what is this pressure wave I get from mouth-taping?

[GreenAvocado]

I've been using mouth taping with nasal pillows to stop mouth-breathing, but most nights I run into this terrible & painful problem that I'll attempt to describe.

I often get woken from sleep with this painful pressure wave that radiates back down my airway and head. If you're familiar with the Valsalva maneuver it feels exactly like that- when you pinch your nose, hold mouth closed and try to exhale. For me I get an instant headache in the back of my head, eye pain, ear pain, etc.

I *think* what happens is that in my sleep my tongue slips, I lose the soft palate seal, and air rushes into my mouth. Since the mouth is sealed and the air can't go anywhere, the pressure wave just reverberates back. Kind of like water hammer in a plumbing system.

Other times in a groggy half-awake state I feel like maybe I was trying to breathe through the tape, possibly due to some temporary nasal congestion or maybe even an apnea? It's so hard to figure out what's happening when this stuff happens in your sleep.

Does anyone else experience this Valsalva-like thing? Anything to mitigate it? Does it get better over time?

I do find that the pressure/pain is reduced when I wear the soft cervical collar, I guess because my jaw can't really fly open anymore and so there is no less of a sudden rush of air into the mouth. But I'm unsure if I should press on with this or just give up on nasal pillows.

[THEVGE]

I am pretty sure I am dealing with the same issue as you, although I do not experience the pain. I keep struggling with waking up ~ 15 times per night on average. I think this event looks like shown below in OSCAR.

I use my Pixel Watch 3 to look for a moment I am awake, and when I go to that timestamp in OSCAR I almost always find this exact event. And every night, independent of the settings, I have about 15. They are wrecking me.

I noted before, but it now made me think, I often see a small leak at this event. Could it be this is the moment where the seal breaks?

I wonder how to fix this. Maybe try a FFM? Or a collar? Or is it jaw fallback and a MRA is needed? Sigh.....so hard to fix my UARS.

[GreenAvocado]

Hi THEVGE,

I did in fact move on to a FFM (Evora hybrid) due to this reason. I hate having to wear a bulkier mask, but the pain was really disturbing me. It doesn't happen for me with the FFM. 

Before switching I did notice that it was happening less often, but not sure if that's due to fewer apneas (from narrowing down the correct settings on my Aircurve) or some other reason. It sure would be nice to be able to use nasal pillows again some day.

[srmackinnon]

Similar experiences here. Went to FFM to avoid taping, chin straps, collar. To my surprise, face mask didnt fix this issue, chin still drops/tucks, tongue still slacks etc etc. and impacts follow. so now im trying FFM + tape, +chin strap, + collar (i havent combined the three yet). Im now getting neck pain, and headaches. Sigh... going to bed does not bring me peace anymore. But you know, keep trying other masks to find one that works better for you and your face...youre not alone.

[GreenAvocado]

srmackinnon, are you getting the pain/pressure wave thing with the FFM? For me that particular problem was resolved once I was no longer taping my mouth. I do still have a problem with mouth-breathing in the FFM, which leads to very uncomfortable dry mouth, but does not interrupt the therapy or cause the pressure wave issue. I also found that the cervical collar is still useful with the FFM, and I have greater success avoiding dry mouth when using it.