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tan
 
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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby tan on Fri Sep 09, 2016 8:20 am

Jay Aitchsee wrote:
tan wrote:The idea is to keep main airflow through the nose and keep mouth under the same pressure and partially tape it to minimize oral airflow, which prevents mouth dryness without orajel-shmorajel and the like. Anyone?


That's the idea behind the cloth mouth cover: viewtopic.php?f=1&t=112758&st=0&sk=t&sd=a&hilit=scunci#p1086296

The pressure equalizer piece is missing. When I fully taped my mouth with P10, I got a "blowfish" effect

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Jay Aitchsee
 
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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby Jay Aitchsee on Fri Sep 09, 2016 9:02 am

tan wrote:The pressure equalizer piece is missing. When I fully taped my mouth with P10, I got a "blowfish" effect

That's the purpose of cloth. It lets that excess pressure "bleed off" in a controlled fashion that does not impair therapy by excess leakage or disturb sleep by being noisy. By letting that pressure bleed off in a controlled fashion, the tendency for dry mouth is reduced and there is no blowfish effect. Yet, it still allows for the occasional natural response of a mouth exhale to normalize blood gases when called for to compensate for the normal nasal passage dead space.

Altogether, a more "natural' application and more natural feeling than tape, as I said earlier:
Jay Aitchsee wrote: I think a method for dealing with mouth leaks should restrict and quiet expiratory mouth flow, but not prevent it completely (chipmunk cheeks and respiratory dead space), while discouraging mouth inhale, yet at the same time, be comfortable, easy to apply and not create additional problems - Pretty tall order and definitely removes tape from the possible contenders, at least IMHO.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby D.H. on Fri Sep 09, 2016 9:16 am

Choice of mask is a very personal thing. It varies from one individual to the next. There's no "best" mask, only best for you.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby Sylvia54 on Fri Sep 09, 2016 9:20 am

Sylvia54 wrote:
englandsf wrote:If you can - try the Amara View mask, combo mouth and nasal pillow. Only full face I can stand...


I agree. I tried out an Amara View mask in a cpap store awhile back then bought one on sale at cpap.com, just to have it on standby. It's the lightest and smallest full face mask available. This mask covers only your mouth and nostrils. The one I have does not have nasal pillows.

I started on cpap last April and haven't woken with bone dry mouth in more than a month now. I do wake up at least twice during the night and take a sip of water and take alittle Biotene spray. But I think for me the mouth leaking has finally resolved on it's own. My sleep doctor told me it would. During the day, I try to keep my tongue sealed to the roof of my mouth whenever I think of it and try to breathe mostly through my nose. Maybe that's what helped.


Char, I haven't read enough of your posts to know if you've tried a chinstrap. That's another thing I do and in the long run, think it's helped. Had to adjust now and then to make it just alittle bit tighter. I have the Halo by Breathewear. It was recommended by my DME callcenter, it has positive feedback. It's stretchy and comfortable enough and I wash it in hot water once a week so it doesn't stretch out too much. I do the same with my headgear straps. My insurance pays for chinstraps. Also, a couple times I've woken to find I'd removed my mask and even turned off the machine in my sleep. I was somewhat congested so I got up and blew my nose and used alittle nasal spray. The spray is part of my routine before hooking up. Anything to help keep the nasal pillow mask working good.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby tan on Fri Sep 09, 2016 9:32 am

Jay Aitchsee wrote:
tan wrote:The pressure equalizer piece is missing. When I fully taped my mouth with P10, I got a "blowfish" effect

That's the purpose of cloth. It lets that excess pressure "bleed off" in a controlled fashion that does not impair therapy by excess leakage or disturb sleep by being noisy. By letting that pressure bleed off in a controlled fashion, the tendency for dry mouth is reduced and there is no blowfish effect. Yet, it still allows for the occasional natural response of a mouth exhale to normalize blood gases when called for to compensate for the normal nasal passage dead space.

So the cloth is not a pressure equalizer but a valve since there is no external pressure, which may work for the author as it does for you. I have tried different methods of tape covering with P10:
- partial: even a tiniest hole of imperfect caused by imperfect taping resulted in a hissing leak, which was disturbing, with somewhat of a "blowfish";
- perfect patching: total "blowfish"

Besides, does the "cloth" method help with the chin dropping? At least the tape pulls it up. You and I may have experienced issues then, I think

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Jay Aitchsee
 
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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby Jay Aitchsee on Fri Sep 09, 2016 10:58 am

tan wrote:So the cloth is not a pressure equalizer but a valve since there is no external pressure, which may work for the author as it does for you. I have tried different methods of tape covering with P10

Yes, I am the "author". I came up with this to help a friend who "had" to tape because of mouth leaks, but "had" to quit due to skin irritation. To see if it would work, I tried it on myself first. It worked so well, I have continued to use it.

For years I have worn a FFM because of mouth leaks. About a year ago, I had to switch to a Nasal Mask due to a nerve problem caused by the headgear of a FFM. Anyway, over some months, my mouth leaks became more tolerable but still somewhat disturbing. In the past, I have used chin straps, tape, cervical collars, etc. to improve therapy, so I am familiar. Here's the bottom line: With this setup; A P10 and cloth mouth cover, my results are better than they have ever been with any other combination of mask and equipment. The nasal mask requires a lower pressure than a FFM to suppress obstructive events and my Flow limitations are nearly non existent. My best Flow Limitation reduction in the past came with using a soft cervical collar. I no longer use one and my FL are better.

Yes, the cloth works somewhat like a valve allowing air out easier than in and it muffles the sound and feel of air exiting so well that I can't actually tell when it is occurring. The blowfish effect doesn't happen with the cloth because pressurized air is allowed to naturally escape through the lips without sound or feel. That is not to say that these "leaks" don't register with SleepyHead, they do, but are rarely over 24 L/min and are not disturbing. My average (not median) leak has dropped from around 12L/m to 5L/m, the median is 0. I think the cloth works similarly here as in cloth mask liners which, I believe, make mask leaks tolerable but don't prevent them.

The hairbands I've been using won't prevent chin drop, but they are wide and stretchy enough to cover the mouth when full open. I think they do discourage chin drop in that there is a small (maybe a 1/2 inch wide) elastic band inside the headband at one edge such that when this internal band is down, it provides a slight upward lift to the lower lip tending to keep it closed. Overall, these bands exert very little pressure on the mouth and their effect results more from just being in place rather than providing any pressure to keep something closed.

Additionally, the cloth is not restrictive to mouth motion so one can swallow, exhale, move the tongue around, etc., much more naturally than with tape and therefore, it is less disturbing. Also, the cloth will allow an exhale through the mouth when it is a natural response to do so.

I consider these hairbands (headbands) to be one of the best devices for improving CPAP therapy that I've used over the past 10 years, or so, that I've been fooling with this stuff and I've tried a bunch.

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Last edited by Jay Aitchsee on Fri Sep 09, 2016 12:07 pm, edited 1 time in total.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby sleepychar on Fri Sep 09, 2016 11:21 am

I think I'm going to try the Scuncii band again while I'm waiting for the mask Pugsy is sending me. I tried it before and I didn't like it but I can't remember why. Can't hurt to try it again.

Interestingly (to me, anyway), even though in the last week or so SleepyHead has been reporting numerous large leaks, and mouth dryness has persisted indicating I am mouth breathing (exhaling only I think), my AHI has been lower than previously, under 1 a number of times, even with the leaks, etc., with very few obstructive and hypopnea events. Go figure... if the mouth dryness/comfort/dental concerns weren't such a big issue right now, I would stay with the P10... But I am definitely ready to try the FFM to see how I do with that.
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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby klm49 on Fri Sep 09, 2016 12:24 pm

sleepychar wrote:I have been waking up everyday with icky, leather-tongue, dry mouth. Using nasal pillow P10 mask. Pugsy has already alerted me that, while it's probably worth trying a full face mask, lots of people using full face mask still experience dry mouth. I would love to hear from anyone who experienced dry mouth with nasal pillow who then switched to full face mask and the full face mask actually did reduce or prevent dry mouth. On top of the discomfort from the dry mouth, I just had my regular 4 month dental cleaning yesterday and after only 7 weeks or so of CPAP, the amount of tartar on my teeth has increased dramatically and I am convinced it is from the CPAP dry mouth. So I am looking for some encouragement that maybe switching to full face mask might actually have a possibility of helping this problem. I have about 6 more weeks to go before my insurance (Medicare) will pay for a new face mask and I am debating with myself whether I want to pay myself for a full face mask now or wait out the next 6 weeks. This dental issue with the increased tartar happened really fast so in one way I don't think I should wait to try a full face mask but if it is pretty doubtful a full face mask would resolve this problem, then I probably wouldn't rush out to get one. Typically when I have my teeth cleaned the hygienist remarks about what a good job I am doing with taking care of my teeth. So this was really different and the only thing I am doing differently is the CPAP.
Also, incidentally, in the last 4-5 days I have started experiencing very large mask leaks. I've already ordered a new pillow for my mask which should get here in the next couple of days and hoping that will help. This hasn't been a problem until now so I can't think why this should start up now...


I have been using a Simplus FFM since I started, but only recently did I start having the very dry mouth and lips on occasion, even with humidifier turned up. I have resorted to taping and it helps a lot. I still get a small amount of leakage at the corners of my mouth but not nearly as bad as it was. I have not tried the Orajel yet.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby avi123 on Fri Sep 09, 2016 12:44 pm

Causes of dry mouth include:

• Side effect of certain medications . Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson's disease. Dry mouth can also be a side effect of muscle relaxants and sedatives.

• Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.

• Side effect of certain medical treatments. Damage to the salivary glands, the glands that make saliva, can reduce the amount of saliva produced. For example, the damage could stem from radiation to the head and neck, and chemotherapy treatments, for cancer.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby chunkyfrog on Fri Sep 09, 2016 12:54 pm

If you have considered taping, take a look at Chin Up strips.
When properly applied, they discourage mouth breathing,
but do not make it impossible (in case of an emergency).

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby Gasper62 on Fri Sep 09, 2016 2:01 pm

sleepychar wrote:I think I'm going to try the Scuncii band again while I'm waiting for the mask Pugsy is sending me. I tried it before and I didn't like it but I can't remember why. Can't hurt to try it again.

Interestingly (to me, anyway), even though in the last week or so SleepyHead has been reporting numerous large leaks, and mouth dryness has persisted indicating I am mouth breathing (exhaling only I think), my AHI has been lower than previously, under 1 a number of times, even with the leaks, etc., with very few obstructive and hypopnea events. Go figure... if the mouth dryness/comfort/dental concerns weren't such a big issue right now, I would stay with the P10... But I am definitely ready to try the FFM to see how I do with that.

With the excessive leaks & mouth-breathing, the machine can't/won't recognize or record apnea events.... it could then be giving a false/low AHI number. :)

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby sleepychar on Fri Sep 09, 2016 3:09 pm

klm, thank you for sharing your experience. Pugsy cautioned me that switching to a FFM is not an automatic fix for dry mouth. I guess I'll be finding out soon when I try the FFM for myself.

avi, thank you for the medication side effect info - I'm not taking any of those meds nor do I have any of those medical conditions that might cause dry mouth. I'm pretty certain it is from the mouth exhaling...

Gasper, that explains why all of a sudden my AHI looks so good! I wondered how that could be, what with all the leaking air... What you said makes sense...
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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby Pugsy on Fri Sep 09, 2016 3:19 pm

sleepychar wrote:that explains why all of a sudden my AHI looks so good! I wondered how that could be, what with all the leaking air... What you said makes sense...


Your AHI is only questionable during the periods of large leak and it has to be fairly prolonged before we question the data.

Example...if you are only in large leak for 15 minutes out of a 7 hour night...only the 15 minutes is in question and only if the leak is deep into large leak territory. The machine will still be fairly accurate until you go past 35 L/min (ResMed machine which is what I think you have).
So just because you have a short period of time in large leak doesn't necessarily mean that the entire night's AHI results are in the toilet.

Just means that maybe the lack of events during a time of large leak might be in question. The rest of the night the data will still be accurate.

The problem with the large leak thing is we don't know if the lack of anything being scored during a time of large leak is because nothing happened (which is entirely possible) or if something happened but the machine was clueless.

So we go back to how far into large leak territory did you go...and how long were you there...before we start worrying about the accuracy of the machine in terms of AHI and again...it's only in question during the large leak times.

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby avi123 on Fri Sep 09, 2016 3:53 pm

@
@
@
@


Is anyone using collars like these to keep mouth closed?

Image

Image

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Re: Did switching from nasal pillow to FFM relieve dry mouth?

Postby palerider on Fri Sep 09, 2016 4:11 pm

avi123 wrote:Is anyone using collars like these to keep mouth closed?

go back to sleep, avi, you're brain dead.

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