New member, hello and a question

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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JustTia
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New member, hello and a question

Post by JustTia » Sun Jul 20, 2014 7:18 am

Hello, all! I've been lurking for several weeks and want to thank you all for the wealth of information that you've already provided first thing. I'm glad I found this place.

I have had my cpap (S9 autoset) for about a month now. I started out with a full face mask because that is what my doctor decided I should have. However, I have small features (close set eyes, narrow nose) and could NOT get a good, leak-free fit with any of the masks that I tried on at the DME. But, because my mouth does occasionally drop open in my sleep, I was told that I needed a full face. So they sent me home with the Mirage Quattro.

The first night that I used it, that sucker woke me up multiple times blowing air - a lot, not a little - straight into my eye sockets. I tried loosening. I tried tightening. I tried positioning higher or lower on my face. Nothing worked. It either leaked near my chin because it was too low, or it blew high powered air straight into my eyes. The air in my eyes got so bad that I was having severe double vision and blurring that sent me to the doctor, afraid that I had developed some type of retinopathy! I went back to the DME and told them that I had to do something different. This was NOT working.

I was given nasal pillows, Swift fx for her, along with a chin strap to hold my mouth closed. That presented a new learning curve, but I've gotten through it mostly. At first my nares were sore in the morning (ha, nares - can ya tell I've been lurking?). I figured out that a handmade lip balm that I have works very, very well for both lubricating and helping seal. No petroleum products, just shea butter and beeswax and such. Love my hippie products, lol. Started having some slight rainout in the pillows, especially on the left side, but it hasn't yet woken me up. Just a large drop of water in the part that sits in the nares (it doesn't go all the way down into the pillow), which tells me this is probably just from my own exhaled moisture and probably not much I can do about it. I just dry it out every morning with a q-tip and it's all good.

Things are going relatively well now. I'm able to consistently wear the mask for 7-8 hours or more. I still wake up a couple of times each night because I haven't yet worked out my hose management plan, but it's much better. My AHI is consistently 0-.4 every night. And I KNOW that it's benefiting my body because my blood pressure has been consistently 150/80-155/85 for several years now. Never been measured below 135/80, and even that only happened once in a couple of years. However, in the last two weeks I've had a couple of different doctor's appointments. My blood pressure was 108/60 and 125/58. I am a believer.

Now - for the question. The chin strap is doing its job - I'm not opening my mouth. However, it's moving my jaw forward, I think, or possibly just clenching my teeth together. Not sure. But every morning when I wake up, my teeth are tender and sore, especially my top front teeth. It feels like my bottom front teeth must be pushing against my top front teeth all night long. I have the chin strap as loose as it can go now. Still hurts. The pain goes away by midday, but it even hurts to eat breakfast in the morning, particularly if I have to bite. Is there anything that I can do to alleviate this? Is there a way to keep my mouth closed without clamping my teeth together so hard? Or another mask that I could use that won't blow air in my eyes because it doesn't fit the bridge of my nose?? Or something I can put in my mouth that would prevent my bottom teeth from pressing against my top front teeth? If you read this far, thank you so much.

*Edited because it's moving my *jaw*, not my *jar*

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Craig-Tx
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Re: New member, hello and a question

Post by Craig-Tx » Sun Jul 20, 2014 8:20 am

Well, it sounds like you've been doing incredibly well.. So kudos there.

Based on the AHI data, I'm going to assume you have a date capable machine that can also measure leak data. I would be tempted to try without a chin strap for a few days. If your AHI and leak data still looks good, and if you don't wake up with serious dry mouth, you may not actually have a problem with mouth breathing. I know many (including myself) used to be a mouth breather, but now that I breath well filtered, and properly humidified air, I simply use a nasal mask without problem.

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JustTia
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Re: New member, hello and a question

Post by JustTia » Sun Jul 20, 2014 8:38 am

Craig-Tx wrote:Well, it sounds like you've been doing incredibly well.. So kudos there.

Based on the AHI data, I'm going to assume you have a date capable machine that can also measure leak data. I would be tempted to try without a chin strap for a few days. If your AHI and leak data still looks good, and if you don't wake up with serious dry mouth, you may not actually have a problem with mouth breathing. I know many (including myself) used to be a mouth breather, but now that I breath well filtered, and properly humidified air, I simply use a nasal mask without problem.
Thanks, Craig, I will try that again. I tried the pillows without the strap for a few nights when I first got it. I should have included that information above, but forgot to do so. I did just fine for the first couple of nights (I assumed - I did not yet have ResScan and didn't know how to check leak data, etc, on the machine either at that point). But on the third night, I woke up to the Sahara in my mouth and throat in the middle of the night. My mouth had opened and all that pressure was flowing into my nose and out through my mouth. It hurt to even swallow, I was so dry, lol. That was when I decided this was for the birds, and added the chin strap. I knew before doing the sleep study that I mouth breathed some because I'd wake up with dried spittle on my face and/or wetness on my pillow. I had high hopes that would only be because of the apnea and that once I had my cpap, the mouth breathing wouldn't happen any more.

I didn't give it any more chances. It happened once with the nasal pillows, I imagined that it would probably happen again. It only happened when I rolled onto my back, though - I am a side sleeper. I can't fall asleep unless I'm on my right side, but then roll back and forth all night. I wonder if it's worth it to do without the chin strap and just deal with a once-in-a-blue-moon mouth breathing episode on the rare occasion that I land on my back for too long?

It seems that there's such a trade-off with getting good treatment and sleep and being comfortable. I really don't want to try to switch back to a full face because I had such a hard time trying to make it not leak. And I LOVE my pillows and the head gear. Love. I can *almost* completely forget that I'm even wearing it, which I found to be important for getting to sleep and staying there.

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oldie

Re: New member, hello and a question

Post by oldie » Sun Jul 20, 2014 9:14 am

If you are not averse to trying taping (some of us do tape) I just put a three inch piece of HD cloth tape vertically over my pinched together lips. Some folks use blue painter's tape horizontal over the lips. Either way, keep a tab folded on an end for removal. Stop mouth breathing!

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Pugsy
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Re: New member, hello and a question

Post by Pugsy » Sun Jul 20, 2014 9:21 am

JustTia wrote: I wonder if it's worth it to do without the chin strap and just deal with a once-in-a-blue-moon mouth breathing episode on the rare occasion that I land on my back for too long?
This was what I decided a long time ago after experimenting with various chin straps and even taped my mouth shut for couple of months.
I never had issues with my teeth but I sure had issues with having chin straps on my head and while the taping was horribly intrusive it was a PITA to have to do each night.

Now after over 5 years...yeah, sometimes the mouth drops open and sometimes the dry mouth occurs but I have learned that dry mouth can happen with as little as 5 or 10 minutes of mouth breathing (doesn't mean I was doing it all night) and sometimes the leak from mouth breathing doesn't even reach large leak territory and still causes dry mouth.
Since dry mouth is rare....and episodes of evidence of large leak mouth breathing (software leak graph) rarely go into large leak territory and rarely exceed 15 minutes in duration....I choose to just let them slide since my sleep quality is overall so much better without taping or chin strap. I sleep right through whatever leaks I might be having from whatever cause.
10 minutes in large leak territory a couple times a night and I sleep great....I am not going to try to fix those leaks because to try to fix them disturbs my sleep more than the leaks might.

Sometimes we just have to make compromises. If it were me I would eliminate the chin strap for a couple of weeks and watch the leak graph itself and see how the teeth discomfort goes. Having no pain in the teeth might be a suitable compromise if you sleep well otherwise and the time spent in large leak territory is minimal. Also it depends on how far into large leak territory you go...couple of L/min above the line in the sand isn't horribly horrible...Now 10 to 20 L/min ABOVE the red line...different story if you spend much time there.

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BlackSpinner
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Re: New member, hello and a question

Post by BlackSpinner » Sun Jul 20, 2014 11:23 am

You might also consider a mouth guard. You can get boil&Bite guards in the pharmacy so you can try them out. They would keep your teeth/jaw in place while wearing the chin strap. If you are ok with them you can get a proper one from your dentist.

Your other option is a mask like the InnoMed Hybrid like I use - for similar reasons.

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JustTia
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Re: New member, hello and a question

Post by JustTia » Sun Jul 20, 2014 11:26 am

Thanks, you guys. I think I'll try a trial of no chin strap for a week or so and see how it goes. If that's a no-go, next I'll try taping I guess. Hoping that I can skip the strap and taping and manage.

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BuddhaCat
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Re: New member, hello and a question

Post by BuddhaCat » Sun Jul 20, 2014 11:58 am

JustTia, I'll also add something I posted a few days ago. I have TMJ and see a specialist who recommends that folks with jaw problems should NEVER wear a chin strap. He's adamant that it will cause more tension on the jaw/teeth.

Have you ever had jaw or bite problems of any kind? It might be something to pursue . . . but in the meantime, I'd lay off the chin strap. Good luck and great progress so far!!

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Re: New member, hello and a question

Post by gdgiles » Sun Jul 20, 2014 12:13 pm

I don't use a chin strap and my 2 front teeth are tender in the morning from having the pillow chamber smash into my upper lip from my sleeping position, face half on the pillow.

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Re: New member, hello and a question

Post by library lady » Sun Jul 20, 2014 12:18 pm

I had trouble with leaks from my Quattro Air FF mask, especially into my eyes, and solved it with mask liners, so if you decide to go back to your FF, you might try those. I won't wear my mask without one now, and I rarely get into large leak territory or have leaks that wake me up. I'm using the AirFit F10 now, but it uses the same cushion. I don't remember if you said you have trouble with leaks from what you are using now, but liners might be an option for that one too.

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Re: New member, hello and a question

Post by englandsf » Sun Jul 20, 2014 12:36 pm

Have you tried sinus rinses to improve nasal air flow?

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JustTia
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Re: New member, hello and a question

Post by JustTia » Sun Jul 20, 2014 1:14 pm

englandsf wrote:Have you tried sinus rinses to improve nasal air flow?
No, I haven't. Like a neti pot? I've never used one because they kinda squick me out, lol. I guess I could try it, though.

Gdgiles - The first night that I used the pillows, My upper lip/gum area was tender in the morning. But I have since then swiveled the hose up over my head, which slightly alters the way the pillows sit. They don't rest against my upper lip so much any more - more like lightly graze it. That wasn't the reason that I moved the hose there, but it was a nice added benefit, lol.

The pain in my teeth includes both my top and bottom, though the top hurt worse. It really does feel like my teeth are grinding or pushing against each other while I sleep, because of the chin strap. My gums and lip haven't been bothered at all since I moved the hose and started using the lip balm I mentioned in my OP to cushion/lubricate/seal the pillows.

BuddhaCat - I have never had jaw problems that I am aware of. I don't have a history of teeth grinding or jaw clenching. The only sleep-related jaw issues that I've had, ever, were in the year before I had the sleep study done. I kept biting my tongue in my sleep and waking myself up. That's it.

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Re: New member, hello and a question

Post by Stevoreno_55 » Sun Jul 20, 2014 1:50 pm

JustTia wrote:
englandsf wrote:Have you tried sinus rinses to improve nasal air flow?
No, I haven't. Like a neti pot? I've never used one because they kinda squick me out, lol. I guess I could try it, though.

Gdgiles - The first night that I used the pillows, My upper lip/gum area was tender in the morning. But I have since then swiveled the hose up over my head, which slightly alters the way the pillows sit. They don't rest against my upper lip so much any more - more like lightly graze it. That wasn't the reason that I moved the hose there, but it was a nice added benefit, lol.

The pain in my teeth includes both my top and bottom, though the top hurt worse. It really does feel like my teeth are grinding or pushing against each other while I sleep, because of the chin strap. My gums and lip haven't been bothered at all since I moved the hose and started using the lip balm I mentioned in my OP to cushion/lubricate/seal the pillows.

BuddhaCat - I have never had jaw problems that I am aware of. I don't have a history of teeth grinding or jaw clenching. The only sleep-related jaw issues that I've had, ever, were in the year before I had the sleep study done. I kept biting my tongue in my sleep and waking myself up. That's it.
http://www.medicalnewstoday.com/articles/249460.php

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JustTia
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Re: New member, hello and a question

Post by JustTia » Sun Jul 20, 2014 9:14 pm

Stevoreno_55 wrote:
JustTia wrote:
englandsf wrote:Have you tried sinus rinses to improve nasal air flow?
No, I haven't. Like a neti pot? I've never used one because they kinda squick me out, lol. I guess I could try it, though.

Gdgiles - The first night that I used the pillows, My upper lip/gum area was tender in the morning. But I have since then swiveled the hose up over my head, which slightly alters the way the pillows sit. They don't rest against my upper lip so much any more - more like lightly graze it. That wasn't the reason that I moved the hose there, but it was a nice added benefit, lol.

The pain in my teeth includes both my top and bottom, though the top hurt worse. It really does feel like my teeth are grinding or pushing against each other while I sleep, because of the chin strap. My gums and lip haven't been bothered at all since I moved the hose and started using the lip balm I mentioned in my OP to cushion/lubricate/seal the pillows.

BuddhaCat - I have never had jaw problems that I am aware of. I don't have a history of teeth grinding or jaw clenching. The only sleep-related jaw issues that I've had, ever, were in the year before I had the sleep study done. I kept biting my tongue in my sleep and waking myself up. That's it.
http://www.medicalnewstoday.com/articles/249460.php
Thank you for that! I had heard about the deaths from people using tap water. Not sure if I'll go the nasal rinsing route or not, but for now I'm leaning toward not. Never say never, I might change my mind at some point, but I'd kind of rather trey every other fix first. Just doesn't seem very pleasant to me.

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JustTia
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Re: New member, hello and a question

Post by JustTia » Mon Jul 21, 2014 7:31 am

Well, huh. That's strange. So, I did not use the chin strap last night, and a few things happened.

1) I woke up at 2:20 am to what sounded like a fog horn - which I then realized was my breathing through my mouth. Cue Sahara - though maybe with an oasis because I must have woken up and caught it fairly quickly after opening up. My mouth and throat weren't as dry as they were back when it happened the first time. I went to the bathroom and got a drink, then put the mask *and* chin strap back on for the rest of the night.

2) When I woke at 2:20, the first thing I noticed after the slightly dry throat and mouth was that my front teeth (top and bottom) were sore/tender. Without the chin strap. Which tells me this issue is not likely a result of the strap, putting me back to square one.

3) When I checked the data on the machine this morning, there is NO leak data. 0, zip, nada. It shows the little blip on usage where I turned off the machine when I took off the mask and went to the bathroom, then turned it back on when I got back in bed. That's it. Leak data shows 0.0. But I *know* that I was fog-horning through my mouth, lol. Didn't even show a blip. My AHI was .6, AI was .4, and my max pressure used was less than what it has been in the previous nights. Median pressure was only 10 last night, when it's been in the 12's and 13's for median pressure for a week or so.

4) LOTS of rainout in the pillows. I've never had more than a drop in the left funnel part (between the inner and outer layers of it). But this morning there were numerous water droplets in both funnel parts AND the main body of the pillow. I'm not sure what could be different - it's rainy here, so maybe the added humidity from the cpap was too much? I typically keep the humidity set at 1, pretty low because we live in a fairly humid place (North-central NC). When I set it down to .5, my nasal passages were dry and stuffy. Anyway - do you think the rainout was caused by a jump in the ambient humidity in the room because of the rainy weather? Temp is fairly stable in the room (and also fairly cool - I need it cool to sleep well). I never got rainout with the FF mask, and have previously only gotten very mild moisture in the pillows. This was a lot.

So, it looks like I'll continue to wear the strap and maybe look into getting a bite guard for my teeth. As for the rest? I dunno.

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