Question re: Leaks & Mouth Breathing

[Tielman]

The other day I woke up with a very sore throat, and quite tired. I was trying a chin strap instead of mouth taping to see if that would be ok (since I drool a lot I've been concerned about mouth leaking). When I was able to look at my numbers I found an awful 8.8 AHI, and a snore index of over 300. My SO confirmed that I was snoring.

What freaked me out was that my leak line was almost FLAT, and only .5 above my normal leak rate. How can this be?

I've had much worse leak lines and rates that this, but never had snoring, never had a sore throat, and I can't remember the last time (if ever) I've had anything above about a 6 for my AHI.

I've resolved it by going back to mouth taping, but I want to understand why the leak rate was SO flat with a snore index and AHI so high.

Any ideas?

[DreamOn]

All chin straps are not created equal. It could be that you used one that pulled your chin/jaw back or it was worn in such a way that it caused more obstruction in your airway by pressing into your neck. I use the PAPCap, which allows the chin strap to be angled in several different configurations. I jut my lower jaw forward before securing it, and I make sure the strap isn't pressing into my neck. My leak line is usually flat, and no snores are detected.

[Sharon1225]

I don't have any suggestions. I've been having problems with opening my mouth while asleep, too. Sometimes it wakes me up. I don't know what a leak line is. When I open my mouth, it makes a loud noise that bothers my husband.

[DreamOn]

Sharon, if you have a machine that's capable of reporting full data, you can check the Leak Rate/System Leak to see if it's too high. Many CPAPs can report this via the machine's LCD screen. If you need help with that, I suggest that you fill out your Equipment Profile (via the User Control Panel on the upper left of the screen), so we can assist.

It is important to manage the mouth (and/or mask) leaks. If your Leak Rate is too high, your CPAP therapy can be adversely affected. The therapy air can't doing its job of keeping your airway open when it's escaping from your mouth or mask. To solve the problem, some people can use a chin strap and/or tape their mouth closed. There is a lot of information about that elsewhere on the forum (see "CPAP Wiki" and past threads). For other people, those measures aren't enough, and they need to wear a full-face mask, which covers both nose and mouth.

[Tielman]

All chin straps are not created equal. It could be that you used one that pulled your chin/jaw back or it was worn in such a way that it caused more obstruction in your airway by pressing into your neck. I use the PAPCap, which allows the chin strap to be angled in several different configurations. I jut my lower jaw forward before securing it, and I make sure the strap isn't pressing into my neck. My leak line is usually flat, and no snores are detected.

I believe you may have hit the nail on the head the more I think about it, that was my complaint on the first night of using the chin strap was that it pulled my jaw back and consequently caused my tongue to be further back in my mouth.

Could that alone have caused the snoring (nasal?) without affecting my leak rate?

[DreamOn]

I believe you may have hit the nail on the head the more I think about it, that was my complaint on the first night of using the chin strap was that it pulled my jaw back and consequently caused my tongue to be further back in my mouth.

Could that alone have caused the snoring (nasal?) without affecting my leak rate?

The chin strap may have been effective in controlling your mouth leaks, but at the same time could have caused changes in tongue placement and/or throat compression that led to snoring. Inadequate air pressure can also allow snoring, but from what you've said that probably doesn't explain it in this case.

Which chin strap were you using? The ones with the "chin cup" are especially prone to pulling the jaw back. I've always used the PAPCap. I just ordered a Ruby adjustable chin strap (which does have a chin cup) because I want to experiment with something different to see how it does affect me.

You may also want to avoid sleeping on your back. Many of us have more apneas when back-sleeping, as the tongue falls back. I tended to snore much more on my back too. Perhaps it was a night when you did sleep on your back more? You could try experimenting with the chin strap for a longer period of time and see if your results vary. It's difficult to make any firm conclusions from one night since there are so many variables regarding sleep.

[Sharon1225]

Sharon, if you have a machine that's capable of reporting full data, you can check the Leak Rate/System Leak to see if it's too high. Many CPAPs can report this via the machine's LCD screen. If you need help with that, I suggest that you fill out your Equipment Profile (via the User Control Panel on the upper left of the screen), so we can assist.

It is important to manage the mouth (and/or mask) leaks. If your Leak Rate is too high, your CPAP therapy can be adversely affected. The therapy air can't doing its job of keeping your airway open when it's escaping from your mouth or mask. To solve the problem, some people can use a chin strap and/or tape their mouth closed. There is a lot of information about that elsewhere on the forum (see "CPAP Wiki" and past threads). For other people, those measures aren't enough, and they need to wear a full-face mask, which covers both nose and mouth.

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Gosh, I don't even know. I think this site might be very valuable. I didn't realize the machines could do that. I just get to talk to my doctor a few times a year. I only recently learned that the hose needs to be replaced every 3 months. I thought it only needed to be replaced if it was broken. The company recently sent me something about how often things need to be replaced. After I have surgery and have a couple of days to rest, I'm going to start getting it updated and see if I can figure out what's causing the noise that wakes my husband up.

[DreamOn]

I only recently learned that the hose needs to be replaced every 3 months. I thought it only needed to be replaced if it was broken. The company recently sent me something about how often things need to be replaced. After I have surgery and have a couple of days to rest, I'm going to start getting it updated and see if I can figure out what's causing the noise that wakes my husband up.

It sounds like the company may have sent you a "replacement schedule" that indicates how often your insurance will pay for replacement of items such as hoses, masks, cushions, filters, etc. You don't need to buy things that often, though. Hoses don't necessarily need to be replaced every 3 months. Many people use their hoses for many months, even a year or more, if there are no holes.

I hope all goes well with your surgery and you recover quickly.