Started on Craigslist - Now need a real machine

[trslp1]

I thought with the nasal pillows I would not be subject to mouth breathing, but it looks like I am.

When I open your mouth while using the nasal pillows my throat is blocked, but if I swallow a certain way it opens up and air suddenly comes rushing out my mouth.

This results in dry mouth syndrome, dry as the sands of the desert of Saudi Arabia. I've never felt that dry before. I guess fixing this might be a priority.

[Pugsy]

Ouch...ugly.

Some people can eventually learn the tricks needed to keep the mouth shut and blocking the air from entering the mouth via that airway. I was like you when I first started therapy and now mouth breathing/opening times are rare and not prolonged when they happen.

I can now open my mouth and stick out my tongue...or even talk without air getting from the airway into the mouth.
I am not alone either. But it does take time and some work and some people can master it and some can't.

FWIW....took me about 3 months to get to a point where the mouth opening wasn't significantly bad.
But my nose has always been open and clear...my mouth breathing was out of habit most likely from gasping for air because of the apnea events.
If your nose isn't clear...gotta get it clear first.

[trslp1]

Things seem to be coming together. This is now with the P10 and a home made chin strap.

What do you think now?

[Pugsy]

Looking pretty darn good.

[trslp1]

I am starting to get into the groove now and the P10 pillows are excellent. But the large leaks that are air blowing into my nose and out my mouth are still not totally conquered. I have an agressively tight chin strap presently. Should I just tighten it some more, or are there other tricks?

[Pugsy]

Why do you feel that they need to be "totally conquered"?
Are the leaks and mouth breathing waking you up often?

22 minutes of large leak out of nearly 8 hours of sleep (4.66% X 480 minutes) isn't the end of the world if you are sleeping soundly and feeling decent.

It's not a real pretty leak line but we don't get extra points for "pretty".
Sometimes we sacrifice good sound sleep for "pretty" by trying to make chin straps act like vise grips or something.
If something we do ends up being uncomfortable and causing us to not sleep well or have difficulty falling asleep and/or staying asleep then the cure is worse than the disease.

What are your priorities? Good math scores and pretty leak graphs?
Or good quality sleep and feel decent with acceptable math scores?
FWIW...it took me about 3 months for my mouth to learn to stay shut. I found taping was less annoying to me than chin straps and chin straps don't always work anyway no matter how tight they are. Clinch your jaws together...now open your mouth a little and breathe...having the jaws clinched doesn't stop a person from opening their mouth and breathing.
Chin straps are meant to be gentle reminders to the jaw to not drop. They aren't meant to be vise grips.

You might consider adding a soft cervical collar to help support the chin. I found it annoying myself to have to wear something else but many people find it quite acceptable and comfortable.

Also...not all leaks are mouth breathing leaks. We can have mask movement leaks too and the only way to know for sure is to tape one's mouth and see if the leaks totally stop. I quit taping my mouth about 3 months into therapy.
A couple of weeks ago I was seeing some pretty significant leaks with a mask that I was trying and I needed to know if the leaks were related to mouth opening or mask movement so I taped for one night and the leaks were still ugly...and the tape stayed in place all night...so the leaks weren't mouth breathing leaks after all. They were mask movement leaks.

[palerider]

I am starting to get into the groove now and the P20 pillows are excellent.

what's a P20?

[trslp1]

I am starting to get into the groove now and the P20 pillows are excellent.

what's a P20?

Sorry, P10

[trslp1]

Why do you feel that they need to be "totally conquered"?
Are the leaks and mouth breathing waking you up often?

22 minutes of large leak out of nearly 8 hours of sleep (4.66% X 480 minutes) isn't the end of the world if you are sleeping soundly and feeling decent.

It's not a real pretty leak line but we don't get extra points for "pretty".
Sometimes we sacrifice good sound sleep for "pretty" by trying to make chin straps act like vise grips or something.
If something we do ends up being uncomfortable and causing us to not sleep well or have difficulty falling asleep and/or staying asleep then the cure is worse than the disease.

What are your priorities? Good math scores and pretty leak graphs?
Or good quality sleep and feel decent with acceptable math scores?
FWIW...it took me about 3 months for my mouth to learn to stay shut. I found taping was less annoying to me than chin straps and chin straps don't always work anyway no matter how tight they are. Clinch your jaws together...now open your mouth a little and breathe...having the jaws clinched doesn't stop a person from opening their mouth and breathing.
Chin straps are meant to be gentle reminders to the jaw to not drop. They aren't meant to be vise grips.

You might consider adding a soft cervical collar to help support the chin. I found it annoying myself to have to wear something else but many people find it quite acceptable and comfortable.

Also...not all leaks are mouth breathing leaks. We can have mask movement leaks too and the only way to know for sure is to tape one's mouth and see if the leaks totally stop. I quit taping my mouth about 3 months into therapy.
A couple of weeks ago I was seeing some pretty significant leaks with a mask that I was trying and I needed to know if the leaks were related to mouth opening or mask movement so I taped for one night and the leaks were still ugly...and the tape stayed in place all night...so the leaks weren't mouth breathing leaks after all. They were mask movement leaks.

The only thing that I would like to conquer is dry mouth. The rest is all just a waste of time. I have to say that this last graph comes with only mildly irritating dry mouth and the one previous is actually the best I have felt since starting cpap. Compared with the dry mouth before chin strapping, we are most of the way there....

What kind of tape did you use?

[Pugsy]

What kind of tape did you use?

You would have to understand that I am the Queen of Cheap.
I used some blue painters tape I had left over from painting my mom's kitchen. It suited my needs. I could easily open my mouth and break the seal if I just HAD to open my mouth for some reason but it didn't come off super easy and it didn't take the skin off my lips. YMMV.

[palerider]

I am starting to get into the groove now and the P20 pillows are excellent.

what's a P20?

Sorry, P10

you had me wondering if I'd missed an announcement.

[chunkyfrog]

P20, P10! Gosh, I was getting aroused!

[trslp1]

You would have to understand that I am the Queen of Cheap. I used some blue painters tape I had left over from painting my mom's kitchen.

Ok, here is some more data with a taped mouth using the P10 pillows. Painters tape wasn't sticky enough, I had to use Duck Tape. First one is very good, and the second one?? I'm not sure what to say about it. I don't understand why the AHI climbs so high in the last hour? Of course the dry mouth is gone, but the first night with taped mouth, I woke up feeling weird, like I had bubbles in my stomach and massive knots in my muscles. It went away quickly in the morning and hasn't reoccurred subsequent nights. Of course the goal is to be able to get rid of the mouth tape and the chin strap if possible.

The one thing I am missing is my baseline, having never had a sleep study. Anyway to figure out the baseline based on the data we have so far? Could I generate a baseline by setting the machine to min / max of 4 ??

[Pugsy]

I don't understand why the AHI climbs so high in the last hour?

Either supine sleeping or REM stage sleep...or maybe a little of both.
With either it is common for our OSA to be worse and simply need more pressure during that time.
Given yours is at the end of the night when we normally have more REM sleep...that would be a primary suspect assuming you are in fact asleep during that time with the ugly clusters...or maybe you were on your back and in REM.

The one thing I am missing is my baseline, having never had a sleep study. Anyway to figure out the baseline based on the data we have so far? Could I generate a baseline by setting the machine to min / max of 4 ??

It won't be totally accurate because even the pressure of 4 offers some therapy value but it might give you a ballpark baseline.
A potential problem with trying to use 4 cm....you may find that so little pressure causes you to feel like you are suffocating and you may not be able to fall asleep while you feel like you are suffocating. You won't suffocate but it can sure feel like it.

I once did a screening with my machine on my sister...I tried the 4 cm on her and she yanked it off in about 20 seconds saying I was trying to kill her by suffocation. We ended up having to use 6 cm starting point for her to feel comfortable.

But you could try the 4 min and 4 max thing and see how it goes. Just be aware it isn't ideal for a baseline to go on because even 4 cm does some work but it's the best option you have since the machine won't go any lower.

[palerider]

The one thing I am missing is my baseline, having never had a sleep study. Anyway to figure out the baseline based on the data we have so far? Could I generate a baseline by setting the machine to min / max of 4 ??

I don't understand why people care about a 'baseline'. I don't know what my apnea was like back before I got a machine, I don't know what it would have been rated at... I do know I felt like shit, and was falling asleep all the time, and had to drag myself out of bed in the mornings... and simply couldn't manage to go to work some days...

and now all those things are gone... that's good enough for me.