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→Mouth Breathing
I’m going to call out 1 particular online vendor for 2 reasons. First they list masks by popularity within the mask type. This means that you can assume that the more popular masks work for more people. The second is that they offer “return insurance”, some free, some low cost, so that you can return a mask that does not work for you. That Vendor is '''[http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List Supplier #1]'''
Your DME is an excellent resource to try different masks. Use them for this purpose. Make an appointment for a mask fitting, under pressure, and preferably lying down in sleeping position.. If you are using a DME it is their job to help you use your PAP system for effective therapy. If the mask doesn’t fit or is extremely uncomfortable they are not doing their job.
== Mask Types ==
'''CAUTION'''
Several masks are coming with magnetic closures which are very convenient unless . . . .
From a sleeptech on another forum
I have been meaning to post about this for a while now. There have been a few masks come out over the last year or 2 with magnetic clips, such as the ResMed AiFit F20, The ResMed AirFit N20 and the Respironics DreamWear full face. The idea has its merits as it makes them much easier to use for people with reduced dexterity, however, it comes with a major caveat. If you have a pacemaker, defibrillator or other implanted device in your upper chest, neck or head area you must not use a mask with magnetic clips. The magnets in them can seriously interfere with the operation of your implanted device. There is a warning to this effect nestled deep in the instruction manual somewhere, but other than the the manufacturers do little to highlight this problem.
We had a patient who used one of these masks with a pacemaker and reported to us that, as every morning when he got up he felt really strange in the chest. we discovered that this was because, when he took off his mask, the <big>'''magnetic strap would pass near his pacemaker and reset it to 120 beats per minute'''.</big> Needless to say, we took that mask away from him and found an alternative. It can also interfere with hearing aids, cochlear implants and similar. If in doubt be cautious and do some research.
So be careful and spread the word.
I refuse to take the chance and get one. My wife is the one with a pacemaker
'''Nasal Pillows'''
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person
With SleepyHead OSCAR look at your Leak Rate graph where it is shaded (large leak/ LL), flat tops on this graph suggest mouth breathing.In SleepyHead OSCAR right click on the left header of the Leak Rate graph and click on Dotted Lines then select "Leak Rate Upper Threshold" to get a line across the graph for ResMed. Manually set the value for Philips Respironics. Severity depends on how much over this threshold and for how long it is in the Large Leak territory.
How to manage Mouth Breathing, not in any particular order.
'''Tongue Trick.''' Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.
'''Cervical Collar'''. A "soft" Cervical Collar(Releaf is popular). This helps support and align the neck and keeps the jaw/mouth from dropping. This is becoming a very popular option. Rarely used prior to mid 2016. Users are posting a high success rate with this device. When OA tends to occur in clusters at different times of night. It's an indication that an obstruction may have occured occurred when the chin tucks towards the chest. It's common, and the solution is either an ergonomic pillow or soft cervical collar that prevents the neck and head from being out of alignment and cutting off the airway, but they can be comfortable, prevent leaks and prevent an airway from closing up due to tucking your chin to chest and other issues. You are looking for a comfortable fit 2 An Anti-inches larger than the circumference of your neck and just tall enough to support the jaw when your head falls out of alignment (measure your neck from collarbone to jaw and subtract 1". It's Snoring collar, which has a very small investment that has worked very well for some people. More pressure may solve the obstruction, or it might go away with positional therapystrap in back (Dr.Dakota is popular)
It'''Chin Strap.''' A chin strap is to manage mouth leaks from s a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to '''''gently''''' keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note very small investment that your jaw is strong enough to open if it wants tohas worked very well for some people. There is one chinstrap that is notably different than others, More pressure may solve the Ultimate Chinstrapobstruction, Search for or it if you desiremight go away with positional therapy.
'''Chin Strap.''' A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw-dropping or opening either partially or wider. The chin strap is to '''''gently''''' keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to. There is one chinstrap that is notably different than others, the Ultimate Chinstrap, Search for it if you desire. '''Ergonomic Pillow''' or CPAP Pillow, The purpose being is to maintain a proper head and neck alignment while allowing for the mask maintaing maintaining the seal in multiple positions.
'''Mouth Guard''' The concept here is a closed mouth guard to keep the air from leaking out.
'''Taping'''. Definitely the most controversial. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.
'''FFM – Full Face Mask '''or''' Hybrid Mask'''. This is a very traditional solution and it is generally effective.
Dry mouth is a symptom mouth breathing that is uncomfortable. It can and does occur with some users of a Full Face Mask. * Many users use a product called ''Biotene'' to get relief from this symptom. == Congestion == How to deal with congestion while using CPAP. For both moderate and severe congestion try this, it works for me, 100% of the time. Using a nasal or pillow mask, use it for 5 minutes, maybe a little longer, force it. The pressure always clears my passages, it does need a bit of time, and when I start I cannot breath adequately thru my nose. Then it opens up. I used to feel that everyone needed a FFM (Full Face Mask) to handle congestion, now I don't, even for bad congestion. Just need to work thru it for a bit.
== Mask Leak Prevention ==
All PAP masks leak, it’s just a question of how much.
== Hose Management ==
Sometimes the CPAP hose just gets in the way, tugs on the mask, or get's wet. Well there is a solution for that.
My CPAP hose caused serious large leaks because it went from my CPAP (night stand) to the floor, to the bed, to my mask (happened to be a P10). The weight of the hose tugged my mask to the side causing large leaks. The solution was simply preventing my mask from supporting the weight of the hose.
Solutions:
* Clip attached to pillow and the CPAP hose
* A lanyard attached to the headboard or a "Command" hook on the wall at the head of the bed and looped around the CPAP hose.
Water in the CPAP hose, it will happen to most of us at some time.
Solutions:
* Don't overfill your humidifier. Overfilling will frequently blow water from the humidifier into the hose and eventually into your mask.
** In addition if you have your hose go up from your CPAP (see Hose Management above) This will be contained at your CPAP. If not it will seek the lowest level, the U at the floor your hose forms, or your face as it still seeks the low point.
* Rainout!!! The condensation of water in the CPAP hose. This is fixed by temperature and humidity control
** Heated Hose. This raises the temperature of the hose to prevent condensation. Typically these integrate with the CPAP and have both auto and manual modes. An additional benefit of improving users comfort.
** A Hose cozy. A cloth covering for the CPAP hose which insulates it preventing condensation. This will also reduce flow noise coming from the hose. CPAP machines have been known to pickup "Snores" coming from the CPAP hose rubbing over an edge, this will also reduce "Snores" of this origin. Keep in mind that "snores" can trigger a pressure increase on an Auto CPAP.
** Decreasing humidification of the humidifier.
** A room humidifier to increase the humidification in the room.
** Raising the room temperature to decrease the condensation in the CPAP hose.
** A combination of all of the above. The goal is your comfort. Some of the above may not be practical in your situation.
Note: One of the biggest risks to your equipment comes from the potential to pull your CPAP machine off of the bedside table or stand. This can result in severe damage from either the fall, or from water getting into the flow generator after the fall. Hose management systems are part of a safety system that can prevent these accidents.
== Understanding Leaks with SleepyHead ==
For this topic I'll reference RobySue's excellent tutorial on <br />
'''[[Beginner's_Guide_to_SleepyHead#Leaks|Leaks]] ''' If you want to understand leaksand how SleepyHead deals with them, read thiswiki article on '''[[Beginner's_Guide_to_SleepyHead#Leaks|Leaks]]'''.
== Speaking with a CPAP on ==
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