Those of you who've been around know that I'm a long time PAPer. In November 2022 I switched from a PR DreamStation BiPAP Auto to a Resmed Aircurve 10 VAuto. I wrote about the early experiment days with the AirCurve in this thread.
I've now been using an AirCurve for 2 1/2 months. I started playing around with the heated hose a while back. I was dealing with my standard winter-time problem of occasional rainout accumulating in the part of the hose that sags between the machine and the edge of the bed where I run the hose (in a hose cozy) under the covers, along with a fairly common "wet puppy dog nose" problem caused by condensation in the nasal pillows, which doesn't really bother me that much anymore. I thought (correctly) that the heated hose might help with the rainout and the wet puppy dog nose problem.
But since I started using the heated hose, I've started to experience some dry mouth problems, which are new, combined with a return of the old chapped lip problems that have plagued me off and on since I first started PAPing back in 2010.
The problem has been slowly growing worse during January, and by a few nights back, the dry mouth problems had become pretty severe: I was waking up with a super dry mouth during the night and having to drink water before I could get back to sleep and by January 20th, my mouth was feeling dry throughout most of the day even though I've been trying to consciously increase my water intake. The inside of my nose has been dry and sore and congested during the daytime most of this month, and the chapped lips are noticeable, but not yet severe. Things finally got so bad with the dry mouth problems that I turned the hose off a few nights ago.
Here's the relevant information about my settings and my bedroom environment when I was using the heated hose:
- Min EPAP = 4 cm
- Max IPAP = 9 cm
- PS = 4 cm
- Hose Temp = 67F
- Humidity setting = 8 (max)
- Bedroom temp in the low 60s
- We have a whole house humidifier attached to the forced air heater; ambient relative humidity in the house stays around 40%
- The humidifier tank is not running dry during the night; I fill it to the max line at the beginning of the beginning of the night, and it's usually at or just above the 1/4 full line when I wake up in the morning.

As you can see, there's no evidence of any significant leaking. So I don't think my dry mouth problems are caused by mouth breathing. And since the aerophagia has not raised its ugly head, I'm pretty sure that my tongue is staying put on the roof of the mouth most of the night. But maybe the fact that I've made a conscious effort to avoid eating too close to bedtime is helping to keep the aerophagia away even if my tongue is allowing some air into the mouth by not staying parked up where it should be.
My mouth was so painfully dry after the night of Jan. 23 that I turned the hose temp to OFF in the hope that maybe that would help. Since turning the hose temp OFF, I have noticed some (small) improvements in the dry mouth problem, the nose is a bit happier, and the lips are about the same. But the rainout problems have returned, along with the wet nose. And I am still waking up at night thirsty with a rather dry mouth, but it's not as bad as it was during the last week I used the heated hose.
Back during my first winter of PAPing I had a lot of these problems, but I don't remember the dry mouth being as severe as it's been this month. I do remember using Biotene mouthwash back then and it helped a bit. I think may also buy some Xylimelts.
But what I'd like to pick folks brains about these questions:
1) Is the AirCurve's humidifier a "smart" humidifier that attempts to prevent rainout even when you're not using a heated hose? I ask because during the last several years I typically had my PR DreamStation humidifier set to Classic 5, which is the maximum setting in the non-smart mode. Yes, I dealt with some occasional rainout problems and some pretty common wet puppy-dog nose problems, but I didn't wake up with a super dry mouth all the time and my nose wasn't painfully dry during the daytime. But switching to "smart mode" would make my nose less happy.
2) Any ideas on why my nose and mouth seem to be getting more dried out when I have the hose temp set to 67F than when I have the hose turned off? A lot of folks here routinely tell people who are complaining of dry mouth problems or dry noses to not only turn the humidifier up, but also turn up the hose temp. Well, I can't turn the humidifier up anymore, and increasing the hose temp seems to have aggravated my dry nose and dry mouth problems. Or maybe my nose and mouth care more about getting the relative humidity as close to 100% as possible instead of having a higher temperature that would allow a higher absolute humidity, but lower relative humidity in the air coming through the hose.
3) Would turning the hose up past 67F increased the the absolute humidity in the hose air in order to maintain a constant target relative humidity in the hose air? I never turned the hose temp above 67F because I really don't like hot, humid air. I have always had trouble sleeping in rooms with an air temperature in the 70s, so the idea of really cranking the hose temperature up to the 80s in an effort to get additional humidity isn't very appealing.
Well it's past my bedtime. So I'm going to see if I can find some Biotene stashed somewhere in the bathroom and use it tonight to see if that helps.