Chin strap failed

[glowradar]

Lying here in bed at 5am and really depressed.
I had a terrible night sleep Sunday night... after three weeks of CPAP therapy the nocturia (which had seemed to be subsiding - going from an average of 4.5x pre CPAP to an average of 2 in the week leading up to Sunday) returned with a vengeance. I got up 8 times in 8 hours.
After discovering this board and learning a few things I decided to change my ramp time to auto and see how I did. There was improvement last night and I only got up three times. By now I had downloaded sleepyhead where I learned I was having some pretty big leak issues. I use nasal pillows so I figured this was a mouth breathing issue, and tonight I tried the chin strap. It was awkward and uncomfortable but I was committed.
After an hour and 48 minutes I apparently removed my Mask. I say apparently because I have absolutely no recollection of doing this, and no idea what I was thinking. I then slept without the mask for an hour and a half and realized what had happened when I woke up to pee. Now I've had to go another 3 times in past 2 hours and I can't get back to sleep, probably due to the anxiety.
I had really placed a lot of hope on the CPAP helping me with the nocturia. Reading posts from others who found immediate relief is making me feel like I don't know what's wrong with me. I'm hoping this is a treatment effectiveness issue and my lack of serious progress is related to the leaks. I've ordered a face mask which I am getting fitted for on Friday. The chin strap was more trouble than it was worth and the only thing I have to show for it is a headache and an overactive bladder.

[Julie]

Well, you're not going to improve sleeping without the mask, though I understand what happened. What are the chances you're drinking a lot of caffeine after noon-3 pm? It can really make a diff. re urination frequency and is also not a good idea if you have any sign of reflux (GERD). Chin straps only work for those for whom they work, and that's certainly not everyone, plus they don't seal your lips of course, but some are more comfortable than others. Have you tried a FF mask that's been properly fitted in your size, while lying down? Or taping - many tape every night, and a lot for a few nights to see if mouth breathing is a problem (then go get a FF mask).

[Pugsy]

I had the same thoughts when I tried the chin strap...it was more annoying and bothered my sleep than I was seeing any positive results from it.

Go ahead and just use the Swift FX nasal pillows for now...some sleep and some therapy is better than no sleep and no therapy.
You aren't mouth breathing all night long...so it's only the time you do the mouth breathing where the therapy is negatively impacted and sometimes the negative impact wasn't horribly horrible.
It's still better than no therapy during that time frame.
And the time you weren't mouth breathing isn't wasted time.

It's not ideal but sometimes we don't get ideal and have to work on improving things.

Use the Swift FX until you get the full face mask to try. Since the chin strap causes more problems than it fixes in your situation...don't use it. 5 hours of acceptable leak and good therapy and 2 hours of big leak with marginal therapy giving 7 hours of halfway decent sleep is still better than no sleep and/or no therapy.

[glowradar]

No coffee after 11am. No fluids after 6pm.

I have an appointment for a mask fitting on Friday.

An hour and a half without the mask could be the trigger of the severe nocturia. I have benign prostate enlargement so that's a contributing factor. And the anxiety that kicked in when I realized the mask was off probably boosted my heart and didnt help either.

I guess I would feel better if other nocturia sufferers took a while to get it under control, but it seems like for almost everyone else it cleared up right away. That doesn't help my anxiety.

[Luthie2006]

My thoughts at least what helped me: I have had 3 chin straps. I desperately need them because my mouth opens in the middle of the night and I have that horrible dry-cotton mouth without. I have tried 3 of them and this last one seems to do the trick, the Puresom ruby chin strap. The first one (the white mummy one) was great that wrapped around my head but then after about 5 months I started getting pimples and sores on my ears, and there is no way to tuck the straps behind my ears. Then I tried a Phillips black one that is flimsy and it was like wearing nothing and my mouth got horribly dry. Then I tried the Ruby Puresom chin strap. So far so good, except I have strap marks across both cheeks. I plan to buy some felt at Walmart and stuff them in there.
For me, I just cannot go without a chin strap, otherwise I have to go to a FF mask which I refuse. I know it is annoying to you, but as long as you keep your mouth closed most of the night, I guess it is ok. For me, it is not an option to go without a chin strap. I also bought (but will try this weekend) the Chin-Up Strips I read online here. I bought them off Drugstore.com and will try it on the weekend. Have you ever thought of these? My only reluctance is that I read that the adhesive is so strong that it can tear your skin off when removing. I am just saying (my opinon) if you have the money or time, try all the chin straps out there. They can be annoying and some are more comfortable than others. Don't give up, if you can.

[Pugsy]

You have to remember that even once your OSA gets controlled that you still have the BPH thing that is always going to be a factor in the nocturia situation.

Also remember that the stress hormone that causes the kidneys to go into over drive can come from any number of stress sources so try not to get too discouraged (I know it's easier said than done) and try to have more patience (again easier said than done) because your stressing out over all this isn't helping things.

And yes...my noctoria went away fairly quickly but I am female and don't have BPH ...and it wasn't until I had my therapy optimized that it went away and it took several weeks to get things optimal...and right now you are having leak and sleep issues so your therapy is far from optimal anyway.

[englandsf]

I have BPH too and have found that drinking LOTS of water all evening means I till go 1-2 times per night but never more. I also avoid salt like the plague. I now wake maybe 3 times but do not need to pee each time. I am also trying Saw Palmetto for the BPH.

[Nick Danger]

Many people remove the mask without realizing it early in treatment. When you notice it is off, just put it back on. Don't give in to the voice in the back of your head that says, "ahh... I had it on for part of the night, it isn't worth putting it back on now" and you'll be fine. Taking the mask off without realizing it is normal - especially early in treatment. Try not to get upset - getting beyond that is just part of the process of adapting to CPAP.

[OkyDoky]

Some people have tried a piece of tape across the side strap of the headgear. That way it wakes them when they remove the mask and can replace it.

[Hosehead4ever]

You might just try good old surgical tape. I am also a mouth breather using a nasal pillows mask. I tried a Ruby chin strap recently and, for reasons unknown to me, my AHI went through the roof. Since then I have done what some other mouth breathers here on the forum have done - taping my mouth shut at night. (I should probably tape my mouth shut during the day, but then my fingers take over at the keyboard. Mittens?) All kidding aside, if you can tolerate the tape, it's a pretty cheap and effective solution. I have also not found it to be too difficult to get off and does not bother my skin. It's worth a try.

[Pugsy]

FWIW...I also elected to tape my mouth early on in my therapy because I didn't care for the chin strap thing and I have my own reasons for not wanting to use a full face mask.
Early in my therapy the mouth breathing I was doing was more out of habit than anything else. Habit from mouth breathing to try to move air because of the apnea events was causing me to feel suffocated.
Eventually the mouth opening habit was more or less broken. I think it took me about 2 months of taping to break the habit.
My nose was always a non factor in the mouth breathing though....my nose was almost always totally clear so I was never mouth breathing out of a physical need due to nasal congestion.

[Luthie2006]

And Pugsy and others, how do you tape? Vertically, horizontally? What kind of tape? I have found when I attempted this, the tape on my face got moist and the stick failed. Blue tape? Surgical tape? Medical tape?

[Julie]

Either blue painter's tape or 3M Micropore (from the drugstore) work well. Some people find horizontal works best, others like vertical... Folding over a 1/8" edge at the end of the strips make them easier to remove in the a.m.

[Pugsy]

And Pugsy and others, how do you tape? Vertically, horizontally? What kind of tape? I have found when I attempted this, the tape on my face got moist and the stick failed. Blue tape? Surgical tape? Medical tape?

I taped horizontally...never thought about vertically but now that I have seen it mentioned I think that would also be a viable option.
It was just never mentioned back when I was first starting therapy.

I just used blue painters tape because I am the queen of cheap and I had some left from an old painting job and figured use it to see if it works or not and then worry about getting a special type of tape but I found I had no issues from the blue painter's tape.
Yeah...it came loose a few times from the drool/slobber that we do sometimes but for the most part it held well enough.
The idea was never to have the mouth to be cemented shut...just a semi gentle reminder to keep the lips closed.

You know when I first started therapy and was reading about "taping your mouth" my initial thought was "no way in hell" but then I found out that desperate people will take desperate measures.
I was concerned about the "what if the power goes out thing" and "what if I need to open my mouth to puke thing"...so I practiced during the day with the tape. I just used the 2 inch blue painter's tape (and not even the delicate kind) and I practiced opening my mouth with the tape on just to see how easy (or not) the tape would come loose in the event I needed to open my mouth for whatever reason. I found out that it was easy to break the seal with just a little yawn or mouth movement...so that alleviated my "what if I need to open my mouth" concern. The very first night I elected to tape we had a thunderstorm come through and yep...lost power. I woke up with mouth still taped and breathing quite nicely without any distress at all...what woke me up was the silence. Laid there a few moments and finally realized that the machine wasn't blowing and I wasn't all in a panic at all.
I was getting enough air just through the vent holes...was a wee bit of an effort but not horrible at all.

Now other people use other types of tape....all geared to what their preferences are or their needs are. I don't have delicate skin so using cheap painter's tape didn't cause me to have any skin issues but if I had seen some skin issues I would have looked further into the various tapes out there so that I didn't tear my skin up.

I have never been one to expect total perfection in that lip seal. A reduction in mouth breathing from 2 hours to 10 minutes was good enough for me.
Likewise if the drool or slobber caused the tape to come loose and I had slept fine otherwise then I didn't worry about it as long as it wasn't going on all night long and kept waking me up.
If I woke up and the tape was off or really loose and I looked at the leak graph and it wasn't horrible....I didn't worry about the tape coming loose.

[Hosehead4ever]

I also use Micropore. It is a paper surgical tape, not like the old thick stuff that would rip your skin off. I use it horizontally.

FWIW, I've been a pap user for almost 4 years and have just started taping my mouth. I thought it was extreme and I didn't want to do it. Now I've found it isn't all that extreme. It isn't uncomfortable. And it closes my lips sufficiently that I can leave one corner open for emergency breathing, or coughing without air escaping unintentionally. I'm hoping that I will be as successful with it as Pugsy and only need it for a short time.

I hadn't thought of folding an end over to make it easier to remove. That's a great idea.