Dry mouth even with humdifier

[Jeff_Snore_No_More]

Last night, I used the heated humidifier on my PR DreamStation Auto BiPAP, and my Resmed AirFit F20 mask. I also used the heated hose. I "half" woke up several times with a very dry mouth. I had the humidifier and hose both set at 3 (settings for both go from 1 to 5). I know the humidifier was working, because there was only a small bit of water left in it this morning. I don't understand why my mouth was so dry. I will say that I had a bad night with the mask: lots of leaking. It's a new mask and headgear, and last night was the 5th night I have used it. It was fitting and working well until last night. I woke up in the early morning, tightened the straps a bit, went back to bed, and the leaking seemed to stop.

So I have 2 questions:

1) Would a leaking mask cause dry mouth? The humidifier was pushing warm moist air that was just escaping.
2) Is it common for headgear to stretch out a little after just 4 nights?

[Pugsy]

Unless someone has a medical condition of sorts or takes medication that can dry out the mouth....the dry mouth is from mouth breathing. Some people just get dry mouth more easily than others for any number of reasons.

It's a common complaint even with full face mask users.
Even a common complaint from full face mask users who are using the humidifier at maximum humidity delivery. The cold hard fact of life is that these humidifiers were never really designed for the mouth/oral cavity. They were designed to help with moisture in the nasal cavity which is much smaller. For some people it simply can't add enough moisture to re-hydrate the oral cavity enough to get rid of the dry mouth. For this reason a lot of full face mask users will add some sort of product that is designed to add moisture to the mouth...they try various products until they find a product that works for them.

Leaking doesn't cause dry mouth but a lot of leaking can cause an increase in the water consumption. This can happen with or without mouth breathing and with or without dry mouth happening.
The things that affect water consumption are
1...ambient humidity in the bedroom
2...leaks
3...pressure used (more pressure will use more water)

You might try max of 5 for humidity setting...the hose setting is just for hose air temp so your choice on that setting... and see if it helps with the dry mouth. It might be enough added moisture to reduce the dry mouth but it also might not. For some it is enough but for others it isn't for any number of reasons.

If it's the mouth breathing (not meds or some other health condition) that is causing the dry mouth then reducing the mouth breathing is an option but unfortunately easier said than done sometimes. If the nose is stuffy and someone can't get it cleared up then they have to mouth breathe.

The headgear with any mask will stretch out over time. 4 nights does seem to be a little too soon in my book but then I am not familiar with your mask or where it might be stretching or what you are doing in terms of fitting.
You might want to look at your detailed reports to see what the pressure was doing when it started to leak more and wake you up.
Maybe the pressure increased significantly from what it was when you fit the mask at the beginning of the night and it simply wasn't quite snug enough to handle the higher pressure. Fitting a mask at say 10 cm might not work so great for keeping the seal if the pressure goes to 18. Facial oils and sweat can also impact the seal later on in the night. If that's the case then adding a mask liner might help reduce that annoyance.

[Jeff_Snore_No_More]

Pugsy,

That is a more complete explanation than I could have hoped for. Thank you so much for taking the time to explain in good detail. By the way, my BiPAP is set to 18/15, not Auto.

Thanks again!

[prodigyplace]

The Amara View mask sits under the nose.
I could never get it to seal well when I tried it. Air would tend to blow into my eyes from the nose area. Trying a different size cushion did not help me. I ended up moving to a different mask.

[Pugsy]

Well with fixed pressures that eliminates changing pressures from the equation...pretty much leaves maybe facial oils and sweat as a potential culprit. Maybe not a factor at all..maybe a little bit.

You are going to find that you have nights where nothing wants to work well and then nights where nothing goes wrong and lots of nights with lots of in betweens and we don't always know the answer as to "why".

I have been at this cpap stuff for over 9 years now and I still have nights just like I described...nothing goes right and then the next night with no changes in anything nothing goes wrong. Plus I have a lot of those in between nights. Mostly good nights though and as long as I am sleeping halfway decently and feeling decently then I am good. Last night was a bad night in terms of sleep but not related to cpap or mask at all. Just life with a neurotic dog and thunderstorms...doesn't equal a good night.
It's going to be a long day today and I have a 3 hour trip one way to pick up a friend from the hospital that is scheduled for today sometime. Couldn't have picked a worse day but it's what life gives us sometimes. I got maybe 4 hours of sleep and severely fragmented at that. My butt is already dragging.

If it were me I would first try adding more moisture using a higher humidifier setting. Might get lucky and that's all you need.
Hopefully more moisture won't make any nasal congestion worse (it can for some people).
If not lucky then consider the other options like the products to add moisture to the mouth or even reducing the need to mouth breathe if it is possible by opening up the nose more.
If the dry mouth is related to something else then maybe just deal with it....like meds or other health conditions as best you can.

This whole cpap process stuff involves a lot of trial and error in figuring out the problem and then figuring out a solution.
Gotta first figure out the problem though and sometimes that involves some work. To fix problem we have to identify it first if at all possible.

For mask leaks or other mask issues...depends on just how much I like the mask how much effort I will put into fixing whatever issues I have with a mask.
I won't spend much time or money on something that I really don't particularly care for in general. Too many other masks out there to try that might suit my preferences better.
Make good use of any mask swapping time you might have available with your DME. You can always go back to a prior choice if you discover that a new one isn't working out so great. Try as many as you can while you can on their dime.
It's the only way you learn your own preferences and needs.

[prodigyplace]

For mask leaks or other mask issues...depends on just how much I like the mask how much effort I will put into fixing whatever issues I have with a mask.
I won't spend much time or money on something that I really don't particularly care for in general. Too many other masks out there to try that might suit my preferences better.
Make good use of any mask swapping time you might have available with your DME. You can always go back to a prior choice if you discover that a new one isn't working out so great. Try as many as you can while you can on their dime.
It's the only way you learn your own preferences and needs.

That is a good point. I started with the P10 and ended up trying other masks, including the Amara View before returning to the P10 as my main mask.

[raisedfist]

You gotta try all the humidity settings unfortunately. For me on a full face mask, the less humidity the better for whatever reason. If I turn up the humidity I feel suffocated.

[prodigyplace]

You gotta try all the humidity settings unfortunately. For me on a full face mask, the less humidity the better for whatever reason. If I turn up the humidity I feel suffocated.

I agree. I have been trying lower humidity and find I just do not sleep as soundly if it is too low when using nasal pillows.

[Jeff_Snore_No_More]

Pugsy, thanks again for your thorough explanation and good points. I'll try a higher heat setting on the humidifier. I am taking 4,934 medications (exaggeration, of course...but close!!), so the dryness could be any one of those. As for masks, I had been using a nasal pillows mask for a few years, but lately I had been waking up with mouth dryness. There's that "D" word again. So I recently tried the Amara View mask. That mask is a great idea. Reminds me of the hybrid mask that I tried, but the pillows were leaking like crazy. The Amara didn't leak at all, but I was waking up with my lower lip under the bottom of the mask. So I decided to try the Fisher & Paykel FlexiFit HC431 and Forma masks, because they both go down under the chin. They both leaked bad at the bridge of the nose. I bought a nasal pad that goes on the bridge of the nose, but I haven't tried it yet. I went right into the Resmed AirFit F20, which is where I am now. That's what I had the leaks with last night, but not the previous nights. I just received the memory foam cushion for the AirTouch F20, which fits the frame for the AirFit, so I will try that.

Lots of things going on.

[prodigyplace]

Sorry, I assumed Amara View because that is listed in your Profile here.

[Pugsy]

Maybe we need a menu choice for "new to therapy trying a bunch of masks" instead choosing just one and trying to remember to change the profile every time we decide to go mask experimenting.

[Jeff_Snore_No_More]

Oops..... Yes, I need to change my profile. But as Pugsy hints at, I'm not done yet. I'd like to make the AirFit work, I guess more because of psychological reasons than anything else. That simply means "I read good things about it." Also, the therapist at the DME told me she swears by it, as do her other patients. I'm in a bad in-between place right now regarding DME's. I was originally using an outfit called American Home Patient, who did a great job for me. They were taken over by Lincare, and then the nightmares started. So I went to another DME called AdvaCare, just within the last few weeks. That's who I just got the DreamStation BiPAP Auto through. Here's the problem. I just got a mask through Lincare a few weeks ago, just before going to AdvaCare. As far as my insurance is concerned, I'm associated now with AdvaCare, not Lincare. So, it's too soon to get any masks from AdvaCare, and I can't play swapsies with Lincare any more. At least that's what the lady at AdvaCare told me. I bought the AirFit mask with my own money. I won't be entitled to a new mask through insurance for another couple months. Then I can run the mask gamut if I haven't settled on one by then.

[Okie bipap]

Normally, if I want to try a new mask that I have to pay for, I either try to find a cheap one on eBay, or order through our forum host. They offer return insurance on their masks at very reasonable rates, and often at no cost. My problem is I tend to keep trying to make them work for more than 30 days, then it is too late to return them if I don't like them. When that happens, I pass them along to some one here on the forum that can use it.

[chunkyfrog]

Normally, if I want to try a new mask that I have to pay for, I either try to find a cheap one on eBay, or order through our forum host. They offer return insurance on their masks at very reasonable rates, and often at no cost. My problem is I tend to keep trying to make them work for more than 30 days, then it is too late to return them if I don't like them. When that happens, I pass them along to some one here on the forum that can use it.

Starting a year after I started, I used cpap.com, because insurance was just plain sucky, as it so often is.
Once Medicare kicked in, I found a local Mom/Pop DME contracted to accept Medicare price as full payment.
(I did make a very brief foray unto the evil beings at Apria--but wised up quickly)

[klm49]

The Amara View mask sits under the nose.
I could never get it to seal well when I tried it. Air would tend to blow into my eyes from the nose area. Trying a different size cushion did not help me. I ended up moving to a different mask.

You must use a different Amara View than the one I have because it seals across the lower part of the nose. If it sat under the nose there would be no air going in the nose. Little wonder it didn't weork for you.