Bursts of air coming out of mouth, CPAP no longer usable

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Authorized Customer
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Bursts of air coming out of mouth, CPAP no longer usable

Post by Authorized Customer » Wed Jan 11, 2023 11:29 am

I am a new user of CPAP therapy. I started in mid-December. I got things working well after 2 nights. I had over two weeks of good sleep. All issues experienced were correctable. E.g., I had chipmunk cheek a few times, and I was able to correct it.

As evidence I was doing fine, for 5 nights, I was in a camp cabin with others. Someone who had not met me previously commented on how quietly I slept.

In the past ~3 days, things started falling apart. While trying to fall asleep, I'll have intermittent, brief mouth leaks. These are occasional bursts of air that come through my closed lips, or I'll do a growl-ish sound caused by my tongue vibrating against the top of the mouth while air flows through it. Sometimes I'll blow spit bubbles.

Before ~3 days ago, all problems were correctible. Now, I find myself incapable of stopping this new problem. While I go to bed with the CPAP on, I have to rip it off within 15-30 minutes, when it's abundantly clear that I cannot correct these problems.

My mouth and tongue did not change! Here's all the recent changes that might correlate but don't seem to be causitive:
  • I washed the hoses and headgear.
  • Bedsheets were changed.
  • I adjusted my hose to wrap around the headband on my headgear. Previously, it would loosely hang--causing the nasal pillow assembly to push down on my incisors--or I'd wrap it up and around a second pillow behind me.
  • Cedar allergy season may have started. This does not change my body shape or functioning, and I treat with second-generation antihistamines, so effects are minimal. While I started daily antihistamines about two days ago, there were 1-2 brief periods during my ~2 week "this works great" phase where I also took the same antihistamine, so I doubt the medication is the issue.
Parameters of my equipment:
  • I use nasal pillows included with my Philips Healthcare Respironics Nuance Pro Headgear. (This model cannot be selected on this site's profile.) They are sealing fine.
  • CPAP set to 7 from day 1, per findings from my at-the-facility sleep study.
  • Humidity at 1. If I go to 2, it starts dripping water in my nose or face.

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LSAT
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by LSAT » Wed Jan 11, 2023 11:55 am

If you are mouth breathing, you are not getting the proper therapy and it disturbs your sleep. Any 1 or a combination of these may help.....
1. Tape your mouth
2. Try a chin strap
3. Try a cervical collar
4. Use a Full FaceMask

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ChicagoGranny
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by ChicagoGranny » Wed Jan 11, 2023 12:46 pm

Authorized Customer wrote:
Wed Jan 11, 2023 11:29 am
CPAP no longer usable
Your CPAP is still usable. You just have to work through initial problems like most of the rest of us did.

LSAT makes some good suggestions. I would add that you should practice placing the tip of your tongue on the roof of your mouth. This is the correct position for normal breathing and breathing while using CPAP.

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Miss Emerita
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Miss Emerita » Wed Jan 11, 2023 2:31 pm

It's really frustrating to have a problem pop up with no clue about why. But try one or more of the suggestions others have made here. You sound like a problem-solver, and I bet you'll solve this one too.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by kteague » Wed Jan 11, 2023 11:37 pm

How I overcame mouth breathing and air leaking from the mouth:

1. Take steps to ensure side sleeping. That could mean some sort of pillow configuration, limiting the width of your sleeping space, or wearing a backpack with something in it to prevent rolling over onto your back.
2. Sleep on a flat firm pillow. It helps gravity work for you as when your head is level there is no pull on the relaxed jaw to drop.
3. As was mentioned, practice keeping your tongue suction sealed forward to the roof of your mouth. It took me a long time but I consciously did it day and night until it became second nature. If the air never makes it into the mouth, it can't blow out your lips. My tongue is always there even when awake.
4. Side sleep just off the edge of your pillow. This usually makes the edge collapse just a bit, tilting the front of the face toward the pillow. This again makes gravity work for you in maintaining the tongue on the roof of the mouth.

Of course once one goes to sleep, all bets are off in staying in optimal positions. Practice until it becomes your preferred sleeping style.

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booksfan
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by booksfan » Thu Jan 12, 2023 8:24 am

I know you said you are having mouth leaks, but I will share my experience with the Nuance Pro. Please bear in mind that everyone's experience varies. I used the Nuance Pro off and on before using the Bleep, it was the least objectionable "traditional" mask for me. However, I found that the pillows only lasted about 2 weeks before starting to leak, and by 3 weeks were unusable. I know, from reading here, that this was NOT the case for others, and I was took care of them so not sure why the issue. Hubby goes absolutely forever on his same P10 pillow, which was really disheartening. If you have not tried a new pillow, it might be worth a shot.

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Authorized Customer » Thu Jan 12, 2023 8:50 am

LSAT wrote:
Wed Jan 11, 2023 11:55 am
If you are mouth breathing, you are not getting the proper therapy and it disturbs your sleep. Any 1 or a combination of these may help.....
1. Tape your mouth
2. Try a chin strap
3. Try a cervical collar
4. Use a Full FaceMask
Thank you. I am not mouth breathing. My jaw stays shut. Pressure in my mouth is causing air to escape. Therefore, I am not clear whether tape, chin strap, or cervical collar are relevant.

I went two weeks with no problems. I am not clear why problems just started. Is that normal?

I had a conversation with a technician at my doctor's office yesterday. They may recommend a full face mask.

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Authorized Customer » Thu Jan 12, 2023 8:57 am

Thanks to everyone for the replies so far! I want to clarify two things that may help the conversation:
  • I am not mouth breathing. My jaw is not opening.
  • My nasal pillows are working fine. They seal great.
Intermittent pressurized air leaks have just started making it past my tongue despite no apparently relevant environmental changes. These pressurized air leaks are behind the issue. While my lips are not parting in a mouth-breathing way--due to the jaw opening--pressurized air bursts permeate my otherwise sealed lips.

Possible good news: While it took me longer to fall asleep last night than it should have--due to these air-burst issues--I eventually fell asleep and keep the CPAP on all night without making noises to bother the spouse.

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Dog Slobber » Thu Jan 12, 2023 11:12 am

Authorized Customer wrote:
Thu Jan 12, 2023 8:57 am
I am not mouth breathing. My jaw is not opening.
One's jaw doesn't have to open to mouth breath, or experience leaks through ones mouth.

sleepye
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by sleepye » Thu Jan 12, 2023 12:38 pm

I use the scunci method to keep air from escaping through my lips. I don't even have to cut earholes as some other people have mentioned doing. The first picture shows the scunci headband (https://www.amazon.com/Scunci-Effortles ... r=8-5&th=1) covering my mouth. After that I add a chin strap (https://www.cpap.com/productpage/premiu ... -mouthleak), then my nasal pillow mask (https://www.cpap.com/productpage/resmed ... h-headgear).

https://imgur.com/ZYYnPy1
https://imgur.com/RoHXhMy
https://imgur.com/5IhXm4o

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ozij
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by ozij » Thu Jan 12, 2023 12:39 pm

Authorized Customer wrote:
Thu Jan 12, 2023 8:57 am
Thanks to everyone for the replies so far! I want to clarify two things that may help the conversation:
  • I am not mouth breathing. My jaw is not opening.
  • My nasal pillows are working fine. They seal great.
Intermittent pressurized air leaks have just started making it past my tongue despite no apparently relevant environmental changes. These pressurized air leaks are behind the issue. While my lips are not parting in a mouth-breathing way--due to the jaw opening--pressurized air bursts permeate my otherwise sealed lips.
That's what I call "mouth leaking" - in close to 18 years of CPAP use, I haven't managed to figure out when or why mouth leaks happen more, nor have a I managed to train my tongue to avoid them. I truly envy those who have....

My two alternating solutions are taping my lips closed, and using a full face mask. You'll have to find which helps you sleep better - and under what conditions. Modern silicon-based tapes can very gentle and easy to use, which is one of the reasons I switched back from FFM to taping. 3M makes a gentle tape (blue) Medvance makes one, and there's BSN Medical Cover Roll Stretch which is also good. Haven't tried the 3M, of the two latter ones, I prefer the Medvance.
Authorized Customer wrote:
Thu Jan 12, 2023 8:50 am
I went two weeks with no problems. I am not clear why problems just started. Is that normal?
I'd say yes - it's probably the result of your growing relaxation as your mind realizes the danger of choking when you sleep is receding.

And PS, if the technician in your doctor's office blanches at the thought of lip taping, tell them the FDA licensed the Oracle, a mouth breather's mask with nose plugs. Why would it be OK to plug your nose, and not to tape your lips????

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ChicagoGranny
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by ChicagoGranny » Thu Jan 12, 2023 12:47 pm

Authorized Customer wrote:
Thu Jan 12, 2023 8:57 am
Intermittent pressurized air leaks have just started making it past my tongue despite no apparently relevant environmental changes. These pressurized air leaks are behind the issue. While my lips are not parting in a mouth-breathing way--due to the jaw opening--pressurized air bursts permeate my otherwise sealed lips.
What you are experiencing is very common. It's typically called mouth-breathing or mouth-leaking.
Authorized Customer wrote:
Thu Jan 12, 2023 8:57 am
Possible good news: While it took me longer to fall asleep last night than it should have--due to these air-burst issues--I eventually fell asleep and keep the CPAP on all night without making noises to bother the spouse.
If you keep practicing placing your tongue on the roof of your mouth, you might be one of the lucky ones who defeats the problem in the easiest of ways.

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ChicagoGranny
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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by ChicagoGranny » Thu Jan 12, 2023 12:55 pm

ozij wrote:
Thu Jan 12, 2023 12:39 pm
And PS, if the technician in your doctor's office blanches at the thought of lip taping
:lol: :lol: :lol: :lol:

I recently changed dentists due to a change in my insurance network. As part of the discussion, I told the hygienist and the dentist, "This sounds crazy if you aren't familiar with it, I tape my lips shut at night."

I was poised and ready to attack if they dissed this practice. To my surprise, both nodded in agreement and said, "That's a good practice for oral health, and nose breathing is also excellent for overall health." :D

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Authorized Customer » Thu Jan 12, 2023 2:23 pm

ozij wrote:
Thu Jan 12, 2023 12:39 pm
Why would it be OK to plug your nose, and not to tape your lips????
If you need to eject something out your mouth, and you can't, you might aspirate it, which can lead to lung infections. I cannot think of a similar risk with nose plugs.

Also, it's me who's reluctant to start mouth taping. I understand why it's done, just not sure I am comfortable with doing it. It's like whether you use distilled water or tap water with your humidifier. There's a super super low chance of tap water causing any real harm, but if it does, it may be something very serious like a fatal amoeba disease: https://www.cdc.gov/parasites/naegleria ... ution.html

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Re: Bursts of air coming out of mouth, CPAP no longer usable

Post by Authorized Customer » Thu Jan 12, 2023 2:31 pm

Addressing some replies about mouth breathing:

When I read "mouth breathing", I think of open-lipped breathing that bypasses the nose. That aligns with the Cleveland Clinic's definition: https://my.clevelandclinic.org/health/d ... -breathing.

What is going on with me does not meet that definition. My lips are closed, and my jaw is in the closed position.

My problem is with escapes of pressurized air that push through my closed lips. I think "mouth leak" is a better term. Some others used that here.