Do I need chin strap yet?

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SunnyBeBe
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Do I need chin strap yet?

Post by SunnyBeBe » Wed Jun 17, 2015 9:31 am

I'm day 15 into therapy. I think I'm doing great and MyAir confirms. Just a few little things, that I have been able to deal with. (Nose was sore and I switched to size medium pillow.)

I'm loving the nasal pillows, but I have had one incident that causes me pause. Last night, I awoke and know my mouth was open. That's not common for me. I normally do not sleep with mouth open. I think I must have had little congestion. Also, my machine was doing a little alarm. I have no idea what it was saying as it stopped quickly. So, do I get a chin strap, wait to see if it happens again or now try a full mask? I didn't like the feel of the full mask at my titration study, because it hurt the bridge of my nose. I find the nasal pillow much more comfortable.

I've looked at this one chin strap from The Cpap shop, but I'm not sure if we are allowed to post links to things for sale online. It gets good reviews and it described as not being so large. It's reported as being more comfortable than the larger contraptions.

I am Eastern time so my MyAir report isn't available until later in the day, so it's not available yet, but normally I get scores from 98-100 most every night since I registered about a week ago. I realize that it doesn't tell the whole story.
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Pugsy
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Re: Do I need chin strap yet?

Post by Pugsy » Wed Jun 17, 2015 9:41 am

You know you can use SleepyHead and/or ResScan and evaluate just how much leak was going on?

Mouth breathing/leaking will show up as excess leak on the software reports and you can see exactly how much excess leak was going on and how long it lasted.

Personally...myself...I know I sometimes mouth breathe with my nasal pillow mask but it rarely goes very far into large leak territory (over 24 L/min excess leak) and if it does it doesn't stay there very long.
So I have elected to not do anything about it because I discovered a long time ago that a chin strap or full face mask caused me more problems than a little bit of mouth breathing might cause.

So I would evaluate just how much leak is happening and the potential effect on therapy effectiveness first...then maybe go the chin strap route if the leak is excessive and lasts a long time.

You will need to use the software available to do the best evaluation though.
Or maybe use the data that is available on the machine's LCD screen in terms of leak numbers to get an idea if there is a potential problem.
You don't know if you were mouth breathing for 5 minutes or 50 minutes...I would try to make sure it was a real problem before I started to try to fix it if it were me.

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SunnyBeBe
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Re: Do I need chin strap yet?

Post by SunnyBeBe » Wed Jun 17, 2015 11:42 am

Okay, Pugsy. That's a great idea. I'm going to put it on hold for now. I will proceed with SleepyHead, as it will give me more info than MyAir. Depending on what that reveals, I'll explore my options. That makes me feel better.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

I guess I do need to check into SleepyHead, since MyAir gave me 100 points for last night, even though, I know I awoke with my mouth open and the alarm was going off. lol Odd.
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Pugsy
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Re: Do I need chin strap yet?

Post by Pugsy » Wed Jun 17, 2015 12:09 pm

You know it's very possible that the mouth dropped open and the air rushed out and you pretty much immediately woke up. Might explain the perfect score on MyAir.
Unless you make a habit of it I wouldn't worry about it. Any leaks, even tiny ones, that wake us up often will need to be worked on but because they are disturbing our sleep and maybe not so much impacting therapy pressure itself.

Also there are varying degrees of mouth breathing and they don't all mean that the therapy is in the toilet the entire time. A while back I happened to wake up and I was very gently mouth breathing...on my side...no huge rush of air out my mouth. Just very gentle breathing and so since it was about the time I would normally be getting up anyway I decided to experiment so I just continued to breathe that way for about 10 or 15 minutes because I wanted to see exactly what it looked like on the leak graph. I knew it would be real easy to spot because it was right at the end of the sleep session so I would know for sure that was the time frame I was looking at. I was amazed when I saw how little the leak line increased and it was well below large leak territory. Now I did have some dry mouth from the mouth breathing but again that doesn't always mean the entire night's therapy was in the toilet. My mouth will dry out with as little as 5 minutes of mouth breathing.

I have a screen shot of that leak graph somewhere and have posted it in the past as documentation of my experiment.
It's why I am not so keen on jumping on the "you need a full face mask" bandwagon unless someone just wants to try a full face mask. If someone doesn't want to go the full face mask route (or the chin strap) then I think that maybe the person needs to evaluate the leak itself and determine just how much of a negative impact it may or may not have made on the therapy....assuming that it doesn't disturb sleep.

For me personally I found that the chin strap disturbed my sleep quality more than my mouth breathing did. I see no sense in messing with a chin strap and have it bug me for half the night just to fix maybe 10 minutes of maybe mouth breathing that is maybe bad enough to impact therapy.
Getting good sleep has always been my number one goal and not getting a perfect math score.

Now I have seen some leak reports where I have to say "you gotta get a handle on those leaks somehow someway" and if that means a full face mask then so be it. I just want proof that leaks were horrible before I toss that out as something that needs to be done.

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SunnyBeBe
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Re: Do I need chin strap yet?

Post by SunnyBeBe » Wed Jun 17, 2015 5:21 pm

Great information. Thank you for your detailed informative and thoughtful response.
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SunnyBeBe
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Re: Do I need chin strap yet?

Post by SunnyBeBe » Mon Jul 06, 2015 1:02 pm

I'm reviving this thread, since I took the advice and have waited to see how things would go before looking into a chin strap. I thought things were good, but I just figured out from reading a post on this site how to view my AHI on MyAir. The last 14 days reveal that I go between mainly .1 and .4. I had one night of 1. I think that's pretty good, so I intend to keep going. I have read that trying to reach Zero is not realistic. Is that right? Is it okay to hover under 1?
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hegel
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Re: Do I need chin strap yet?

Post by hegel » Mon Jul 06, 2015 7:46 pm

I just came back from seeing a sleep doc at Kaiser. About the topic of chin straps, she suggested "people are going to breathe through their mouths if they need to no matter what". I have been experimenting with a chin strap and I must say, the same thought occurred to me: it's on pretty tight, but I could still open my mouth in my sleep. Still, who know, it might help.

In any case I think that my chin strap experiment is over and I don't really need one---but ymmv!

I did come home with a Resmed airfit f-10 mask to try. It covers both nose and mouth. If nothing else, maybe when I'm stuffed up this mask will help.

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Tassie Devil
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Re: Do I need chin strap yet?

Post by Tassie Devil » Mon Jul 06, 2015 8:03 pm

I tried a chin strap but gave up - it was cumbersome, made preparations for retirement complicated (getting all the straps adjusted) and I finally realised it was not needed anyway. Maybe OK for anyone not on CPAP but otherwise forget it IMHO.

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Pugsy
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Re: Do I need chin strap yet?

Post by Pugsy » Mon Jul 06, 2015 8:19 pm

SunnyBeBe wrote:The last 14 days reveal that I go between mainly .1 and .4. I had one night of 1. I think that's pretty good, so I intend to keep going. I have read that trying to reach Zero is not realistic. Is that right? Is it okay to hover under 1?
AHI around 1 or less is excellent.
That elusive 0.0 AHI is an unrealistic goal anyway. Remember these machines sometimes flag awake breathing irregularities and it's entirely possible that a little awake "event" flag is messing up that almost perfect 0.0 math score. I have seen many an almost perfect 0.0 AHI night messed up by 1 or 2 little hyponeas or an awake central getting flagged by mistake.

If you are consistently seeing less than 1.0 AHI now....give yourself some time and I wouldn't be surprised if in a few months you do see some 0.0 nights here and there.

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