A Theory.....Does this make any sense?

[Bones]

I have a theory about my sudden lack of mouth leaking. If anyone feels this is totally out to lunch, please say so.

First a little background. My GP, my ENT and my Respirologist (sleep doc) all say I have one of the narrowest airways they have ever seen. I was titrated on cpap Dec 20. 2005 at a pressure of 11. I was raised to 12 a week or so later due to some snoring. I started out with a comfort gel mask and swapped for an Activa a couple of weeks later. Things seemed to go fairly smoothly for a while, but I never really felt the benefit of cpap that I was reading of others having. In March, I realized that air was leaking out of my mouth. I called my RT and told him what was happening. Due to the fact that I had lost about 20 lbs., he felt it might be that my pressure was now too high and had me drop it to 10. Well that didn’t work, so I began a months long process of trying to find a full face mask I could live with. Been through ‘em all, don’t like any of ‘em, but found I could at least tolerate the F&P HC 431. But even with the mouth leak thing taken care of, I never felt any better. In late November I did a trial on autopap for a while so they could get some data on me. They had the range set from 9-15 and I started feeling better in a few days. I returned the auto on schedule and soon was feeling bad again. I got a call from my RT on Jan. 9 telling me to raise my pressure to 14. I did so, and a week later ordered my own auto with software and reader from our hosts. I also ordered a comfort gel mask; because I had noticed at the higher pressure I never had dry mouth and used hardly any water overnight... Last Friday night, I used the nasal mask for the first time and have used it with no problems for over a week now.

So my question is: was my mouth leaking due to my pressure being too low to hold my airway open? Was the air rebounding out my mouth because it couldn’t into my airway? I’ve never read anything confirming this, but it’s all I can think of.

Incidentally, my numbers are much better with the comfort gel than they were with the 431.

Brian

[dsm]

Brian,

An interesting experience and sounds like you are in control & making very good headway.

Re the theory, just can't be sure - will think about it some more but it is unusual.

Good going

DSM

[blarg]

So my question is: was my mouth leaking due to my pressure being too low to hold my airway open?

Before I used CPAP I used to wake up with dry mouth all the time. I also slobbered a LOT when I slept.

My thoughts are that if you can't get air through your nose, then of course you're going to open your mouth and try to breathe. Now that your airway is being held open sufficiently, you aren't struggling against the OSA, and you have no reason to open your mouth. That's my theory anyway.

[Bones]

Blarg,

I wasn't actually "mouth breathing". What was happening was the air was filling up my mouth and eventually forcing itself out. I actually lay awake one night with my cpap and could feel my cheeks filling with air. My mouth never opened until the pressure became so great I could no longer hold it in.

Brian

[blarg]

Well, in that case, ignore the noise please.

[Elle]

Your theory sounds plausible to me.

[lvwildcat]

Brian-hmmmm- you may have something in your theory. Could be that the CPAP was forcing air into your mouth but pressure wasn't high enough to keep your airway splinted open. Glad you're on the right track now! Barb

[Bones]

Blarg wrote:
Well, in that case, ignore the noise please.

Hey....you were trying to help and I appreciate that. I should have been a little more clear about what I mean by mouth leaks in my original post.

Brian
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[birdshell]

Yes, it makes some sense to me and maybe the "blowfish" effect of which others complain is SOMETIMES related.

Please may I suggest that you mention this to everyone. Back in the early '70's in college, I was told many things about the body that did not jive with my common sense.

For example, we learned that cartilage helps the joints absorb shock and lubricates them--then, many folks with knee injuries were having their knee cartilage totally removed. This just seemed extremely counter-intuitive to me at the time.

Now, the same folks are having problems from the bone-on-bone stress for years, and cartilage is being totally removed only when necessary due to extreme circumstances. Artificial and other forms of cartilage are being developed for implantation.

So, Bones, it is my belief that you may be on to something here. The true test will be to go back to the old pressure and method for a night to see what results. If nothing else, you may help a budding sleep specialist to earn his or her wings by studying this phenomenon.

If you hear of a study, let me know! I also have a small airway according to the anesthesiologists, and tape my mouth.

[rested gal]

I'm still playing catch-up on topics I missed for over a week. Bones, your theory makes sense to me, regarding a possible cause of mouth air leaks as opposed to mouth breathing (which is my particular problem, leading to my use of tape over my mouth.)

What you described (pressure too low to effectively splint the throat open at times) sounds like it could very well be the case for some people with persistent mouth leaks. If the blockage ain't cleared, yeah... that incoming cpap air's gotta go somewhere. Detouring out as a mask leak or mouth leak.

[SleepGuy]

Bones, I've noticed that the muscles at the back of my throat have become stronger over time. They're the ones that close off the passage to my mouth--but I've certainly felt pressurized air leak past that point and enter my mouth so I know what you're talking about.

Perhaps your muscles are just getting stronger along with everything else.

Good news in any event!