Best choice for mask

I'm finally down to the point of waiting for a return call from the cpap sales rep. My wife says I tend to alternate between breathing through my nose and my mouth, so I am guessing I will need a full mask. The doctor showed me different types of mask but offered no significant information on them.

Does any one have any experience to pass along or information that will help me make an informed decision? Also, since I tend to wake up with a dry throat and nose, would a humidifier is a wise choice?

Thanks,

If you often breathe through your mouth, a full face mask would probably make your adjustment to cpap easier at first. I like the ResMed Ultra Mirage FF (full face) mask. Despite the name, a full face mask covers just mouth and nose, not the entire face.

Yes, definitely get a heated humidifier. Even if you end up keeping the heat turned down low, the extra humidification that warm air can carry could make all the difference in the world in keeping your mouth from getting very uncomfortably dried out while mouth breathing.

I was a confirmed mouth breather at first - probably from years of untreated apnea making me open my mouth in an attempt to get more air during sleep. I used a full face mask almost all the time at first. Gradually over the year's time (and with lots of aids..first taping the lips shut, then a lot of experimentation with homemade "mouth dams", and finally a big piece of soft silicone slapped over the outside of my lips with an Ace bandage to hold it in place) I've trained myself to breathe through my nose at night and can enjoy many other comfortable nasal only type masks, like the Breeze/nasal pillows.

Rested Gal,
Please tel me about the piece of soft silicone you use over your mouth. Where did you get it? I have been using a headband made of knit t-shirt material from wal mart. It is not completely adequate. I wear a chinstrap over it. The chinstrap helps hold it in place. But, it tends to get in my mouth or slide out of place.

rested gal wrote:If you often breathe through your mouth, a full face mask would probably make your adjustment to cpap easier at first. I like the ResMed Ultra Mirage FF (full face) mask. Despite the name, a full face mask covers just mouth and nose, not the entire face.

Yes, definitely get a heated humidifier. Even if you end up keeping the heat turned down low, the extra humidification that warm air can carry could make all the difference in the world in keeping your mouth from getting very uncomfortably dried out while mouth breathing.

I was a confirmed mouth breather at first - probably from years of untreated apnea making me open my mouth in an attempt to get more air during sleep. I used a full face mask almost all the time at first. Gradually over the year's time (and with lots of aids..first taping the lips shut, then a lot of experimentation with homemade "mouth dams", and finally a big piece of soft silicone slapped over the outside of my lips with an Ace bandage to hold it in place) I've trained myself to breathe through my nose at night and can enjoy many other comfortable nasal only type masks, like the Breeze/nasal pillows.

Gary, the soft silicone stuff I use as a big patch over the outside of my mouth is called a Retouch Silicone Scar Reduction sheet. I bought a 5 x 7 " sheet of it on eBay several months ago for $22.95. I cut it to make two big "mouth covering patches" out of it, and they've lasted amazingly well...holding up perfectly after months of nightly use. I just rinse it off in the morning - I haven't ever used soap on it. There's no adhesive at all. It's extremely soft and thin. So soft and pliable that one would think "no way will this seal against air puffing out of the mouth." And of course, it doesn't seal by itself. I'm using the silicone patch just as an extra layer of something solid, yet soft and comfortable under an Ace bandage. The silicone sheet acts as an additional barrier to help prevent air from leaking through the porous Ace - and to encourage my lips to stay shut and the lower lip to stay up. The silicone also keeps the Ace from getting damp.

Here's how I use it:
I place a big rectangle of the scar reduction sheet horizontally across my closed lips. It needs to be big enough to extend considerably past the corners of the lips and be "tall" enough to still cover the mouth if the mouth drops open somewhat. Even though it has no adhesive at all, it kind of clings to my lips/mouth area. I then put an Ace bandage over it... the Ace being worn as if it were a sweatband worn over the mouth instead of over the forehead. I had already cut and sewn the Ace bandage to the correct length to go one time completely around my head - covering my lips and going around the back of my head.

To keep that Ace from slipping down off my mouth, I cut a second piece of Ace to run over the top of my head. The ends of that "vertical" second Ace are sewn to the sides of the horizontal lip-covering Ace. Looks kind of like the simplest horse halter imaginable. Once you've made the "halter" out of the correct length of two Aces, you never have to take it apart...just slide it on and off over the silicone mouth-covering sheet. It sounds like a lot of "stuff" to wear, but is very light and comfortable. Since I'm very prone to air leaking out even from between closed lips, I wear this rig under every mask I've got (except my FF mask.) An extra benefit of the Ace going around my head at mouth level is that it helps keep my cheeks flat - not as apt to balloon out with air chipmunk-style. Ballooning cheeks seem to make lip/mouth leaks happen more easily. The whole contraption is helping me keep my lips closed much more comfortably than with chin straps. Keeping the jaw up does nothing to keep air from puffing out from between closed lips.

I've tried Chin-Up strips, which can help keep the lower lip raised up in a closed position with the upper lip. Those work pretty well, but I wanted something that didn't involve pulling off adhesive each morning, and that could be re-used indefinitely. I also wanted something that actually covered my mouth/lips completely, acting as a soft barrier across the front of my mouth. The Retouch Silicone Scar Reduction sheet and the Ace halter don't provide an absolutely perfect leakproof dam, but together they seal well enough for me to not have much problem with mouth leaks any more. Might not work well with high pressures. My autopap's pressure usually stays in the 5-10 range but does occasionally go up as much as 13. By keeping my lips closed better, I've been able to get my tongue in the habit of maintaining a better seal with the roof of my mouth. A good tongue seal is the real key to preventing treatment air from escaping through mouth/lip leaks.

You can find the sheets by doing a search on eBay for these words: Retouch Silicone Scar Reduction.

P.S. A completely unintended but welcome side benefit of wearing that silicone scar reduction sheet over my mouth every night is that all the "lip age lines" - those fine vertical lines above the upper lip - have just about completely disappeared!

rested gal,

How were you able to determine you had a mouth leak problem?

The leak graph on my silverlining software never goes above the max line so I assume I'm doing OK. Is this correct.

I wake up with a slightly dry sore throat like I used to when I snored (I don't snore any more). I'm suspecting this is from the pressurized air exiting my mouth. My typical pressure range on the PB420E is similar to yours, so it's not real high.

I'm just trying to find out if I'm doing OK.

I'd like to try a full face mask but I hope to hold out until the Activa FF comes out (early next year?).

Thanks!

Wader, it wasn't hard for me to know that I had mouth leaks. When I'd wear my Breeze and wake up many times during the night with my mouth wide open and treatment air gushing out, that was a pretty big clue.

As you suspect, dry mouth or dry/sore throat is a pretty good indication of treatment air escaping out the mouth. It's not possible to tell if leaks are coming from the mask or from the mouth just by looking at software leak graph lines. I'm quite sure my leaks are not from my masks - Breeze and Activa seal great for me. Also, on any night when I tape my lips firmly shut, the leak line on my graphs stays steadily low all night. Without tape (using just my Ace/Retouch dam) the leak graph sometimes zig zags up and down a lot indicating I'm still having minor mouth leaks, but they stay well below the max.

Minor mask or mouth leaks are no problem for most machines to handle. They'll register the leak on the graph, but will compensate for them. However, since the sound or feeling of even minor leaks might be disruptive to sleep whether they wake us up fully or not, it's best to try to prevent them as much as possible, imho.