Non-mouth breather suddenly has dry mouth with new APAP

For 10 years I used a ResMed S9 CPAP machine – the last three years without a humidifier, after I dropped the machine and that part stopped working. For all that time I never had an issue with mouth-breathing, and my mouth was very rarely dry, even during those last three years. I used my CPAP at 7.2 pressure with the Swift FX nasal pillow mask.

My S9 finally started to die, so I got a new machine last week after taking CPAP.com’s home test. I got the ResMed AirSense 10 APAP with humidification because my husband and I both had such good luck with our first ResMeds (he took his home test later than I did, so he hasn’t ordered a new machine yet). I also got another brand-new Swift FX mask, since I’ve had no problems with it.

Every night for the first four nights with the AirSense and the Swift FX, my numbers have been good in the myAir app, with overall scores in the mid to high 90s (I’m not one who gets really deep into the numbers; if I’m comfortable, I’m happy so I don't have the detailed charts I see in other threads). I appear to have a good mask seal and have less than one event per hour.

However…now my mouth gets so dry and sticky it wakes me up several times during the night. Obviously I’m opening my mouth, but why would I be a non-mouth-breather for over a decade, and then get a new machine and suddenly have issues? My head has also felt like a Thanksgiving parade balloon the last two nights, which leads me to suspect too much air pressure (the range is set between 4 and 20 on the new APAP). So I spoke to someone at CPAP.com and she helped me set the range a little lower to see if that helps. I thought I’d start with between 4 and 15 and fiddle with the numbers from there if I need to.

Are there any other settings I should look for that might ease the dry mouth, especially? Or should I take a look at another nasal pillow mask that might work better for this machine? I know APAPs are different in the way they work, but it seems like I should be able to come closer to the comfort of the old CPAP, rickety as it had become.

I read the FAQs and did a search for other threads that might address my situation, but couldn't find anything that matched my question. Thanks for any advice you might have!

Can't imagine who you talked to at Cpap.com - possibly she didn't understand, but the usual thing to do is raise the lower pressure (4 is almost impossible for most to breathe at) to e.g. 6 or 7 and keep the upper one at 20 and see how you do after a few nights. You haven't said if you used the humidity or not with the new machine...? It's possible also that the ambient room temp. was different than it was prior to the change, and/or that it was not set up correctly.

PS - Myair is really not much good according to all, and Oscar (see Stickies) is much more comprehensive - if you post results here others will help interpret for you and advise if anything needs tweaking.

I had nearly the same thing happen to me…moved from the S9 for Her with humidifier to the S10 AirSense for Her using Swift FX on both and suddenly all the mouth breathing happens. My scores weren’t great though, with leaks in addition to dry mouth. I tried all the settings - the “for her” and standard modes, adjusting the pressure and multiple masks. I can’t use full face masks due to sensitive skin that develops pressure ulcers and variations on nasal pillows all yielded the same results. It seems I now open my mouth, which I don’t do on the couple of nights I’ve been back on my S9. So for the S10, I went back to the Swift FX, on the standard APAP mode, back in my standard range and had to add a mouth guard and chin strap to solve the issue. I hate the new setup, missing the simplicity of “mask on and sleep”, but hate feeling of sleeping without solid APAP support more. I’m sure my dentist is thrilled I am minimizing teeth grinding I’ll be curious what those with more experience have to say and any tweaks that may help, especially if I can eliminate the chin strap.

It takes very little mouth breathing to cause dry mouth....as little as 5 or 10 minutes can do it for me.

Also medication side effects and/or other health issues can impact the hydration of the mouth.

Is it possible at the addition of humidified air caused some nasal congestion that might have caused you to mouth breathe?

Pressures themselves don't usually cause dry mouth though.

The usual culprits
1...mouth breathing ...and it doesn't take much
2...medication side effects
3...other health conditions
4...decreased saliva production for some unknown reason
5...general overall hydration

@Julie, I did use the humidifier, on 5, and I will try upping the lower number instead and see if anything changes. I'll also look at that Oscar sticky.

@WanderingWolf, I'm dreading having to use a chin strap, too. I don't want to tape my mouth because I'm allergic to most bandage glue and even paper tape leaves red marks on my skin. Although I've been trying to talk my husband into getting a chin strap for years (he IS a mouth-breather when he sleeps on a certain side), so maybe if I have to get one, he will too.

@Pugsy, it's very possible the humidified air blocked me up a little, since I haven't used it in so long. I don't take medications, only vitamins, but I do use Flonase when my seasonal allergies bother me (which they haven't done the last week). I may have to make Flonase an every-night thing. I didn't realize it took so little mouth breathing to dry you out. Sigh...just when you think you have it down cold, the universe changes everything on you.

Thank you all--I really appreciate the information, and you've given me a place to start tinkering. I'll report back if I crack the code!

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

I used my CPAP at 7.2 pressure

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

the range is set between 4 and 20 on the new APAP

This is a significant change in pressure settings. I suspect at the newer settings you are struggling to breathe and opening your mouth. If you were doing well at 7.2, I would set the new machine to 7.2 straight CPAP. If that eliminates the mouth-breathing, you can consider further optimization with the use of APAP settings.

ChicagoGranny wrote: ↑

Mon Oct 18, 2021 5:24 pm

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

I used my CPAP at 7.2 pressure

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

the range is set between 4 and 20 on the new APAP

This is a significant change in pressure settings. I suspect at the newer settings you are struggling to breathe and opening your mouth. If you were doing well at 7.2, I would set the new machine to 7.2 straight CPAP. If that eliminates the mouth-breathing, you can consider further optimization with the use of APAP settings.

+1

came to see this, left satisfied.

ChicagoGranny wrote: ↑

Mon Oct 18, 2021 5:24 pm

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

I used my CPAP at 7.2 pressure

LindaF5775 wrote: ↑

Mon Oct 18, 2021 2:32 pm

the range is set between 4 and 20 on the new APAP

This is a significant change in pressure settings. I suspect at the newer settings you are struggling to breathe and opening your mouth. If you were doing well at 7.2, I would set the new machine to 7.2 straight CPAP. If that eliminates the mouth-breathing, you can consider further optimization with the use of APAP settings.

Setting the minimum to 7.2 would be better, and let the machine raise the pressure if needed.

palerider wrote: ↑

Mon Oct 18, 2021 6:11 pm

Setting the minimum to 7.2 would be better, and let the machine raise the pressure if needed.

Aren't you the one who taught me to only change one variable at a time? She has changed machines. Changing the pressure should be done as a second step.

ChicagoGranny wrote: ↑

Mon Oct 18, 2021 6:17 pm

palerider wrote: ↑

Mon Oct 18, 2021 6:11 pm

Setting the minimum to 7.2 would be better, and let the machine raise the pressure if needed.

Aren't you the one who taught me to only change one variable at a time? She has changed machines. Changing the pressure should be done as a second step.

That sounds more like Pugsy

I'd say what I said, set the min to the same pressure the previous machine was set to, but let the auto see if the auto wants to do anything...

In this situation....S9 to AirSense ...not changing brands.
I didn't understand if the 7.2 on the S9 was fixed or not but if it had been me and going to auto from fixed (and staying in same brand) I wouldn't be hard nosed about the "one change at a time" thing.
Without seeing what all the 7.2 results were....I would have most likely suggested around the 7 ish minimum in auto mode and see what happens.

The question was about dry mouth though....

The other option is use exactly what was used on the S9 and not be in a hurry to change anything and see if the dry mouth is still a problem. Just because we can change stuff and all that....doesn't mean we have to do it all RIGHT NOW.

Whatever is causing the dry mouth Xylimelts work pretty well at preventing the dryness. Here's a link to them so you can read about them:

https://www.amazon.com/dp/B07TSFS3XX?re ... xylim&th=1

Best of luck at finding a good solution!

Pugsy wrote: ↑

Mon Oct 18, 2021 10:11 pm

In this situation....S9 to AirSense ...not changing brands.
I didn't understand if the 7.2 on the S9 was fixed or not but if it had been me and going to auto from fixed (and staying in same brand) I wouldn't be hard nosed about the "one change at a time" thing.
Without seeing what all the 7.2 results were....I would have most likely suggested around the 7 ish minimum in auto mode and see what happens.

The question was about dry mouth though....

The other option is use exactly what was used on the S9 and not be in a hurry to change anything and see if the dry mouth is still a problem. Just because we can change stuff and all that....doesn't mean we have to do it all RIGHT NOW.

Seems to be straddling the hard-nose fence.

Okay, so here's what I did last night, and the results:

I changed the mode to CPAP, set the pressure to 7.4 (I didn't realize I'd ticked it up a notch until this morning), kept the humidity at 5...and I had the best night's sleep I've had in ages (probably since I broke my humidifier on the S9). I went to bed at 10:30, got up once at 12:30 for a bathroom dash, and slept straight through until 6:30 this morning. That's highly unusual for me; usually I wake up 2-3 times a night. I'm reasonably certain I didn't mouth-breathe all night, but will check with my husband when he gets up to see if he noticed it. However, I didn't have dry mouth once. And this morning, I actually feel like I got a good night's sleep and am starting work without yawning. Oh, and I understand that MyAir isn't the best indicator, but it's all I have at the moment so my score was 99, with a perfect mask seal and 0.8 events per hour.

I'm going to leave the machine at the current setting for tonight, and see if my experience repeats itself. I just know I am SO grateful for everyone's feedback, because it gives me a lot of variables to play with in case last night turns out to be a fluke. Again, thank you!

LindaF5775 wrote: ↑

Tue Oct 19, 2021 6:34 am

And this morning, I actually feel like I got a good night's sleep and am starting work without yawning. Oh, and I understand that MyAir isn't the best indicator, but it's all I have at the moment so my score was 99, with a perfect mask seal and 0.8 events per hour.