Occasional mouth breathing while using a nasal mask

Hello everyone!

So I have been using CPAP for a week now and for the most part things are going rather smoothly and find that I am able to adjust to this new situation. However sometimes I find myself being awakened by this loud noise only to then realize that this is due to my mouth being opened. When I close it everything suddenly becomes quiet and then I fall back asleep again. It happens sometimes probably because of of my nasal passages ( could be either one it varies) becomes blocked, so I suddenly only have one hole to breathe in so I guess my brain is telling me to use my mouth. I guess I could always try a chinstrap or a decongestant of some type for now but would really like to train myself to only nose breathe without these things at some point, and would rather not (for now at least ) take the FFM route. Has anyone had the same problem and then have it resolved at some point? How long does it usually take(approximately)?

Does the machine take this into account? I'm wondering if this occasional mouth breathing can give me false readings? I'm guessing the machine only gets its data from the nose and does not 'see' my that mouth sometimes opens? I hope this this not the case! For now, I am not yet using sleepyhead and can only access the basic data, which shows that my AHI is usually under 3 and mostly under 1. I always see the smiley every morning and my average leak rate is 19L/min. I'm hoping these numbers are right and that when the clinician/doctor sees the full data that the mouth leaks will be shown so that I can take the appropriate steps to correct the situation. I also hope that my treatment isn't being compromised due to this, as I realize that mouth breathing while using a nasal mask defeats the purpose. But again, I would really like to train myself to only breathe through the nose if possible. I do find it a lot easier to do so on CPAP than before. I hope I expressed myself clearly.

Regards

Chris

Yes, mouth breathing would defeat your treatment. You should avoid it. A full face mask does not stop you from mouthreathing but in this case the treatment is almost not effected. The leaks around the seal of a full face mask ruined my treatment for almost a year untill I changed to the present set up.

YOu could try a chinstrap or tape your mouth. The simple solution is a full face mask.

If it's only been a week, then you may still learn to block your mouth airway as you sleep. I use a nasal mask mask and the first few nights woke up with my mouth open. But by consciously curling our tongue up to the top of our mouth, we can still have our mouth open and have a sealed airway. Try it and see. Over time you will do it during sleep. If not, then maybe the FF mask or chin strap, etc is needed.

As far as leaks and false data... every time your mask has a major leak, your overall mask pressure drops to near zero and the therapy stops. It will show up on the data as a mask leak and the flow rate will show a spike. But because you didn't have an air blockage (apnea) the AHI score may not change. Though, some scoring systems might score a hypopnea due to the false increase and then decrease in breath flow, or call it an unknown event.

However, if you then have a REAL apnea during a major leak, you will be unprotected and the AHI index will not change to even know it happened. Some systems might later score a hypopnea due to the false increase and then decrease in breath flow, though rare.

So bottom line is an ocassional leak is OK, even a tiny leak all night, but strive to get leaks down as low as possible and your whole system will work better and report more accurately.

Tom

Thanks for the thoughtful replies!

So I just got back from the drugstore and got a nasal mist, hoping it will do something. I still do not want to go with the full face mask yet, not if I can help it. I would like to exhaust all my options before going that route. Might eventually try the chinstrap option, if only to train myself to mouth breathe. I will definitely try the tongue trick thanks! Where precisely do I place my tongue? On the roof of my mouth or near my top front teeth?

As for the data reporting that my machine gives me, does that mean that if I have an apnea episode with my mouth open it will not notice? Sorry for the question perhaps I am misunderstanding. Also I do not think my mask has any major leaks. I do not feel air coming out into my eyes or anything , save from some air escaping through the tiny holes of the mask which I believe is normal. Plus I keep getting the smiley. I just want the info my machine gives me to not be wrong

Thanks again!

Chris

chris-p wrote:So I just got back from the drugstore and got a nasal mist, hoping it will do something. I still do not want to go with the full face mask yet, not if I can help it. I would like to exhaust all my options before going that route. Might eventually try the chinstrap option, if only to train myself to mouth breathe. I will definitely try the tongue trick thanks! Where precisely do I place my tongue? On the roof of my mouth or near my top front teeth?

Chris-P,

I copied a excerpt below about how I do the tongue technique from another thread I posted in a while ago. I do it this exact way every night and it works very well for me. Though, everyone is different so YMMV.

John

I also use with the chin strap the 'tongue technique' I learned from posts here on the forum (search the forum for tongue technique if my description is confusing). You put the tip of your tongue at the back of your upper teeth, push the remaining part of your tongue upward toward the roof of your mouth. Then with your tongue in this position swallow any saliva that may be between your tongue and the roof of your mouth (I kind of suck backwards like I using a straw, but I don't open my mouth or lips). What you want is a slight suction to develop which will keep your tongue in this position while you sleep. Unfortunately this technique does not work for everyone, but you might still want to try it if you haven't before.
viewtopic.php?f=1&t=76732&p=700120&hili ... ue#p700120

chris-p wrote:As for the data reporting that my machine gives me, does that mean that if I have an apnea episode with my mouth open it will not notice? Sorry for the question perhaps I am misunderstanding.

If there is a massive leak then yes, the machine might miss it.
On my ResMed machine I have had some sizable leaks up to the 40 to 60 L/min range and it score a bunch of "unknown" events in a cluster...so I lost enough pressure that the events happened in a large cluster (rare for me to see them) and it didn't know what to call them. FWIW...I didn't have bad enough leaks to earn a Mr Red Frowny face that night.
We talked about it in this thread.
viewtopic.php?f=1&t=76445&p=698087&hili ... ne#p698087

A year and a half ago I got these ResScan events from my S9 Elite. Those Unknown yellow colored events are the results of larger leakes than the machine could diagnose. Let me see if I can find their sizes.



Yes, here is the ResScan Stats from that night:




Notice that the 95 Percentile of Leak, on that night, was 31.2 Liters per Minute, while normally it should have been below 24.

It happened b/c the air hose at the inlet to the FF mask elbow was torn half across. Having the air hose rest on my chest it opened and closed the tear depending on my chest respiration movements.

chris-p,

I struggled with congestion a year ago. I was using a full face mask and I REALLY wanted to transition to a nasal mask. Many nights I'd go to bed with the nasal mask and wake up in the middle of the night with blocked nostrils and have to switch to the full face mask for the rest of the night.

I tried different things. What finally worked was a combination of nasal irrigation (daily at first) with NeilMed saline packets and distilled water, and a prescription nasal spray, Nasonex, that is safe for daily use. There are others, like Flonase, that work in a similar way. I use the Nasonex nightly just before bed and I never wake up blocked anymore. I only do the nasal irrigation occasionally now.

Good luck. I'm sure you'll eventually work it out. It's good to have a full face mask on hand though, for those times when you need one (a cold, bad allergy day, etc).

Hi Chris,

I have found the "tongue suctioning" technique described above to be effective, except that I start with the tongue about 1/4 in behind the teeth in the natural hollow on the roof of my mouth. By creating this separation between the nasal airway and the mouth, even if you open your mouth, you maintain the airway. I occasionally (maybe once a night at the most) loose suction, but the feeling of the air going in the nose and out the mouth is weird enough that I wake up quickly and easily get the separation back, and settle back in.

Thanks everybody for the very helpful replies! You guys are awesome and I'm so glad I am not alone and found this board!

I will definitely try the tongue trick starting tonight! Thanks for the details. I think last night wasn't so bad and don't recall waking up at all.

I will also look into perhaps getting a prescription for a nasal spray, since only one of my nostrils seem to be working some of the time.

And eventually, if all else fails, I guess I could look into also getting a FFM at a last resort.

Thanks again all

chris