Gulping air, chin straps and Sleepyhead?

[BikeisDusty]

I am gulping air (aerophagia) and need to use a chin strap. I just started on the CPAP just before Christmas, using the Swift FX LT nose pillow and AIrsense 10. Over the holiday, I visited my dad and he had a spare strap which is too big and it bothers my jaw, but showed that it helps with this. With the strap, I do not glup much air and sleep longer, at least over the 4 nights I tried it. Last night at home, I tried again without the strap and ended up gulping a lot of air again.

My question Is there a way to see when the gulping is occurring on Sleepyhead data?

Any suggestions on straps and which ones are better than others? The one my dad gave me, is branded of his DME, has neoprene lining for all the straps; it is hot. Is is the XL size, I need the Standard Size. It also binds with the nasal pillow mask. It is similar to this one: https://www.cpap.com/productpage/ruby-s ... strap.html

Thanks,
Bill

[Pugsy]

There's no definite for sure way to see when the gulping is happening unless perhaps you happen to be doing considerable mouth opening/breathing to create a big leak spike that might show up on the leak graph.
Not all mouth openings will result with leaks big enough to show up on the leak graph.

The leak graph would be the place to look though...but it may or may not shed any light on the situation.
People can have aerophagia happen and it not be related to mouth breathing at all but instead its just something that happens because the LES is a bit weak and lets the air enter the stomach.

The fact that using a chin strap seems to help you does tend to point to mouth opening though.
Is your nose ever congested so that you just have to mouth breath or do you think the mouth opening is just more out of habit? If the nose isn't a problem have you considered perhaps taping the lips closed (maybe partially) to help prevent the mouth opening? That's what I did when I started therapy and was mouth opening out of habit...I found the chin straps more annoying than helpful and tape was my preferred, less annoying choice but it isn't necessarily a preferred choice for others.

[BikeisDusty]

Tape is not a option for me, most tapes give me a rash.

I am not sure about the habit. I just started the CPAP, so I have never noticed the open mouth before. It could be that I snored for so long that it is a habit. I also wonder if the pillow is right for me as the medium size fits, but the holes feel small. The large size does not fit well, but flows better for me. For instance, I cannot do the the auto ramp with medium but can tolerate it with the large size. I will try the large size again.

I looked at the Sleepydata again and do see more leak data point last night than when I had the chin strap, so maybe that is when I had my mouth open.

So many factors to work out.

Thanks
Bill

[Pugsy]

If the medium Swift LT nasal pillow is not quite a perfect fit and the large is not either...you might look at the ResMed AirFit P10 nasal pillow mask...the pillows are similar in form but not identical and the sizing of the P10 is overall a little tiny bit smaller than the LT sizing.

I have used the Swift LT, the Swift FX...and the sizing is almost identical and I easily could use both the XSmall and Small in those masks but when I changed to the AirFit P10 I found that the XSmall was just a tiny bit too small and ended up being able to use the Small and Medium with the P10.

I can't help with the chin strap selection process...I never got far enough into using chin straps to gain much experience as I quickly bailed on them and chose tape instead.
Chin straps are pretty much like masks...what one person loves the next person will hate and you won't know for sure where you will be with a chin strap until you actually try it yourself.

If it's any consolation though...I was able to give up taping after 2 or 3 months as I seemed to break the "habit" of mouth opening which I think was primarily a habit driven out of gasping for breath during the night because of the apnea episodes. Once I no longer had those apnea events my body learned it no longer needed to open the mouth so much to get extra air.
I can't guarantee that will happen to you but there's a good chance that it could happen because I am not alone with being about to give up using some sort of method to enforce that the mouth remains closed.

As long as you don't do the mouth breathing because of nasal issues there's a chance that you will learn to keep the mouth shut and break the habit of mouth opening or get to a point where it doesn't happen nearly as often so that it really doesn't create a big problem. I sometimes see evidence of mouth opening leak on my reports but it is rare now and brief if it does happen. Not enough for me to go back to taping though...

[OkyDoky]

During the day practice placing your tongue at the roof of your mouth with the tip behind the front teeth. Breathe through your nose using your abdomen. If this becomes a habit, it seals the airway from the mouth and will help prevent mouth breathing.
Rather than a chin strap you could also try a soft cervical collar for some people this is enough support to align the airway.