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please help, large leckages, how to solve this
#1
please help, large leckages, how to solve this
how to avoid air coming out of my mouth every night some times (blows out of my mouth)?
 
I am using cpap now since about 9 month and the results are very good. My AHI is about 1-3 (instead of 38 before CPAP)  and my only problem is, that every night i have some large leckages. I tried many different masks (full-face, nose and pillows), with full face mask it is better (but still exists), but i prefer nose and pillows very much. But even if i tape nearly daily my whole mouth, I have some large lecks. (less then without taping, but still existing)
 
I am not a mouth breather at all, but somehow during the night - I think I get to much pressure in my mouth and then air flows out of the mouth. (like a blower or hairdryer). My wife says i even do not breath in this time, seems like the air coming through the nose directly to the mouth (perhaps without going to the lung). And there are mostly no other events (apneas or something), also it mostly happens when the pressure is normal (not when going up..)
 
I have consulted my doctor several times, but he says everything should be o.k with my nose and throat (exept a minor nasal septum curvature)
I also tried chin straps, servical collar, bite guard, but nothing helps really. Also i tried to put my tongue on the roof of my mouth, works perfect-not possilbe to breath trough the mouth any more when i am not sleeping - but sometimes during the night large leckages happens again.
 
I have to say, that i am a side sleeper and turn around often..
Mostly i do not realise the leckages at night, sometimes I feel it, that it comes like bubbles coming into my mouth...
 
I really think something is not normal with me...
If somebody can advise some help, it would be very welome..
BR Christian
https://imgur.com/a/KxUrM
https://imgur.com/a/ZsH9P
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#2
RE: please help, large leckages, how to solve this
You will have to try different full face masks until you find one that works for you. I have the same problems as you and found the Simplus full face mask to work for me, but you will have to find something that works for you.

When you are mouth-leaking like that the leaking means that there isn't sufficient pressure in your airway to keep it open, so it collapses just as if you were sleeping with no CPAP machine. And when that happens the machine is not capable of determining whether or not your airway has collapsed, so it can't report an accurate AHI. The data is meaningless.

If you insist on staying with the nasal mask you can try a soft cervical collar to keep your chin from dropping. That may work. You may have to also use the chin strap along with the collar.
Sleepster

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#3
RE: please help, large leckages, how to solve this
Occaisonally I used to get the same problem. Nowadays, I use a chin strap along with taping. You need to make sure to wash around your mouth area and face well with soap and dry before using the tape. Also use a long enough length (much longer than your mouth) and fold one end over to create a tab so that the tape is easy to take off afterwards. I use medical 3m cloth tape. Ever since I have been using these methods I have not gotten any mouth leaks.
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#4
RE: please help, large leckages, how to solve this
I had (past tense) the same problem.  The mouth leak would wake me up and I was unable to stop it without turning off the machine and restarting.  Unlike Sleepster, my pressure was high enough (18-20) but I had to interrupt the air circuit then go back to sleep.  Eventually persistence paid off.  At the time I alternated between a nasal mask (Activia) and a FFM.
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#5
RE: please help, large leckages, how to solve this
(01-19-2018, 01:18 PM)bonjour Wrote: I had (past tense) the same problem.  The mouth leak would wake me up and I was unable to stop it without turning off the machine and restarting.  Unlike Sleepster, my pressure was high enough (18-20) but I had to interrupt the air circuit then go back to sleep.  Eventually persistence paid off.  At the time I alternated between a nasal mask (Activia) and a FFM.

Do you still tape Bonjour? I think I recall you used to...  Did you manage to wean yourself off of that eventually?  I'm wondering if I will be able to in time also.
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#6
RE: please help, large leckages, how to solve this
I had severe problems with leaks using a nasal pillow. They kept me awake all night. They also make the machine underreport the AHI (I got fewer events during leaks).

Yes, I had the "bubbles in the mouth" problem. It made me anxious because I knew a big leak was coming.

I finally switched to an FFM. I should have switched a long time before. I tried several different FFM's. As I started out, I did have some leakage, but I got better at dealing with leaks.


I did try an experiment to get my leaks under control..... I assumed I wasn't getting treatment because of all the leaks. So I lowered the pressure quite low (maybe to 8). My goal was to control the leaks. I kept at that pressure for however many days it took until the leaks were fractional. Then I increased that pressure by 1 cm. I repeated the process over a period of about 2 weeks. Every time I could manage the leak for a couple of days, I increased the pressure.

Soon, I was at my prescribed pressure, minimal leaks, a mask that fit, and a whole lot more confidence about the whole process. This experiment helped my treatment and it helped my attitude.

Also, you can use Pad-a-cheek for mask liners that cut down on mask leaks.
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#7
RE: please help, large leckages, how to solve this
(01-19-2018, 06:00 PM)Marillion Wrote:
(01-19-2018, 01:18 PM)bonjour Wrote: I had (past tense) the same problem.  The mouth leak would wake me up and I was unable to stop it without turning off the machine and restarting.  Unlike Sleepster, my pressure was high enough (18-20) but I had to interrupt the air circuit then go back to sleep.  Eventually persistence paid off.  At the time I alternated between a nasal mask (Activia) and a FFM.

Do you still tape Bonjour? I think I recall you used to...  Did you manage to wean yourself off of that eventually?  I'm wondering if I will be able to in time also.

I am no longer using tape, though for a while I needed it every night.   Oddly tapping did not prevent me from occasionally blowing out like the OP.
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#8
RE: please help, large leckages, how to solve this
Dear all,
thank you very much for your replies and tipps....although I have already tried almost all, it is very good to see, that others have the same problems... Thanks

@bonjour: seems your problem was very simular, how could you stop taping? What did you do instead? I prefer the nose masks very much, but on the other side i want to avoid taping. I get dry mouth most of the time, even with taping and I do taping very tight. I always thought, that if i tape for a long time, my body gets used to it and lecks does not accur any more. If no other way, I have to continue taping, if I am not able to use FF-Masks (I do not feel well with FF-masks and awake always with all FF-masks, because of mask lecks, which does not accur with most nose-masks.) But I also will get soon a Simplus FF-mask, which i did not try till today. (tried Airfit and Airtouch F20, Mirage quattro, Amara View...)Hopefully it will be better with this mask, but I do not really believe in this..
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#9
RE: please help, large leckages, how to solve this
(01-20-2018, 03:52 AM)christian4870 Wrote: Dear all,
thank you very much for your replies and tipps....although I have already tried almost all, it is very good to see, that others have the same problems... Thanks

@bonjour: seems your problem was very simular, how could you stop taping? What did you do instead? I prefer the nose masks very much, but on the other side i want to avoid taping. I get dry mouth most of the time, even with taping and I do taping very tight. I always thought, that if i tape for a long time, my body gets used to it and lecks does not accur any more. If no other way, I have to continue taping, if I am not able to use FF-Masks (I do not feel well with FF-masks and awake always with all FF-masks, because of mask lecks, which does not accur with most nose-masks.) But I also will get soon a Simplus FF-mask, which i did not try till today. (tried Airfit and Airtouch F20, Mirage quattro, Amara View...)Hopefully it will be better with this mask, but I do not really believe in this..

Try a loose fitting soft cervical collar. On Taping, I use a tape from which has a light hold ( I MUST be able to open my mouth ) but It started by the tape getting damp and just coming off and me just not re applying the tape.  I just used it less and less over time.
The tongue on the roof of the mouth works for a lot of people and is what I do out of habit now,
The concept to remember is not to keep the mouth shut, but just to keep the air from escaping thru the mouth.  

Hope that helps

Fred
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#10
RE: please help, large leckages, how to solve this
(01-20-2018, 10:57 AM)bonjour Wrote: Try a loose fitting soft cervical collar.
I do have a soft cervial collar, but I do not think that this is "loose fitting" and I also do not understand what "loose fitting" means.
The collar should avoid that the chin is not droping, correct? So if it is "loose" it is easy for the chin to drop down? Or I do not understand the meaning correct? (Sorry, english is not my mother tongue).
me and my soft servical collar:
https://imgur.com/a/vqGM9
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