Mouth breathing technique for seasoned nose breathers

[summer]

Hi All,

I have been trialing a couple of nasal masks, F&P opti360 and sleepweaver, my current mask is a F&P flexifit H431 FFM.

My problem is mouth breathing, I have gleaned and tried several methods of reducing these occurrences but have not had success. I also have noticed that I am more tense with the nasal mask probably due to fact that I think that I will not be able to sustain sleep due to blowfish arousals etc.

Firstly this I what I have learnt technique wise;

1. Use the back of the tongue to close of airway.
2. Move front of tongue to roof of mouth with tip just behind front teeth near gum margin (top teeth).
3. Use of chin strap
4. Taping lips

I have been successful (I am a natural!! ) to a limited extent with technique 1, but I loose the seal at pressure above 10. I then will get bubbles of air traveling from the back of the throat to the front of the mouth (either as I nod of to sleep or during sleep) . This alone usually wakes me up if I don't wake up from that then the bubbles turn into a full blowfish, this will wake me up. I then find it differcult to get back to sleep, I use all other techniques simultaneously but is the loosing the seal that's the problem. I really like the nasal masks they are just so much lighter and easier on the face than the FFM.

Question for those seasoned nose breathers, do you allow air in to the mouth, but keep the cheeks in and obviously lips closed or do use techniques 1 & 2?

It seems to me that I now need to equalize the pressure between the throat and mouth, and contain the blowfish affect and also preventing air leaking through lips. This would mitigate the seal breaking at the back of the throat thereby (hopefully) reducing arousals! What are your thoughts?

Thanks for your advice!!

[Maxie]

I'm working on the keeping my mouth closed issue also, especially during sleep. I'm mostly a nose breather but occasionally my mouth does come open during sleep. At first I used the nasal prongs but couldn't keep my mouth closed with a chin strap. After trying a couple of full masks, I'm back to the prongs because they are so much more comfortable to me. I may get desperate and try tape. If you find a good solution, please post it because I would love to hear it!

[summer]

I'm working on the keeping my mouth closed issue also, especially during sleep. I'm mostly a nose breather but occasionally my mouth does come open during sleep. At first I used the nasal prongs but couldn't keep my mouth closed with a chin strap. After trying a couple of full masks, I'm back to the prongs because they are so much more comfortable to me. I may get desperate and try tape. If you find a good solution, please post it because I would love to hear it!

Not simple this mask business!, I think I need my partner to stay awake all night to monitor my mouth and lips and make sure that they are closed (but she must not wake me doing this!!). I know were she tell me to go!! LOL Hey I think I will ask and just say but I thought you loved me

Sorry for the English sense of humour!! I will let you know if I find a solution.

[nanwilson]

If you can't keep your mouth closed then go to a full face mask. I tried all the tricks and methods, nothing worked, so I now use a Respcare Hybrid ----- nose pillows and a mouth only piece. Less invasive than the other full masks, go to cpap.com and take a look at the pictures - best of both worlds as far as I am concerned.

[summer]

by nanwilson on Thu Feb 02, 2012 2:17 pm

If you can't keep your mouth closed then go to a full face mask. I tried all the tricks and methods, nothing worked, so I now use a Respcare Hybrid ----- nose pillows and a mouth only piece. Less invasive than the other full masks, go to cpap.com and take a look at the pictures - best of both worlds as far as I am concerned.

Hi, does the Hybrid causing the top front teeth to ache, I just read reports that was the case. Also I like to sleep on my side, does this mask move around a lot, are the leaks controllable?

[Pugsy]

You call it blowfish effect....we call it chipmunk cheeks. I think we are likely talking about same thing.
Lips are closed...air entering the nasal passage proceeds down the airway and the tongue has relaxed its vigil at the back of the mouth...allowing air pressure to enter the oral cavity...inflate cheeks...highly annoying and we wake up.... or we don't wake up and we open mouth and air escapes and we lose pressure.

I was fortunate and never really had this issue so much. Others have had it. I think this is the reason Rested Gal uses a chin strap and tape together. Her tongue just won't block the opening well enough.
She uses gentle chin strap pressure on the cheeks to stop them from inflating.

The thing about using a full face mask...if you are still nose breathing and chipmunk cheeks occur...they can still be annoying and wake you up...only difference with full face mask is that if you open your mouth then the pressure isn't lost. Full face mask won't necessarily stop the cheeks from inflating but it will allow for therapy to be stable with no loss of pressure.

[nanwilson]

by nanwilson on Thu Feb 02, 2012 2:17 pm


Hi, does the Hybrid causing the top front teeth to ache, I just read reports that was the case. Also I like to sleep on my side, does this mask move around a lot, are the leaks controllable?

Top teeth do not hurt at all and I too sleep on my side only with no problems. My leaks are very low and are only from the nose pillows. There is a very informative thread about fitting the hybrid by Roster, take a look at it. Also there is a video you can look at go to cpap.com and follow the links.

[summer]

Pugsy on Thu Feb 02, 2012 2:31 pm

You call it blowfish effect....we call it chipmunk cheeks. I think we are likely talking about same thing.
Lips are closed...air entering the nasal passage proceeds down the airway and the tongue has relaxed its vigil at the back of the mouth...allowing air pressure to enter the oral cavity...inflate cheeks...highly annoying and we wake up.... or we don't wake up and we open mouth and air escapes and we lose pressure.

I was fortunate and never really had this issue so much. Others have had it. I think this is the reason Rested Gal uses a chin strap and tape together. Her tongue just won't block the opening well enough.
She uses gentle chin strap pressure on the cheeks to stop them from inflating.

The thing about using a full face mask...if you are still nose breathing and chipmunk cheeks occur...they can still be annoying and wake you up...only difference with full face mask is that if you open your mouth then the pressure isn't lost. Full face mask won't necessarily stop the cheeks from inflating but it will allow for therapy to be stable with no loss of pressure.

As you drift of to sleep do you gently allow air into you mouth to equalize pressure, or do you do the tongue thing at the back of the throat and keep the air out of the mouth completely?

[summer]

Top teeth do not hurt at all and I too sleep on my side only with no problems. My leaks are very low and are only from the nose pillows. There is a very informative thread about fitting the hybrid by Roster, take a look at it. Also there is a video you can look at go to cpap.com and follow the links.

Ooh!, I will have a look, but when I last looked at the Hybrid it looked like the thing could slide around. Actually its got an intergral chin support, is that effective in supporting the chin, you don't need a chin strap?

[Pugsy]

As you drift of to sleep do you gently allow air into you mouth to equalize pressure, or do you do the tongue thing at the back of the throat and keep the air out of the mouth completely?

No, I don't allow air into my mouth at all. The pressurized air will take the path of least resistance and try to exit out the mouth...give it a little and it will want a mile till it builds up pressure and inflates the cheeks. Eventually the inflated cheeks will either wake us up or mouth opens and air pressure leaves the mouth. If the mouth immediately closes..probably not a huge deal if it is just for a couple of seconds but it probably causes us to wake up and anything that disturbs sleep cycles is unwanted.

I did tape for a couple of months when I started on the machine. I sort of had a habit of opening my mouth most likely from gasping for air. After a couple of months I got lazy and quit taping and low and behold my leak line wasn't horrible. For some reason I have never really had any issues with the chipmunk cheek thing. I always breath through my nose even during the day and I find that the tongue blocks the doorway to my mouth even during the day. I never noticed it before cpap. Very likely it is just something I have always done. When on APAP I sometimes saw pressures well above 16 cm and I still never had the air try to exit my mouth. Perhaps my tongue is just larger and blocks the small mouth easier.

[archangle]

4. Taping lips

Taping your mouth risks suffocation or other problems if the machine quits blowing and you don't wake up with a nasal mask. You will be rebreathing your own exhaled air. Oxygen will decrease and CO2 will increase. This can cause you to sink deeper into unconsciousness and stop breathing. This is why the FDA requires all full face masks to have an anti-asphyxia valve.

Most people will wake up and be able to take the mask or tape off, but it's not a sure thing.

There is a risk of aspiration pneumonia if you vomit before you can get the tape off. Aspiration pneumonia is very bad. Google it.

Many people tape anyway despite the risks. The risk may be small, but you'll probably be doing this for the rest of your life so risks add up.

[drdrew]

by nanwilson on Thu Feb 02, 2012 2:17 pm


Hi, does the Hybrid causing the top front teeth to ache, I just read reports that was the case. Also I like to sleep on my side, does this mask move around a lot, are the leaks controllable?

Top teeth do not hurt at all and I too sleep on my side only with no problems. My leaks are very low and are only from the nose pillows. There is a very informative thread about fitting the hybrid by Roster, take a look at it. Also there is a video you can look at go to cpap.com and follow the links.

i use the liberty mirage. another hybrid mask that happens to leak less on MY face. my teeth and nose did hurt for a few days but then it went away. so if you have this happen dont get discouraged it gets better

[summer]

by Pugsy on Thu Feb 02, 2012 3:14 pm

summer wrote:
As you drift of to sleep do you gently allow air into you mouth to equalize pressure, or do you do the tongue thing at the back of the throat and keep the air out of the mouth completely?


No, I don't allow air into my mouth at all. The pressurized air will take the path of least resistance and try to exit out the mouth...give it a little and it will want a mile till it builds up pressure and inflates the cheeks. Eventually the inflated cheeks will either wake us up or mouth opens and air pressure leaves the mouth. If the mouth immediately closes..probably not a huge deal if it is just for a couple of seconds but it probably causes us to wake up and anything that disturbs sleep cycles is unwanted.

I did tape for a couple of months when I started on the machine. I sort of had a habit of opening my mouth most likely from gasping for air. After a couple of months I got lazy and quit taping and low and behold my leak line wasn't horrible. For some reason I have never really had any issues with the chipmunk cheek thing. I always breath through my nose even during the day and I find that the tongue blocks the doorway to my mouth even during the day. I never noticed it before cpap. Very likely it is just something I have always done. When on APAP I sometimes saw pressures well above 16 cm and I still never had the air try to exit my mouth. Perhaps my tongue is just larger and blocks the small mouth easier.

Pugsy thank you!!, I wish I had a big tongue like you! Oh well, I keep trying, my be I could do some weights with my tongue to beef it up abit

[nanwilson]

Top teeth do not hurt at all and I too sleep on my side only with no problems. My leaks are very low and are only from the nose pillows. There is a very informative thread about fitting the hybrid by Roster, take a look at it. Also there is a video you can look at go to cpap.com and follow the links.

Ooh!, I will have a look, but when I last looked at the Hybrid it looked like the thing could slide around. Actually its got an intergral chin support, is that effective in supporting the chin, you don't need a chin strap?

No, it doesn't slide around at all stays put all night. The chin flap does support your chin, but I have a very long face so I cut it off to make it fit better. This mask comes with 3 sets of nose pillows and 3 sets of mouth cushion to accommodate all sizes. Do take a look at Rosters thread "taming the hybrid"

[summer]

by archangle on Thu Feb 02, 2012 3:32 pm

summer wrote:
4. Taping lips


Taping your mouth risks suffocation or other problems if the machine quits blowing and you don't wake up with a nasal mask. You will be rebreathing your own exhaled air. Oxygen will decrease and CO2 will increase. This can cause you to sink deeper into unconsciousness and stop breathing. This is why the FDA requires all full face masks to have an anti-asphyxia valve.

Most people will wake up and be able to take the mask or tape off, but it's not a sure thing.

There is a risk of aspiration pneumonia if you vomit before you can get the tape off. Aspiration pneumonia is very bad. Google it.

Many people tape anyway despite the risks. The risk may be small, but you'll probably be doing this for the rest of your life so risks add up.

Archangle that's a very valid point, thank you for the head's up!!

Drandrew
by drdrew on Thu Feb 02, 2012 3:54 pm

nanwilson wrote:
summer wrote:
by nanwilson on Thu Feb 02, 2012 2:17 pm

i use the liberty mirage. another hybrid mask that happens to leak less on MY face. my teeth and nose did hurt for a few days but then it went away. so if you have this happen dont get discouraged it gets better

Ok that's good to know, I check Liberty mirage out as well, thank you!