Mouth filling from inside with air

Hello all

This is a similar post that had some odd comments so I am going to try again.

I have been using my APAP for almost 2 weeks and wanted some feedback.

Using the sleepyhead program, I know that all of my AHIs are less than 5 but I wouldn't say that I have huge increases in energy but some!

I still have several hypopneic events and was advised to increase my baseline low pressure from 4 to at least 7.5 or 8

I did this hand had a miserable night!

Pretty much my only issue is with the higher pressure (which I know is not that high!).

I sleep on my side and when I start to fall asleep, I think my pharynx relaxes and I get a lot of air being redirected to my mouth which kind of blows up a little like a balloon and then releases pressure from my lips. That wakes me right back up again and it is a viscous cycle. I tried a chin strap but it seems to be from the air on the inside of my mouth, blowing on my lips from the inside. it is not my mouth opening as in people that sleep open-mouthed. I feel that this is bad so it makes me get frustrated and worry and then can't fall asleep. Dumb how the mind works.

When I do fall asleep and my apap responds to correct the apnea or the hypopnea, starting the whole process again and is more frequent with the higher pressure opening my mouth from the inside, releasing, making noise and waking me up.

I am a side sleeper and I am afraid the full face mask wont work (but some members say no problem!) Currently using nasal pillows.

Has anyone ever heard of this? I read taping the mouth may help but the air is not coming from the outside, but the inside. Not sure how tape will help other than just make my cheeks expand.

Just wanted your expert advice.

Thanks!

Mike

mikeinstlouis wrote: ↑

Fri Aug 10, 2018 9:26 am

Has anyone ever heard of this? I read taping the mouth may help but the air is not coming from the outside, but the inside. Not sure how tape will help other than just make my cheeks expand.

I am a side sleeper and I am afraid the full face mask wont work (but some members say no problem!) Currently using nasal pillows.

See the airflow diagram in this post:
viewtopic.php?f=1&t=112758&p=1085906#p1085906
Tape prevents air from flowing OUT of the mouth.


See an alternative to tape here:
viewtopic.php?f=1&t=112758&p=1085906#p1086296

Many side sleepers use a FFM successfully.

People tape their mouths so that they don't open their mouth and allow the pressurized air to flow OUT from it, which can cause the airway to collapse resulting in an obstructive apneic event.

Edit: Sorry Jay, you beat me to it.

i have no idea why you can't read the answers to your question in the other thread but, having said that-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

some people tape their mouths, but i think the above is a much gentler approach.

good luck!

mikeinstlouis wrote: ↑

Fri Aug 10, 2018 9:26 am

I sleep on my side and when I start to fall asleep, I think my pharynx relaxes and I get a lot of air being redirected to my mouth which kind of blows up a little like a balloon and then releases pressure from my lips. That wakes me right back up again and it is a viscous cycle. I tried a chin strap but it seems to be from the air on the inside of my mouth, blowing on my lips from the inside. it is not my mouth opening as in people that sleep open-mouthed. I feel that this is bad so it makes me get frustrated and worry and then can't fall asleep. Dumb how the mind works.

It happened to me too for a few weeks after I forced myself to breathe only through my nose at night. But only a few times at night. Then it went away, and I am fine. My RT said that was just me adapting to the machine or whatever.

I am a side sleeper and I am afraid the full face mask wont work (but some members say no problem!) Currently using nasal pillows.

Has anyone ever heard of this? I read taping the mouth may help but the air is not coming from the outside, but the inside. Not sure how tape will help other than just make my cheeks expand.

[/quote]

I've been at this trial and error for about a month now...which qualifies me as someone with a LITTLE knowledge...so I may be dangerous! However, I do share some of your issues. I am a side sleeper, nose breather. At first, I used the nose pillows and experienced a LOT of what you describe. Previous members have posted illustrations of WHY it happens. The question is how to STOP it from happening and waking us up all the time. For me it happens when the pressure gets higher than usual. I hate it! I can't wear the scunci because of jaw issues and tape over my mouth doesn't thrill me either. I had read (from Pugsy, I think) about learning to teach your tongue to push up on the roof of your mouth. I've been working on this and as soon as I feel a "blurp" in my mouth, I force my tongue up and it stops right away without waking me completely, or forcing my mouth open creating a HORRID dry mouth and throat. I also switched to a nasal cushion (instead of pillow) and it has greatly reduced that issue for me as well.
My post is certainly not professional advice, but just wanted you to know you're not the only one doing it and it's important for you to try the things the knowledgeable people on this forum suggest to you. Also, take the time to read through older posts searching by key words. This forum is the ONLY place I have learned ANYTHING of value in this CPAP process!

Mouth leaks (pressurized air leaking from the nasal passages out through the mouth) are difficult to control because they are allowed by a failure of the of the back of the tongue to seal at the throat (the velopharyngeal sphincter). An example of a proper seal can be experienced by noting the placement of the tongue when starting to make a "K" sound. Holding the tip of the tongue at the roof of the mouth behind the front teeth places the tongue in a similar position and aids in making a seal. People practice, and some learn, to keep the tip of tongue in this position while sleeping to help reduce leaks. "Learning" this can take some time.

People are often disturbed by the noise and feeling of these leaks and therapy effectiveness may be reduced by a loss of airway pressure with them. In leak graphics, mouth leaks are typically represented by longish, flat, plateau shaped traces.

Chin straps are often ineffective because they do not stop the air flow out of the mouth as can be seen by the ability to exhale through clenched teeth. But chin straps may help prevent mouth breathing (inhalation through an open mouth) which I see as a slightly different problem. Additionally, chin straps can exacerbate obstructive apnea because the straps tend to pull the chin backward which tends to compromise the airway.

To prevent these leaks, air has to be stopped from flowing through the throat and out of the mouth. It can be done in one of three ways: Keep the tongue in the proper position, keep the lips sealed by tape or other means, or wear a full face mask. A full face mask eliminates the differential in pressure between mouth and nose which promotes the leaks.

A FFM may eliminate mouth leaks and therapy degradation due to loss off pressure, but might not prevent mouth breathing and the sometimes attendant dry mouth. Taping can lead to chipmunk cheeks (oral cavity fills with air) which may also result in disturbance and dry mouth.

Thank you for the advice... I have switched to using the nasal cushion I guess is what you call it, the Triangular mask that fits around the nose, and it's not as bad as it was with the nasal pillows but it still exists. I try to do the tongue on the roof trick but it relaxes as soon as I fall asleep. I guess my last resort before giving up on all of this would be to use a full face mask but I don't know if I'll be able to sleep with that. Thank you again

There is nothing wrong with a FFM except being a little more difficult to fit. Some of newer ones are quite light and actually border on comfortable If a full face mask reduces the disturbances you are experiencing from throat leaks and allows you to sleep longer, it is a winner.

In the meantime, you might try the Scunci as I've described in this post: viewtopic.php?f=1&t=112758&p=1085906#p1086296. I and others have had good luck with it.

The Scunci doesn't stop mouth leaks, but it slows and quiets them which tends to make any leaks less noticeable and disturbing. At the same time, since air is allowed to escape, chipmunk cheeks are less likely to form, again reducing a source of disturbance. One might think of the Scunci as "training wheels" while learning to keep the tongue in the proper position.

clenchingtobreathe wrote: ↑

Fri Aug 10, 2018 11:47 am

I am a side sleeper and I am afraid the full face mask wont work (but some members say no problem!) Currently using nasal pillows.

Has anyone ever heard of this? I read taping the mouth may help but the air is not coming from the outside, but the inside. Not sure how tape will help other than just make my cheeks expand.

I used to use a ffm, I always sleep on my side. If you don't try, you'll never know. Stop being "afraid".

Taping keeps the air from blowing out your mouth, which causes severe dry mouth. Who cares if your cheeks puff out while you're asleep?

mikeinstlouis wrote: ↑

Mon Aug 13, 2018 11:53 am

I guess my last resort before giving up on all of this would be to use a full face mask but I don't know if I'll be able to sleep with that.

Have some resolve. I use a FFM and sleep on my back, sides and stomach. I also know how to prevent dry mouth. Be a learner and problem solver.

zonker wrote: ↑

Fri Aug 10, 2018 11:14 am

i have no idea why you can't read the answers to your question in the other thread but, having said that-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

some people tape their mouths, but i think the above is a much gentler approach.

good luck!

The OP said that mouth opening is not his problem...It's the air inside his mouth blowing up his cheeks.

LSAT wrote: ↑

Mon Aug 13, 2018 3:17 pm

zonker wrote: ↑

Fri Aug 10, 2018 11:14 am

i have no idea why you can't read the answers to your question in the other thread but, having said that-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

some people tape their mouths, but i think the above is a much gentler approach.

good luck!

The OP said that mouth opening is not his problem...It's the air inside his mouth blowing up his cheeks.

There's nothing that will fix that. Probably best to focus on what is possible.

If taping over the mouth is too scary, check out Chin Up strips.
When applied correctly, breathing through the mouth is possible, but very awkward.
Sometimes even hilarious.

I used to have this problem when I started nasal.. now with ultimate chin strap and taping it's gone. I ran out of tape recently and still don't seem to get the problem. really I don't know exactly why it went away. it may just be that over time my pharynx is able to accomodate the higher (now 13) pressure without any extra leakage.