Cervical collar works to keep jaw shut, but....

[mcs2015]

So I have been trialing the recommended Coreflex cervical collar. While it is effective in keeping my jaw shut, it fails to prevent my lips from eventually flapping open from the CPAP pressure once my tongue relaxes. Then comes the dreaded dry mouth just as bad as without anything. Forget mouth tape or full face masks - they do not work in my case. I'm in a dilemma again. What else can I do now?

[Dog Slobber]

Tape your mouth. I was so intimidated by the thought of taping, and now it's no big deal. What is it about taping that doesn't work for you?



I use cover-roll stretch, available on amazon.

[loggerhead12]

I don't really like the tape either. This works for me.

https://sleepapneasolutionsinc.com/

[Recoil]

This helped me avoid taping. https://www.amazon.com/dp/B0D9RT76NC?re ... asin_title

[McSleepy]

What ended up working for me (and my pressures go as high as 22 cm H2O) was a silicone molded mouthguard that I trained myself to bite hard on, in conjunction with an elaborate headgear (off of my rigid mask structure) that supports the jaw, and a ski-mask-like contraption to press the lips shut - all custom built or modified by me (and yes, that includes the mask itself, as it has been discontinued for years). And I still need to use Spry to help with saliva secretion.
McSleepy

[mcs2015]

The problem is not keeping the jaw shut. It's keeping my lips from flapping open while my jaw is shut. Chinstraps, tried them all, they force your chin to recede causing worse apnea + TMD and also do not alleviate the leak from the mouth.

[Janknitz]

A couple of things to try:

I never tried it, but some people used to use denture adhesive on their lips. Along the same lines, I found waxy chapstick had just enough stickiness to work for me in the beginning.

Try a single piece of vertical tape that doesn't cover your entire mouth, but just keeps the lips closed. Are can still escape if you cough or something, but it may be enough to keep the lips sealed.

[loggerhead12]

Chinstraps, tried them all . . .

Did you try one that covers your mouth and applies pressure up instead of back?

[mcs2015]

Here's the bottom line after trial and error: the problem is neither keeping the jaw or lips shut. It is keeping my tongue from relaxing and falling back. Once I lose the vacuum my tongue creates by keeping it pressed against my teeth, the air pressure from the CPAP pushes up into my mouth and forces my lips open even when my jaw is shut. That is what's causing dry mouth. Are there any types of devices that keep the tongue forward? Perhaps a tongue retaining or mandibular advancement device?

[Janknitz]

Here's the bottom line after trial and error: the problem is neither keeping the jaw or lips shut. It is keeping my tongue from relaxing and falling back. Once I lose the vacuum my tongue creates by keeping it pressed against my teeth, the air pressure from the CPAP pushes up into my mouth and forces my lips open even when my jaw is shut. That is what's causing dry mouth. Are there any types of devices that keep the tongue forward? Perhaps a tongue retaining or mandibular advancement device?

That's a question you might want to ask your dentist, but one other "low tech" solution: Practice ALL DAY. If you're not eating, drinking, or talking, that's where your tongue should be. Some doctor suggested taking a toothpick horizontally and practice holding it up toward the roof of my mouth with my tongue to strengthen that (if you do try this, the ends of the toothpick are outside your mouth so you don't accidentally swallow it). I did not try that! But I did make a very conscious effort over days to practice holding my tongue up, and it helped me during sleep, as it became the natural position for my tongue.

[KittyBunts]

Here's the bottom line after trial and error: the problem is neither keeping the jaw or lips shut. It is keeping my tongue from relaxing and falling back. Once I lose the vacuum my tongue creates by keeping it pressed against my teeth, the air pressure from the CPAP pushes up into my mouth and forces my lips open even when my jaw is shut. That is what's causing dry mouth. Are there any types of devices that keep the tongue forward? Perhaps a tongue retaining or mandibular advancement device?

I joined the board today to post because I'm having the exact same problem, and here you are stating it perfectly, so I'll follow along for ideas.

I've found a couple of devices claiming to help with tongue positioning, but I don't know if they'd work for sleep. I'm on a tight budget and am curious to see if someone here has had experience with them before I spend money on one. This one is designed for athletes, not sleep, but I wonder if it might work in conjunction with a chinstrap?
https://optio2labs.com/?variant=32193888780322

The other is marketed as a device for training tongue positioning for nose breathing, called a Nose Breathe Trainer. Amazon reviews specifically from CPAP users are mixed, but generally lean negative.

Another idea is something called myofunctional therapy, sort of a physical therapy for teaching proper positioning and use of the tongue for swallowing and breathing. I went through it as a child but that was a long time ago. I vaguely remember that in addition to several exercises, they used a little stick to draw along the sides and top of my tongue toward the tongue tip, tap on the tip, and touch the spot on the roof of the mouth where it should rest. That helped to increase sensory awareness of the tongue, making it easier to hold in position. They also suggested holding a lifesaver or something similar to the roof of my mouth with my tongue.

I've been doing some searching today for the myofunctional exercises, and this is the best set I've found so far: https://youtube.com/playlist?list=PLwKZ ... JiZv6CKVBQ

After doing those, my tongue seems to sit in place more readily. I don't know if it will help with positioning during sleep or not. Perhaps it may, with practice. I hope so, anyway.

I hope you find a solution that works for you. Plase share if you do.

[mcs2015]

Thanks for sharing your ideas.

After reading more on the Opti02 and MFT exercises, the more accurate description of this issue is: improper tongue posture and tongue collapse or lazy tongue and palate tissue which, I assume, loses elasticity and tone as we age.

More on the device here: https://sparrowclinic.com/products/opti ... cw0d-lsYuj
"The patent-pending design enforces proper breathing technique by allowing nasal airflow only while opening the airways with an elevated tongue and forward jaw." That sounds great, but will it really do the job?

The only other devices are TSDs (tongue stabilizing devices): https://www.google.com/search?client=fi ... +%28TSD%29

MFT is like PT for the mouth and face. I would be interested to see if it would help, but I'm impatient and don't have a lot of spare time to experiment, so a device appeals to me right now.

The only way to really know if anything works is to give it a shot and try it.