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dry mouth with nasal mask and mouth tape
#1
dry mouth with nasal mask and mouth tape
Hello all,

I started out my CPAP therapy using a ResMed Airtouch N20 but quickly learned that mouth leaks were a problem for me. I switched to an Airtouch F20 full face mask which I liked but the foam always split at the bridge of the nose after about 2 weeks. Because of this I was buying cushions out of pocket on Amazon. I learned about mouth taping from watching some youtube videos and thought I would go back to the Airtouch N20 and mouth tape. This combination works well to eliminate mouth leaks but when I wake up in the morning it is like someone put glue in my mouth. Everything is really dry and stuck together. I have had this happen for each of the 3 nights I have been doing this. The mouth tape is doing its job and still sealing in the morning. Is this normal or am I doing something wrong?

If anyone had any insight on this I would really appreciate it. Thanks
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#2
RE: dry mouth with nasal mask and mouth tape
I buy Xyliments off of Amazon:

https://www.amazon.com/dp/B07TSFS3XX?ref...prefix=xyl

These help a lot with dry mouth.  Lots of folks here like them.
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#3
RE: dry mouth with nasal mask and mouth tape
Thank You, I just ordered some. Thanks
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#4
RE: dry mouth with nasal mask and mouth tape
Hi.    I had the same weird experience last night -- an inexplicably and impossible dry mouth despite taping to lessen leaks.   

About a week ago, I had returned to the practice of taping my mouth to lessen leaks after a spell of using the headband-over-the-mouth approach.   Last night, I woke up in the middle of the night with a mouth that was inexplicably and impossibly dry.   Additionally, as I was drifting in and out of sleep, I could feel my mouth filling with air that would eventually force itself out through my taped-shut lips.   I'm guessing that this was the source of the extremely dry mouth.   (The air eventually escaped from my moth -- kind of bubbling out slowly, finding its way through the porous tape and out along the lipline where the tape didn't adhere tightly.)  My mouth was driest when I woke up on the middle of the night and not so dry when I woke up in the morning but I did wake up with a splitting headache that hasn't disappeared yet and it's almost 4 p.m.    The headache seems like a tip-off about oxygen deprivation during the night.  I don't have a pulse oximeter hooked up during the night so I can't be sure, but that would make a lot of sense.

What was different last night?  Nothing except that I dropped my EPR from 3 to 2.   (I'm trying to get better quality sleep by doing some experiments to see how get my CA events down without pushing up my OA events.)   Yes, CA's disappeared -- but OA's multipled, leaks went up, flow limits went up.

The previous several nights, I had used the same taping technique but had EPR set at 3 rather than 2.  I didn't have perfect sleep but I had much better sleep than I did last night and (a) no incredibly dry mouth and (b) no splitting headache in the a.m. and © lower flow limits (under .10) and lower leaking.

Take a look at the flow limits and leak rate data in last night's OSCAR data.    They are both much higher than they were when EPR was set at 3.  (The attachment with the higher AHI is last night with EPR 2; the lower AHI is an earlier night with EPR 3.) 

In a post http://www.apneaboard.com/forums/Thread-...ot-use-EPR , Gideon wrote:  "Increasing EPR improves the efficiency of your breathing with gains in both oxygen saturation and CO2 desats. Sounds good but the later can cause increased Central Apneas in suseptable individuals when the CO2 concentration in the blood is lowered to below the apneic threshold. Lowering EPR is one of the best options to avoid Central Apneas.

Increased EPR is the best treatment for flow limits, RERAs, hypopneas, UARS and snoring. On other words EPR acts like pressure support on a BiLevel, but limited to either 1,2, or 3 cmw."

So, have you changed your EPR recently?   It is clear that I need to keep mine at 3.   

Just a thought.

           
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#5
RE: dry mouth with nasal mask and mouth tape
I guess I have been away a while and methods change, but I am surprised to read so much about people taping their mouths shut. Years ago people on this forum would advise against mouth taping as a dangerous practice.  I guess the state of the practice and the adhesives have evolved to where people now consider it a safe and viable technique.

From my original titration study, first they tried a nasal mask, and within a half hour the tech switched me to a full face mask and told me I wouldn't be able to use a nasal mask because I was a mouth breather. So I got my CPAP machine with a full face mask.  It took a couple of months for me to get used to it to the point where I wouldn't be woken up in the middle of the night by the swoosh of a big air leak.  And along the way my numbers improved with the quality of my sleep. 

Over time I learned on this forum about two things that seemed to help others who were mouth breathers ...

(1) I think it was @OpalRose who described the technique of closing the mouth and pressing the tongue flat up into the roof of the mouth. Then suck just a bit to kind of seat it in place.  This has the effect of blocking the air flow so you don't get that little puffing out of the lips and cheeks that turns into a balloon before swoosh! big air leak.  

(2) I also read about people having some success with headbands/chin straps, and so I got one of those inexpensive Ruby chin straps to try out.

Over the next two months I was able to virtually eliminate air leaks altogether while still using the full face mask. I decided that if full face mask was as good as it gets for me, then I would be happy with it.  I was reasonably comfortable and I was getting enough rest to feel like my old self. 

Then one day I wondered if maybe I could hope to switch from full face mask to nasal pillows.  They were pretty novel at the time and one of the vendors was offering them on sale with free 'insurance' that would allow me to return the P10 mask if it didn't work out.  With nothing to lose and maybe something to gain I gave it a shot.

To my delight I found that the tongue seal technique coupled with the chin strap held up with the pillows. No air leaks by mouth, and once I found the right size pillows there were no air leaks from the mask.  Wow, so much more comfortable!  Immediate pressure drop of almost six points from 14.5 down to about 9.   The success of this little experiment with P10 pillows was a bluebird, and I have never gone back to the full face mask.

To maintain this new practice without air leaks, it was necessary to continue to consciously press the tongue flat into the roof of my mouth just behind the teeth. Once you position it you kind of suck just a bit which kind of seals it in place, and it's quite easy to maintain.  After a while it became second nature.  It's not as much effort as it might seem and not at all uncomfortable. No teeth clenching required.  Once you find the sweet spot, the tongue naturally seals the mouth preventing the air pressure from pushing forward from the throat. Anymore I rarely even think about it.

About 8 months into this my chin strap broke unexpectedly, and while I waited for the new one to arrive I tried a few nights without a chin strap. And ... no air leaks.  And so I have been a couple of years or so now using just the P10 mask with nasal pillows.

Hard to believe that a gaping mouth breather like me could train myself over time to graduate from leaky full face mask to airtight nasal pillows.  But I know it is doable with a little practice.  And the benefits are much lighter weight mask, much lower air pressure, no more wake ups to adjust the mask, and fewer lines on my face in the morning.

We all find our own way to what works best.   That said, I'm here to tell you that it is possible to learn how to stop or reduce mouth breathing to and perhaps even migrate to nasal mask or pillows with the benefits described above.  

I will say that as a side sleeper it is a bit easier to do, and when I happen to sleep on my back I can still wake up blowing air out of my mouth. I don't roll around a lot, so if I go to sleep on my side I'm usually good for the night.   For me it's a 95-98% solution and I consider it a significant improvement even from full face mask with no air leaks.

Hope you find this encouraging and maybe pick up some ideas to try on your own.  Each plateau you achieve is a new baseline for your next experiment in continuous improvement.  If you get the mouth tape working for you, enjoy it for a while, but then think about the next step to see if you could improve and find a new baseline of comfort and effectiveness in your therapy. 

best wishes, 

Saldus Miegas
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#6
RE: dry mouth with nasal mask and mouth tape
I have an appointment with my sleep doctor on the 20th so I haven't changed any of my settings.

Anyway I haven't had the dry mouth problem with taping since I first posted. I wonder if it just my body's way of adjusting to the mouth tape? Smile
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#7
RE: dry mouth with nasal mask and mouth tape
if you are opening your mouth while using a mouth tape I think you will feel a jaw pain when you wake up. I switched to full face mask after experiencing that.
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#8
RE: dry mouth with nasal mask and mouth tape
Saldus Miegas

Thank you for that very encouraging post.

Amazing story. I have chosen to recently change from my FFM F30i to P30i nasal mask again.

I have briefly tried the tongue trick in the past with little success and abandoned that, I am now using (partial) mouth taping.

However, I now have renewed confidence after your own story that I can succeed. Applying the tongue trick now as I type this! I think you are right, the brain and connecting pathways are plastic. I will stick with this for now.


Thank you again!
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