Love the pillows but too much mouth leaking

[TedVPAP]

Hello,
I really need your help.
Been trying to adjust to this for 2 months. My pressures are 19/15. The nasal masks killed my nose. I love the Swift LT.
I am using a chin strap but I am still getting too much leaking (1 l/s). The tighter the chin strap, the less I mouth leak but it is uncomfortable. This leak rate is after accounting for the built-in mask leak. My ResMed VPAP S manual says that a leak rate over 0.4 l/s is too much. My AHI is 7 and AI = 2. Not bad but the mouth leaking definitely interrupts my sleep.
I have not tried taping my mouth.
Should I try Innomed Hybrid?
It looks like the Optilife pillow has a chin strap for support. I doubt this will keep my lips closed since a tight chin strap does not fully do so.

I definitely feel the benefits of bi-Pap (better rested and no more heart arrythmias) but I really need your help to get to the best solution.

Thanks
Ted

[Janknitz]

Try taping first--it's easy and inexpensive. A lot of people use painter's tape. If that doesn't work, you may want to try a hybrid.

The Opti-life has a chin "rest" rather than a chin "strap". It's not designed to keep your mouth closed and in my experience it didn't do that at all--but I have a very small, receded chin, so the strap just rode up to below my bottom lip. I could not get the Opti-life to seal or be comfortable.

[TedVPAP]

good suggestion. I'll try it tonight and report back. Thanks

[Janknitz]

Be sure you read up on taping. I don't tape, so I don't speak from personal experience, but I think you don't just slap a piece of tape all the way across your lips. You need a way to push air out so you don't end up looking like a blowfish and have problems from un-expelled C02.

[BlackSpinner]

Get a hybrid - pillows and mouth cover in one - no taping required.

[DreamOn]

Here is Rested Gal's collection of links regarding mouth leaking, including tips on taping: viewtopic.php?t=8011. If nothing else, mouth-taping may help you to narrow down if that is the only problem. You could also be losing air from the nasal pillows while you're deep asleep. Many of us sleep right through that. And/or you may have a hole(s) in your hose(s) or connections. May be a good idea to investigate that because your leak rate is very high. Your reported AHI may not be accurate because of that.

I hope that helps you, Ted!

[rested gal]

Be sure you read up on taping. I don't tape, so I don't speak from personal experience, but I think you don't just slap a piece of tape all the way across your lips.

You're right about not just slapping a piece of tape on without reading up about it first, but it's not quite because of this:

You need a way to push air out so you don't end up looking like a blowfish and have problems from un-expelled C02.

The purpose of putting tape over the mouth is to prevent pushing air out of the mouth. Any air that detours into the mouth and puffs the cheeks out giving a "blowfish" appearance pretty much just stays there in the mouth while the person continues to breathe in (fresh cpap room air) and out (expelling CO2 as usual) -- both ways through the nose.

The only problems I know of with "blowfish" is that the puffed out cheeks can be uncomfortable and/or can loosen the tape if the cheeks are getting pushed outward excessively. I have to tape my mouth securely AND use a chin strap to prevent puffed out cheeks. The chin strap is not to keep my jaw up -- even with jaw closed enough to clinch my teeth, air still can escape from my sleep-relaxed lips -- been there, done that.

My addition of chin strap WITH taped mouth is simply to keep my cheeks flat. Flat cheeks give less room inside the mouth for air to build up in there and possibly loosen the tape during the night. The chin strap, for me, prevents the discomfort of "blowfish" cheeks and prevents a mouth full of air from pushing so hard against the tape from the inside that it might loosen the tape.

Some people can get by with partial taping of the mouth, leaving the corners of the mouth untaped. I can't. Air would gush out the untaped corners of my mouth. I've gotta use a BIG patch of tape covering my mouth completely. And a chin strap. All of that is still far more comfortable for me to sleep with each night in order to use the nasal pillows mask I love. Full face masks and I don't get along well together... at all. Been there, done that, too.

[TedVPAP]

I tried tape last night and it worked well. No mouth leaks all night. My leak rate decreased to 0.48l/s. I used a light chin strap. I was surprised to see that my leak rate was still slightly above the allowable level. I think my chin strap causes my swift to move so tonight I will try no chin strap - just tape.

Rested-gal, have you tried using a hybrid?

[DreamOn]

I tried tape last night and it worked well. No mouth leaks all night. My leak rate decreased to 0.48l/s. I used a light chin strap. I was surprised to see that my leak rate was still slightly above the allowable level.

Well, your leak rate is still a bit too high, but you're definitely moving in the right direction!

You may want to check out these Lab Rat Fix links (also compiled by our beloved Rested Gal!): viewtopic.php?t=15104. There may be a tip there that will help you stabilize your nasal pillows, to minimize leaks. There are tips for most other masks there too.

Also, evaluate your bed pillow. There are many different types, some made especially for CPAP users. You can search past threads for a multitude of ideas regarding that. I'm using a soft, shapeable one from Wal-Mart that works great. It cost me all of $9. Target sells a similar one that's good too. Others like the pillows with cutouts or filled with buckwheat hulls. The proper pillow can help to minimize mask movement/leaking. It also may help to sleep close to the edge, with the mask hanging over.

[Bob3000]

I have a Swift FX and a Hybrid. The Swift FX is so comfortable, I love it! However, I have been unable to stop mouth leaks, even with taping. I've just recently switched over to the Hybrid. As I become more comfortable with it, I think my sleep will improve. I would definitely recommend you purchase the Hybrid or the Liberty to try - even if you mainly use nasal pillows, sometimes you will be too congested to breathe properly through your nose (e.g. when ill) and if you're like me, mouth leaks will forever be a problem without a full-face mask.

Good luck!

[rested gal]

Rested-gal, have you tried using a hybrid?

Yep.