Mouth Breathing Solutions?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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OwlCreekObserver
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Mouth Breathing Solutions?

Post by OwlCreekObserver » Sun Jul 02, 2006 6:35 pm

I've had good success with the mouth taping strategies that have been posted here. They've made it possible for me to switch from a full-face mask to a nasal mask, for which I'm extremely grateful.

But I've also read about several folks who have somehow trained themselves to breathe properly through their nose after they drift off to sleep. Some say you should "park" your tongue against your upper gums; others say lower gums. Maybe it's different for different folks, sorta like the various masks.

My question is, how long did it take for any of you to finally get it right? As soon as I drop off to sleep, the airflow from my CPAP immediately goes through my mouth. I wake up, close my lips, drop off, wake up, etc. If this retraining is really possible, how long should I expect to be working on it? I'd really like to avoid the tape hassle someday.

Thanks in advance.


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inacpapfog
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Post by inacpapfog » Sun Jul 02, 2006 8:06 pm

Guess it differs for each person!
Myself? I've been working on it for 18 months and I still have not been able to sleep soundly, less mouth leaks! So I continue to tape. I also make it a point to find and fall asleep in that ideal body position (head, neck, shoulders ) where, even if I drop my tongue from its sacred position, no cpap air rushes into my mouth. When I am able to maintain this body position in comfort all night, I sleep like a log and my numbers are great the next morning!


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Goofproof
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Post by Goofproof » Sun Jul 02, 2006 9:02 pm

Most, who use this method, are actually, just Swimming in De-Nile, a very few, it works some, but if you can convince yourself it works, swim on.

It would be nice to have a clean easy fix for mouthbreathing, the only two that are 100% effective in all cases are a FF Mask, and mouth tapeing or it's like. Everything else is a crap shoot, mileage may vary.

I can't afford a miss, so I bite the bullet. Jim

Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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rested gal
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Post by rested gal » Sun Jul 02, 2006 10:52 pm

Back in 2004, I thought I'd conquered it....

Aug 31 2004 subject: Mouth leak training wheels

I've been through a lotta' rolls of tape since then.

I'm sure there are a few who have eventually gotten their tongue to stay parked. I'm not one.

Another rather interesting thread, posted by snork1, from way back then...

Jul 01 2004 subject: yes, mouth leaks again...a new variation

Those threads and lots more can be found in this ever-growing list:

Links to: Mouth leaks - Air Leaks - Tape - DIY Guard

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NightHawkeye
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Re: Mouth Breathing Solutions?

Post by NightHawkeye » Mon Jul 03, 2006 6:47 am

OwlCreekObserver wrote: . . . how long did it take for any of you to finally get it right? As soon as I drop off to sleep, the airflow from my CPAP immediately goes through my mouth. I wake up, close my lips, drop off, wake up, etc. If this retraining is really possible, how long should I expect to be working on it?
OCO, what worked for me was not tongue position, but simply training myself to breathe nasally while using CPAP and deliberately holding my mouth open. In just a matter of days after first practicing this, I quit mouth breathing almost entirely while sleeping. When air from the CPAP rushes out my mouth, I usually wake up quickly, but if I don't, then the noise wakes my wife up and she then wakes me up with a shove because the noise bothers her.

However, there appear to be more subtle forms of mouth breathing than having the full air supply go straight out the mouth. Goofproof may be correct in saying that it's not possible to entirely quit mouth breathing 100% of the time. I find that air which has been shoved down my gut sometimes comes back up and goes out the mouth. This is what drove me to use poligrip strips. I found that the strips helped minimize this and that many nights since using them I've experienced no apneas, however, ensuring that the mouth stays entirely shut while using the strips has itself been an exercise in futility. (Maybe it's time to start a new thread on this topic.)

The bottom line for me is that effective therapy is possible even with some amount of mouth breathing. Although my oximeter often shows very shallow desaturations, these stay above 94% most nights. I'd use a full-face mask if I could, but that hasn't worked out for me. Maybe one day I'll consider mouth taping. In the meantime, if a new approach comes along, I'll likely give it a try.

OCO, it's good that you've found an approach which allows you to achieve effective therapy. Many folks never quite get that far. I suspect some of those who complain about continuing symptoms after months or years of therapy without ever having objectively tried to monitoring its effectiveness have problems similar to the ones you've just resolved.

Regards,
Bill


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Post by KenS » Wed Jul 05, 2006 7:39 am

inacpapfog,

Can you describe the body position you use so air does not rush into your mouth? I have only used my CPAP machine for the first time last night, but it was a disaster. Every time I would start nodding off, my mouth/throat/tongue would relax and a big whoosh of air would fill my mouth and puff out my cheeks (I had securely taped my mouth as recommended here). So, basically, everytime I was about to actually sleep the whoosh of air into my mouth woke me up. I kept at it all night, but I got virutally no sleep. I'm hoping for a better result tonight and any tips will be appreciated!

Thanks,

Ken


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Post by picard2bridge » Wed Jul 05, 2006 6:48 pm

> I have only used my CPAP machine for the first time last night, but it was a disaster.

Despite the fact that the technicians and doctors pretend otherwise a quick read of this forum will tell you that almost everyone's first night is a disaster

> I kept at it all night, but I got virutally no sleep.

That's what most of us experienced at first. I am 4 weeks in now, and still getting the odd wakeup, but usually only one a night now, and getting about 6 hours plus on the machine each night. Hang in there, it does get better.

Ken, I'm wondering what possessed you to tape your mouth on the first night. This is an extreme strategy which works for some, but is hardly the thing you'd try from the outset, I would have thought.

I must admit, I'm not sure how air is getting into your mouth with it taped up. But let me share my experience, as it is recent and I had similar problems at first.

Because I sometimes mouth breathe, the technician gave me a mouth and nose mask from the outset. Bad move. they should have ascertianed to what extent mouth-breathing was an issue first, because a ful face mask is ging to be more uncomfortable and therefore discourage compliance. Anyway, I found when I nodded off everything relaxed, and as my mouth, even in the mask, sagged open, the seal kept on coming undone and leaking, waking me and my partner. Back to see technician twice. They tightened the mask, tested it at full pressure and proclaimed it fine. But that didn't take into account my mouth falling open. Cretins. When I read up here about this I taped up my mouth and was immediately improved. Was still woken by rainout, but before this the rainout weakened the seal and the mouth finished off the job.

So I now went back to the tech and said, since the mouth taping worked I think I can go with a nasal only mask and taping or chin-strap. I bough a vhin strap and tried it and it works fine for me. Keeps my jaw shut fine and is more comfy than the tape. The technicians had basically dine nothing to help me to this point.

Anyway, this setup is now working for me. I still get rainout because of temperature differentials in my bedroom with heating in winter. I am intending to try nasal pillows next to see whether that's better.

I assume you are ona month trial somwhere. My advice is try the chin strap or just panty hose to keep your jaw shut and lay off the taping for a few days. Also try increasing the ramp time on your machine by 10 minutes or more. It maybe the big rush of air is due to the machine going from its low pressure to the higher pressure before you are completely asleep. This might be called 'settling time' on your machine--basically it starts at a lower pressure to let you go to sleep, before increasing to operating pressure. If you're sound asleep by then, you won't notice that happenning.

Can you tell us what sort of machine and mask you have, by the way?

All the best. It will get better. After 4 weeks I still need it to get better some more, as I am still more tired than before, but I believe I will get there. My problem now is I have to return the machine because my trial is over, and find the money to buy one [/code]


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Re: Mouth Breathing Solutions?

Post by bitfoggy » Wed Jul 05, 2006 7:12 pm

OwlCreekObserver wrote:
But I've also read about several folks who have somehow trained themselves to breathe properly through their nose after they drift off to sleep. Some say you should "park" your tongue against your upper gums; others say lower gums. Maybe it's different for different folks, sorta like the various masks.

My question is, how long did it take for any of you to finally get it right?
Rather than try to resort to these exotic techniques, wouldn't it be just better to just fork out $175 and buy the Hybrid????

inacpapfog
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Post by inacpapfog » Wed Jul 05, 2006 7:35 pm

Ken, that "ideal" body posture thing that I was referring to came from a post frequentseeker made several months ago concerning mouthleaks. Basically, she suggested several ways that an individual could find their ideal head/neck/shoulder alignment in which the cpap air is able to maintain it's intended pathway in the respitory tract and not become diverted into the mouth cavity! After experimenting, I found this ideal position for me. On my back, pillow supporting shoulders and allowing head to rest with chin in a "not-tucked" position. Once I find this position, I relax my tongue to check for that rush of incoming air. If it happens, I know that I have to readjust my posture before trying the leak test again. Once I'm in that ideal position, I can relax my tongue, and as long as I remain in that position, no air diverts into my mouth! Granted, once I fall asleep and shift from this position, I lose the no-leak advantage. However, there have been nights where I've remained in alignment most (or all!) of the night and my numbers are super!
Hope this helps! You might just give it a try to see if such an alignment exists for you !


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Re: Mouth Breathing Solutions?

Post by OwlCreekObserver » Wed Jul 05, 2006 8:11 pm

bitfoggy wrote:Rather than try to resort to these exotic techniques, wouldn't it be just better to just fork out $175 and buy the Hybrid????
Maybe, but I just forked out $115 for a ComfortCurve because my insurance requires a prescription before they'll reimburse for any new mask. I didn't want to try and convince my doc that I needed the ComfortCurve when I wasn't even sure if it would work for me. It did, but the purchase is out of my pocket.

I had terrible results with the ComfortFull full-face mask which is why I bought the ComfortCurve in the first place, and there is certainly no guarantee that the hybrid would work any better for me than the ComfortFull.

Perhaps somewhere down the road, after I've read more long-term results on the hybrid in this forum, I might consider going that route. Of course if the manufacturer would like to send me a sample to evaluate as someone who can't tolerate a full-face mask . . . . .


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NightHawkeye
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Re: Mouth Breathing Solutions?

Post by NightHawkeye » Wed Jul 05, 2006 9:39 pm

OwlCreekObserver wrote:Success is getting what you want but happiness is wanting what you get.

-- "Brother" Dave Gardner
OCO, it's good to run into somebody else who appreciates the inimitable Brother Dave. Other notable quotes from Brother Dave which come to mind are:

"Leroy, get away from that wheelbarrow! You know you doesn't know nothin about machinery."
(Note: This was said in a distinctly politically incorrect manner.)

'If you ain't John, I'm gone!"

"The worst I ever had was wonderful."

I just had to listen to an old Brother Dave recording this evening. - Great stuff.

Regards,
Bill

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Post by KenS » Thu Jul 06, 2006 8:12 am

Thanks, inacpapfog. I will play around with positioning and maybe I will be one of the lucky ones that can find an ideal position to avoid mouth leaks.

picard2bridge,

Thanks for replying. I am located in London and am using the REMstar Auto with C-Flex and a Comfort Curve Nasal interface. I’m on a two week at home titration.

Regarding mouth taping, having read quite a bit on this forum I thought that taping sounded like it might be necessary/helpful depending on how things went for me. So, I had bought a roll of the 3M tape just in case. I started out the first night tape free. Every time I would start to dose off and my tongue and throat relaxed, the CPAP air would rush through my mouth and out, waking me up and defeating any benefit of the CPAP. After a few hours of this, I decided to try taping my mouth. It solved the problem of air escaping from my mouth. However, instead when I would doze off the air would rush into my (now sealed) mouth and puff my cheeks up like a blowfish. Again, every time this would wake me up.

I am not a natural mouth breather. When I breathe normally with CPAP no air escapes into my mouth. I guess my tongue naturally blocks the path when I am awake. When I doze off, I guess the tongue changes position and air gets through (and it really rushes through). I don’t think a chin strap will help as my mouth is staying closed but the lips are getting forced outward and open by the air. I also don’t think using the ramp feature will help, but no harm in trying. But, since I am titrating and the unit has to be in auto mode, I didn’t think the ramp function is usable on my machine (when in AFLE mode).

Last night was better, and I think I managed about 3-1/2 hours of uninterrupted sleep before waking up (and I didn’t wake from an air leak problem but my son crying in the middle of the night. But from then on every time I dozed off, I awoke from the “blowfish” problem. I’m not sure why I didn’t seem to have the issue for the first 3-1/2 hours of my sleep, but I am curious to see what happens tonight. I’m also toying with the idea of putting some sort of strap around my head over my cheeks (like a sweatband but instead of on my forehead pulled down over my mouth and around the cheeks) to reduce the blowfish effect. I might be able to sleep with the air pressure sealed within my mouth, but it is quite startling when my cheeks in an instant get filled with air and puff out. If I could make the cheek puff less expansive it might help.

Thanks for listening and the words of advice and encouragement.


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Post by inacpapfog » Thu Jul 06, 2006 8:35 am

Ken, that "blowfish" issue was exactly the reason I have to keep my cheeks "bound" with the Deluxe Chin Strap. When in place, the strap prevents my cheeks from expanding. Tape over the mouth is simply not enough for me!
I am looking forward to receiving my Hybrid arriving tomorrow and I will report back if this new mask will remedy our type of mouth leak issues!

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Post by rested gal » Thu Jul 06, 2006 8:39 am

KenS wrote:I decided to try taping my mouth. It solved the problem of air escaping from my mouth. However, instead when I would doze off the air would rush into my (now sealed) mouth and puff my cheeks up like a blowfish. Again, every time this would wake me up.
Ken, you described perfectly what happens sometimes (the "blowfish" effect, when we seal our mouths with tape.
KenS wrote:I am not a natural mouth breather. When I breathe normally with CPAP no air escapes into my mouth. I guess my tongue naturally blocks the path when I am awake. When I doze off, I guess the tongue changes position and air gets through (and it really rushes through).
Exactly. The tongue is the key.
KenS wrote:I don’t think a chin strap will help as my mouth is staying closed but the lips are getting forced outward and open by the air.
I think you're right, Ken. A chin strap is worth a try, since keeping the jaw closed with the help of a chin strap is, indeed, enough to keep the TONGUE in a sealing position inside the mouth for some people. Not for me, though. My jaw can be so tightly closed that my teeth are clenched, yet my tongue does not maintain a sealing position inside my closed mouth. Air slips easily around the back of my tongue and puffs straight out from between closed lips. Chin straps are useless for me.
KenS wrote:I also don’t think using the ramp feature will help, but no harm in trying. But, since I am titrating and the unit has to be in auto mode, I didn’t think the ramp function is usable on my machine (when in AFLE mode).
You're absolutely correct, Ken. A true Ramp function is not available in AFLE mode with the REMstar Auto. Ramp timer must be set for 0:00 when using that machine in APAP or AFLE mode.
KenS wrote:I’m also toying with the idea of putting some sort of strap around my head over my cheeks (like a sweatband but instead of on my forehead pulled down over my mouth and around the cheeks) to reduce the blowfish effect. I might be able to sleep with the air pressure sealed within my mouth, but it is quite startling when my cheeks in an instant get filled with air and puff out. If I could make the cheek puff less expansive it might help.
What you are proposing to do is a good idea and would probably keep the cheeks from filling up and ballooning outward a la "blowfish". I've read of other people putting a strap around their cheeks to good effect.

Good luck, Ken! You sure did your homework and are well ahead of the game so far!

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Post by cmkoivu » Thu Jul 06, 2006 8:42 am

i am new to all this CPAP stuff, but my father had his Darth Vader gear for a while. He basically lectured my ear off on breathing through your nose to reduce snoring. I tried years ago a firemans head gear during a sleep study and it was miserable. I have been practicing breathing through my nose since as a discipline. I just decided to try again after learning about the new gear out, and it works