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Air blasting out of mouth
#1
Air blasting out of mouth
Hey guys so it was my first night with the machine last night. I ran 8-20cwp with EPR 2 for most of the night and found EPR 2 to be pretty comfortable. When I started to doze off and my tongue and jaw began to relax some air would come into my mouth and kind of blast out of there lol. I was using some mouth tape at the time, but I also have somnifix strips that I think might work better than the 3m micropore tape I have been using. Do you guys this it is an issue with my settings or an issue with the tape?
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#2
RE: Air blasting out of mouth
could be one or both. obviously higher pressure increases the probability of leaks. I get lip leaks at pressures above about 13 & I also get them in deeper sleep, especially if I end up on my back. I wear a soft cervical collar to reduce lip leaks. tape works for others.

scroll through your charts to see if there's a relationship between pressure & your leaks. if you don't need 20 cmw, back it down to find the sweet spot balancing leaks & events.
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#3
RE: Air blasting out of mouth
It may just be the tape wasn’t on good enough. Really push down on it. A soft cervical collar will prevent your jaw from dropping also. That has worked wonders for me. Awkward at first but now it’s awkward to not have it on when my head hits the pillow with my mask on.
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#4
RE: Air blasting out of mouth
Or a bit less intrusive would be a chin strap. I didn’t have good luck with those. My chin dropped anyway without it being super tight
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#5
RE: Air blasting out of mouth
I will look into the cervical collar! This was my first night and as soon as my SD card reader comes into the mail I will 10000% take a look at the graphs. Which collar do you guys recommend?
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#6
RE: Air blasting out of mouth
I've only ever used the 2 types stocked by the local walgreens. $20. lots more varieties online. many prefer a snore wedge as cooler in summer.
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#7
RE: Air blasting out of mouth
It's hard to know what's going on.  I had the very same first night experience, phoned my advisor first thing, and she said a chin strap or get used to taping.  I didn't fancy more gear around my head, so I opted for 3M's water-resistant NexCare white tape in the plastic spool that is about an inch across. 

I make sure my mouth is both clean, little-to-no oil, and that I am clean-shaven around my mouth.  I use enough of the tape to extend just 1/4" past the corners of my mouth on either side.  When I apply the tape, there's more of it below the lower lip than there is above my upper lip.  I dunno, that's what has worked reliably...for my facial geometry.  You'll have to fiddle.

When it's first in place, I use my finger tips to hard-press it firmly into place all across its surface.  Again, that has offered me the most reliable service of the tape.

I feel ethically bound to advise you that a time will come when you will awaken with a start and realize you can't breathe.  Nostril's stuffed, something else, a cat curled up over your mask....  You'll want to get that tape off in a hurry.  When you tear off a strip at night, fold over a small tab at the free end first.  That'll be a quick and handy grip for next morning or...earlier.
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#8
RE: Air blasting out of mouth
From the Mask Primer (see my signature)

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 OSCAR look at your Leak Rate graph where it is shaded (large leak/ LL), flat tops on this graph suggest mouth breathing. In 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, does not happen overnight, but it works for some. The tongue trick is where you want to be but it takes a lot of time and some people just cannot get it. Place the tongue on the roof of your mouth and breathe with your mouth shut. Breathing thru your nose, right? Now leaving the tongue where it is open your mouth, you should still be breathing thru your nose. Now that you have that down move your tongue, breathing thru your mouth right? OK, put your mask on, under pressure, and repeat the above. Expect to need to turn your machine off when you start to repeat. Add talking while under pressure, It takes a while to get any of this down. It took me months. The exercises above are to help you understand the positions that cause the issue and how to correct it. For all this to become automatic will take a while.
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 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. An Anti-Snoring collar or Sleep Collar, which has a small strap in back also works. (Dr. Dakota is popular)
It's 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 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, Knightsbridge Dual Chin Strap which pulls up instead of back. Search for it if you desire.
Ergonomic Pillow or CPAP Pillow, The purpose is to maintain a proper head and neck alignment while allowing for the mask to maintain 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.
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#9
RE: Air blasting out of mouth
A full face mask is the most effective way to address the problem.
Sleepster

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#10
RE: Air blasting out of mouth
Okay so like any generic one should do? I’m going to tape with somnifix tonight and see if I keep having that issue, and if I do then grab the cervical pillow. Thanks guys!
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