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some new problems with my nasal pillows
#1
Kind of an embarrassing description to follow, but I need to ask.

The SwiftFx pillows that were recommended to me at the titration had been absolutely great for the first week. I slept like a baby the first few nights with my machine. However now I'm starting to develop some complications which may just be general CPAP issues, but I'm not sure. I really want this mask to work for me. Here are my issues:

I noticed that lately I am having trouble holding in the air pressure. I'm not mouth-breathing. I just can't prevent the air from escaping from my (closed) lips. I have been awakening in the morning hours to find that my cheeks are inflated and the air is hissing out between my lips, sometimes making those sounds that a balloon makes when you let out the air. Once I realize this is happening, I tighten up my cheeks and put my tongue forward to fix it. This cycle repeats several times. I need conscious effort to keep my mouth airtight. If I'd been sleeping on my sides, I'm likely to find that I'd been drooling as well. (That's the embarrassing part).

Today my lower lip has been bleeding, but I don't see any reason for it to bleed. I don't have any sores or chapped lips, so the only thing I can attribute it to is the air leak. I'm just guessing.

Despite all this, the machine is reporting very little leakage, if any. I usually leak between 0-3 L/min, and last night was no exception. My AHI has also been < 1 on average. Last night was 0.3 with most being CA-type events.

Have others experienced this? Do I just need more CPAP "training" to maintain that muscle control throughout the night? And can I trust the machine's glowing report?
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#2
Is your jaw closed when you have mouth leaks? I am a side sleeper, and what I do is mold my pillow so that I jam my lower jaw against it so that it's somewhat supported while closed. There have been a couple of times that I've had the same situation (drool), but most of the time, this works for me. You might want to consider a chin strap to keep your mouth closed.

Having said that, if your mouth leak is small enough, you might not have to worry about it. Not all leaks have to be fixed, as long as the machine is able to maintain the required pressure and to be able to statistically determine inhale and exhale. On the other hand, mouth leaks seem to rank right behind leaks into the eyes for morning annoyance (dry mouth, etc).
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#3
As far as I know my jaw is closed, but could be a little lax I guess. I haven't been able to get the chin strap to sit properly. Followed the instructions, but as soon as I go to fasten the two ends of it it slips off the front of my head. Maybe my head is sloped differently, I don't know. I'm afraid to put the upper strap too far back on my head because then I'm putting too much horizontal force on my lower jaw... might end up with a wicked overbite.

I wouldn't mind some leak if it didn't cause me to wake up. My AHI might be under control, but my sleep quality isn't.

I'm perplexed about why this issue developed after a solid week of problem-free CPAP use.
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#4
(07-03-2013, 03:12 PM)Paptillian Wrote: As far as I know my jaw is closed, but could be a little lax I guess. I haven't been able to get the chin strap to sit properly. Followed the instructions, but as soon as I go to fasten the two ends of it it slips off the front of my head. Maybe my head is sloped differently, I don't know. I'm afraid to put the upper strap too far back on my head because then I'm putting too much horizontal force on my lower jaw... might end up with a wicked overbite.

I wouldn't mind some leak if it didn't cause me to wake up. My AHI might be under control, but my sleep quality isn't.

I'm perplexed about why this issue developed after a solid week of problem-free CPAP use.

I rest my strap as far back on the top of my head as possible. It stays there all night.
I hope your not trying to put your strap straight up and down, if so it will never stay on.

Hope this helps.

CoffeeSleep-well
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#5
(07-03-2013, 03:56 PM)Bompa Wrote: I hope your not trying to put your strap straight up and down, if so it will never stay on.

Bompa, sorry to make you do work but in order to play well with the forum rules I have to do it this way:

If you go to Supplier #1 in the list and search for "premium chinstrap," you should see some pictures of the Respironics chinstrap. That's the one I ordered with my machine. If you look at the third product photo, it explains that this particular strap is made to sit more vertical toward the front of the head. That helps alleviate problems from putting rearward pressure on the lower jaw.

The design so far hasn't worked out for me.

Maybe a different one is in order, but hopefully it's a last resort? I can see how a chinstrap helps keep the mouth closed but I don't understand how it keeps air from escaping between the lips. The air is, after all, pressurized. Dont-know I feel as though the 'ballooning' of my cheeks under pressure is something that I'll need to control somehow myself to keep the pressure directed down my airway and not going into my oral cavity.

I might consider a full face mask before a chinstrap unless... well unless it'll collect drool. That will definitely not help my sleep quality.

Has anyone solved this kind of problem without a chinstrap?
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#6
This person recommends taping the mouth shut Unsure That just sounds like a bad idea.

http://www.sleep-apnea-guide.com/questio...leaks.html

I do have a roll of duct tape somewhere...
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#7
I tried a product called "chin ups" that made it so I could keep my lips closed. They did a good job for that, even with the pressures I run. They are adhesive strips that stick on the front of your lower lip and the curl up onto your cheeks. You can still breath through your mouth, with effort, by raising your top lip. Google it to see for yourself. I would imagine you could cut that same shape out of adhesive tape and make your own. The problem is, they don't keep your cheeks from ballooning, which is something I found to be intollerable.

Let me know if you figure something out. I eventually gave up and accepted the full face mask.
Dont-know
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#8
Interesting product those "chin ups" strips. I might try something similar if I can't solve this with more humidification or getting the chin strap to work.

"We will either find a way or make one."
— Hannibal, Carthaginian General

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#9
You know, this problem may actually be a good sign. It means you are getting some deep sleep despite the waking up.

A chin strap may not help you if it is lip flapping vs mouth opening.

Sit up with it on during the day. Play with your mouth and tongue until you can duplicate the leak. Then figure out what you need to do to stop it. Practice turning this on and off until you can literally do it in your sleep. Just keep practicing and it will stick.

As for the tape, it is a bad idea in so many ways. I get particularly icked by it because I am allergic/hypersensitive to adhesives and the idea of tape on my mouth makes me, well, feel icked.
PaulaO2
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#10
(07-03-2013, 08:15 PM)PaulaO2 Wrote: You know, this problem may actually be a good sign. It means you are getting some deep sleep despite the waking up.

Hmm... I wouldn't have thought that at first but it makes sense now that you mention it.

Too bad Zeo went out of business. I could use an EEG to track my actual sleep. Not worth buying now, since there's no more tech support Sad

Quote:Sit up with it on during the day. Play with your mouth and tongue until you can duplicate the leak. Then figure out what you need to do to stop it. Practice turning this on and off until you can literally do it in your sleep. Just keep practicing and it will stick.

Brilliant!
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