Newbie who is a bit bewildered and in need of advice.

[tpone]

I have recently been diagnosed with severe sleep apnea and am undergoing a trial with a CPAP machine ( Lowenstein).   I have been given some masks to try nasal pillow , nasal regular  and full face mask.

I prefer Nasal mask but always wake up with air being expelled through my mouth - even when closed ( through the lips.) I briefly tried a chin strapped but felt my head was in a vice . In desperation at 3AM I found some medical tape in the first aid box  and used some over my mouth.  I still woke with air being pushed through my lips and escaping around the tape.

For some nights I have tried a full face mask. However, when the pressure ramps up to 15 ( from 8) , air escapes around the mask edges.  Even when very tight I will get l sleep interrupting leaks with any facial movement.  I asked the provider for a larger mask but they gave me the same one back with the expectation to persevere.   They also resisted my earlier requests to increase the start up pressure from 4 to 8 because I could not draw enough air, but did bump it up after a few days. 

My thoughts are that I should discontinue with this provider and take more control over the process. I figure that there  has to be a lot more options out there, however subtle the differences may be.   I would welcome anyones thoughts about going down that path  as well as any suggestions for full face masks that cover the mouth better than some of the postage stamp sized ones.

[staceyburke]

If you can get a Resmed airsense  autoset or even better is a Resmed Aircurve Vauto.  That is the gold standard in regular cpap machines.  It is the most used machine here and you will get more suggestions with one of the two.  And a full mask if harder to get a good seal with the smaller masks.  Facial is also a reason many people do not use a FF mask

[tpone]

Am I correct in assuming that the Resmed Aircurve Vauto being a bi-level machine  will leak less because of the pressure reduction when exhaling?

[FLcracker]

I've been dealing with the same problem of mouth leakage with Mizz C...I have it slowed down a lot since a change in her settings to 7start and and lowered her 15 max, to 13max, and EPR set at 2. Lowering her top pressure level stopped a lot of the major leaks and dropped her AHI from over 5 back to 2-3's. I also just ordered her a real silk pillow case this morning from Amazon for around $20.00 (queen size) delivered tomorrow. The silk apparently will help the pillows and harness from 'dragging' on a standard pillow case, when moving around and causing leaks during her sleep cycle. Now if I can just get her to try a soft cervical collar, I hope I can soon get her back into the 0's and 1's.
VBW, FLc

[Dormeo]

Here are some ideas about mouth leaks.

1. Tongue position. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar

3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

4. Tape. Some people (including me) rely on tape to keep the lips from opening. (I can't rely entirely on the tongue thing, though it definitely helps.) When the lips open, all too often that eventually leads to a noisy and disruptive mouth leak. To see whether tape would be feasible for you, I recommend that you invest in a box of Somnifix strips. They are very gentle on the skin but hold very well. Be sure to curl your lips inward per instructions before placing the strip. If these work for you, then you can experiment with lower-cost options.

Note about tape: Some people avoid it, for two reasons. (1) If you suddenly need to vomit in the night, the tape could lead to your aspirating some vomitus, which would be bad. However, you can sacrifice one strip to see for yourself how well you can pull you mouth open in an emergency using only your jaw muscles. (2) If there is a power failure and your machine goes off while you're sleeping, you won't be able to do the natural thing and open your mouth to breathe. As for that, out of an abundance of caution, I've put a circuit alarm in a plug on the same circuit as my machine. It wakes me up immediately if I lose power to the machine.

[Deborah K.]

Many of us who tape our mouths use 2-inch wide, good-quality tape cut to 4 to 5-1/2 inches long. Cover Roll Stretch Tape and Hypafix are good tapes. I like kinesiology tape better because it is more stretchy and adheres better to facial contours.

[tpone]

Thanks for the response - I'm on a trial with the sleep specialist company so I have asked them to reduce the  maximum air pressure - fingers crossed!

---

I will  try the tongue thing - I used to do that naturally  so will  try again. 

I will need to try the tapes suggested. I've been reluctant so far simply by the thought of it but I'll give it a go nevertheless.

[Dormeo]

For what it's worth, I was a little spooked by the idea of tape before I tried it, but now it just gives me a nice feeling of security. One less thing to worry about -- my lips will stay in place.

[LaurenceShaw]

Here are some ideas about mouth leaks.

1. Tongue position. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar

3.  Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar ...

Please note we, Knightsbridge Sleep Solutions, are Supplier #37.   (A keyword search will, still, likely lead you to the counterfeiters, but hopefully that will be legally rectified soon ...)