Because the pressure on each side of the valve is the same.

Quote:Why doesn't this phenomenon show up on SleepyHead as a leak?

It does. Look at the elevated leak rate graph around 4:00 am and then again just before 6:00 am. You have other shorter spikes throughout the night. Perhaps you wake up when you start mouth-leaking, close your mouth, and go back to sleep, sometimes immediately with no memory of it happening. This will ruin your night's sleep. Try a full face mask, just to see if you like it. You can aways switch back and forth between masks until you get settled. It's a process.
Sleepster
Apnea Board Moderator
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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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#4
Leaks arn't bad. Like OpalRose pointed out your probably on the wrong machine. I'd turn off the EPR and set the maximum pressure to 6cm. Hopefully this will help reduce the clear airway events and help with the leaks.
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