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cant control mouth leak
#1
cant control mouth leak
I have been on cpap for 3 months now. I use nasal pillows and mouth tape but I still leak out of the tape a ton. I use the cover roll tape. I am still new to interpreting oscar data so Im not sure if my settings are dialed in well but I have tinkered with them a bit. Ive been on pressure of 10-12 and sleeping with cervical collar for a week now. Still have a lot of leak. I wake up a ton throughout the night and I notice that the tape is intact but my tongue has dropped low so I get the puffy cheeks. Been trying for months now to keep my tongue posture on roof of mouth but I have a narrow pallet and not enough space so I am not sure if i will ever be successful with proper tongue posture during sleep. I will attach my oscar data below and I would appreciate any suggestions on settings that maybe could improve me therapy. Lastly I really would love to stick to nasal pillows but the mouth leak through the tape is so bad I am wondering if a full facemask is my only option, I am just worried the leak will be worse out of the sides of a full face mask and will be noisier. Thanks again for any suggestions! 

Also EPR is set to 3 full time and ramp is off just an FYI


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#2
RE: cant control mouth leak
I've had the same puffy cheeks you mention -- and so I started using Cover Roll tape. I still get leaks. but not near as bad. But what helped me was to turn down the pressure. BUT, my machine is different than yours, and I'm not familiar with it. I can say I still use Cover Roll tape, but the cheek problem has gone away, and I'm getting good sleep and feeling like a human again. Good luck.
Also, minimize your calendar on the chart. It will reveal more information to help others to help you.
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#3
RE: cant control mouth leak
Make sure you press your lips tightly right before you tape. If you have facial hair, its better to be shaven to allow the tape to really hold your lips together well. I think u can get away with light stubble with cover roll. When i was using mouth tape, having the humidifier too high would cause the tape to get wet and loosen, so maybe u can also try lowering the humidification a bit. Aside from that, you could always try another tape that may work better for you
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#4
RE: cant control mouth leak
From what is on your graphs, you have mask leaks not mouth leaks as your main problem.  Sharp spikes are caused by the mask leaking while tall flat top leaks are from your mouth.  All of your large leaks are from your mask.  You do have mouth leaks but not large enough to cause real problems.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: cant control mouth leak
I tried a DreamWear nasal mask and mouth tape and a DreamWear hybrid mask, but I immediately solved the large leak problem with a ResMed AirTouch F20 full mask, which is much more effective than the nasal masks. You can try a full mask and see how it works for you.
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#6
RE: cant control mouth leak
(05-16-2023, 07:17 PM)staceyburke Wrote: Sharp spikes are caused by the mask leaking while tall flat top leaks are from your mouth.  

Well, it depends, see https://www.apneaboard.com/forums/Thread...#pid457254  In my case, all spiky leaks are mouth leaks whereas the flat ones are mask leaks.  We had this before.  For evidence, have a close look at the flow rate; a zoom of three minutes would be helpful.

Hence in my opinion there's a constant mask leak at about 8l present, sometimes superimposed by massive mouth leaks at about 20:50 to 21:30 and apparently between 23:45 and 0:30. I won't judge about the leaks between 19:15 an 20:30; these might be mask leaks as well. A closer examination of the flow rate would give more insights. --

You suffer from extreme dry mouth, don't you?

Mike.
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#7
RE: cant control mouth leak
I was able to stop mouth leaks using 2 inch surgical tape that went beyond the edges of my mouth.  I also used a chin strap to keep the tape intact.  After a while, I am back to using only a chin strap.  I like the narrow single strap that is referred to as the "ResMed type chinstrap" although I am not sure that it is really made or sold by ResMed.
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#8
LEAKS
My thoughts...

- Be sure you have the correct fitting pillow.  You could experient with an upsize (or downsize) to see if that affects your leak rates. Try doing a Mask Fit Test before sleep, but simulate a real usage (head on pillow).

- Be sure tape is very secure, especially at mouth corners.  Try blowing out after securing to see if there are leaks.  Do the same if/when you wake during the night to test.

- Pressure changes, even thouse between IPAP and EPAP (pressure relief), can find opportunities to leak.  So that "pumping action" of the EPR of 3 finds opportunities.  You could try lowering the EPAP to 2 (or 1, if you can handle it) to see if that affects your leakrate.  Your IPAP pressure range is only 2 (from 10-12), which isn't so large.

- Positional sleep changes.  If one switches positions during the night, those are great opportunities to mess with mask seals.  One could do things to try to limit those known or unknown position changes during the night.


Mouth tape is a tremendous solution for mask fitting and leakage.  In your case, something is amiss.
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