Newbie with Jaw Pain after CPAP Use

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TeddyBfan
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Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 12:49 pm

I have been on CPAP therapy for 3 and a half weeks now. My AHI at testing was 32. My max pressure is 13. I adjusted the starting pressure at 6 (from 4) and reduced the ramp time to 30 min (from 45). I may reduce the ramp time to 10 min, as the pressure does not bother me.

Results have been mixed. I am breathing a lot better when I wake up in the morning and I am not waking up as frequently at night as I was prior to 3 weeks ago. My AHI per MyAir have ranged between 1 and 3. Not too bad. But, I am not feeling as rested and energetic as I expected.

Other issues:
-- I wake up at times to adjust the mask to stop leaks. Last night was the worst.
--My mouth becomes very dry but I can tolerate that.
--My teeth/jaw often hurts in the morning but that usually subsides in an hour or so.
--For 2 to 3 weeks I have been feeling discomfort and sometimes pain on the right side of my jaw, at the joint, under my cheekbone and by my ear. I don't have a history of TMJ.
Pugsy wrote: Your pain/discomfort issues could be related to the strap tension of your mask. Might be pressure on a nerve of something.
You are using a full face mask...why? Chronic nasal congestion or DME just said it would be best or whatever?
Are you tightening the straps a lot in an effort to stop the leaks? Tighter isn't always better.
The mask part of this therapy is probably the most difficult.
It was my decision to use a full-face mask because I often have nasal congestion. However, I notice that my nose is often not congested when I use the CPAP. I was considering buying a different mask.

I don't believe the straps are tight. But I am sleeping mostly on my right side. Could that be the reason?

The AirSense 10 allows you to test the mask fit. At lower pressures, there are no leaks. At 13, I get leaks on the side of my mouth. Overall, the mask is comfortable. For a couple of nights, I felt minimal, if any, leaks.

So, I wondered if any other members here have the jaw pain/discomfort by their ear that I am having. Could this be a result of my clenching my teeth more, now that I am using a FF mask? I would also appreciate some suggestions to minimize the leaks. Thank you. It is great that there is a place to go to get feedback and support when trying to adjust to something new.

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Pugsy
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Re: Newbie with Jaw Pain after CPAP Use

Post by Pugsy » Sun Jul 24, 2016 1:21 pm

It might be possible that the strap on the right side is simply putting pressure on an area with a nerve acting up.
It might be possible that you are clenching your teeth that is causing the problem.

There are some simple things to try to see if they help or not with both the minor leaks that wake you up and the jaw discomfort.

For mask leaks..try a mask liner. You can buy them or make your own. I don't have personal experience with them (never used a full face mask) but from what I have read the liners seem to reduce the annoyance factor that often wakes people up. Often used at higher pressures but there's no reason why they can't be used at lower pressures also.
Padacheek makes a great mask liner that will last for months and months with common sense care
http://www.padacheek.com/PAC_Maskliners.html
I usually suggest that people try making one out of an old TShirt first...just to see if it seems to help before spending money on one.
Just because a leak is minor and not really harming the therapy effectiveness itself doesn't mean that they can't be harming sleep quality with frequent wake ups...so if a leak (even if it is tiny) wakes a person up then it needs to be fixed.

For the jaw discomfort I would try a mask strap cover first...again you can make your own or buy them.
http://www.padacheek.com/PAC_Strap_Pads.html
http://www.padacheek.com/PAC_Original.html
Something a little softer or cushier on the jaw might be enough to relieve the discomfort and hurts nothing to try. I made my own first strap covers (I didn't like the dents in my cheeks from the mask straps) before I bought from Padacheek. They weren't real pretty but they got the job done.

Finally...at some point you probably will be lured by the thought of trying a mask that simply has less presence on the face and head. It's entirely possibly that the cpap pressure and added moisture has helped the nasal congestion that lead you to decide on a full face mask to cover possible mouth breathing issues. It's funny but I often wake up with the nose much clearer than when I went to bed and I am not alone in noticing that fact. So if you want to try something else...then try it. Wanting to is a good enough reason. It may or may not work out but you will learn something from it. I have tried way too many masks to count...some were dismal failures but some turned out to surprise me with my having good success with it. I always learned something...even if all I learned was how much I hated the damn thing.

Check with your DME (equipment supplier) to see what their mask swapping policy is. Often they have 30 days in which you can try other masks and not have it cost you anything. Make use of whatever time you have to utilize any mask swapping options they offer. You can always go back to your first choice if it ends up being the best option but you won't know unless you try something else.
I mention this now because you are probably fast approaching the end of any mask swapping time your DME might offer. Hence the recommendation to maybe try a homemade mask liner or strap so you don't have to wait for shipment. In reality the mask manufacturers all offer a 30 day return policy for each mask but DMEs elect to make their own in house policy about mask swapping...so check with your DME to see what their policy is. Insurance will only pay for one mask per the allowance schedule but DMEs can get reimbursed from mask manufacturers for mask swapping if they would just do the paperwork...often they are just too lazy to do the paperwork.

Don't be afraid to try something else if it interests you...even a nasal interface mask. You might find out that you don't really have to use a full face mask. You won't ever know unless you try.
Now you might find out that you mouth breathe too much and a full face mask is the best choice but at least you will know and not be "what iffing I could use so and so mask".
I thought I was a mouth breather...but with the cpap pressure and humidity helping with the clearer nose and the cpap stopping the gasping for air in the middle of the night, I found that I didn't really mouth breathe all that much and what little I did really didn't hurt anything....and had issues with straps and full face masks so a nasal mask was pretty much my choice anyway...it's a good thing that I don't have to use a full face mask. I did try a lot of masks though so that I knew what my own needs and preferences were...It took some time and effort (and picking up cast offs from forum members to keep the cost down) but it's a great learning experience when you can do it.

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Nin6
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Re: Newbie with Jaw Pain after CPAP Use

Post by Nin6 » Sun Jul 24, 2016 2:10 pm

I had been having trouble with sore front teeth in my lower jaw, and also with the dry mouth. I wear a full face mask and assumed that the sore teeth were from the pressure of the mask on the teeth. But then because I didn't like the dry mouth from mouth breathing and air leaks, I tried a small piece of tape to keep my lips together at night. The dry mouth went away because I wasn't mouth breathing, but also, surprisingly, the sore teeth lower went away too. So I'm thinking that the dry mouth and flow of air over the teeth were causing the pain in the teeth. I should probably try a chin strap, but the little tape (not across the whole mouth, just a vertical strip to keep my lips together) has made things a lot better.

TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 2:50 pm

Thank you for all these suggestions. It is really appreciated.

Like you, using the CPAP appears to have helped with the nasal congestion. I am thankful for that. However, it seems that I open my mouth while sleeping . So, I want to keep the FF mask and I am open to buying a nasal mask to try. I believe the medical supply company told me that my insurance company will cover a new mask every 3 months. Does that sound right? Should the masks be replaced that frequently?

I will try to make a liner before purchasing one. A liner probably will keep the mask cleaner, no?

I will also try to find something to put in between the mask strap and my head to provide some cushioning, as you suggested.

I will try whatever is necessary to optimize my CPAP therapy. Thank you again for your help!

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Pugsy
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Re: Newbie with Jaw Pain after CPAP Use

Post by Pugsy » Sun Jul 24, 2016 3:04 pm

Mask replacement frequency can vary between insurance companies so you need to check with yours to make sure what it is but in general 3 months or 6 months for a new complete mask is common.
Mask cushions can be replaced more frequently.
So yes you could use your next new mask allowance to try something else and not have to give up the current mask. I didn't mean to make it sound like you need to rush out and try all those other masks next week. I think when I was in my mask experimenting phase I did the bulk of it over a period of 6 months.

Watch the forum...often members will offer up a gently used mask either for free to get it out of their house or real cheap. That's how I got most of my mask experiments...even used they will give you an idea if it is worth proceeding with further experimentation or it simply won't work.

And yes...mask liners will greatly reduce the accumulation of facial oils on the cushion. Liners will help keep it cleaner.

In terms of the expected life of the masks..most will last a lot longer than 3 months. There are parts that will last longer than other parts depending on the mask. Plastic frames will last forever with common sense care. The elasticity of the headgear will vary depending on the mask type and how much it's used. The silicone part...the cushion probably lasts the shortest time for some people and again it depends on a lot of things...cleaning routine or facial oils or just handling. Some people need to change monthly (and for full face mask cushions insurance will usually pay for 1 cushion per month) and others not so often. This is something you will need to sort through on your own as to how long they will last but get a spare cushion as soon as you can because you never know when one might tear or something.
It's good to always have a back up of some sort for everything.

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Sir NoddinOff
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Re: Newbie with Jaw Pain after CPAP Use

Post by Sir NoddinOff » Sun Jul 24, 2016 3:52 pm

After you've tried taping and adjusting for leaks etc try this:

I use Doctor's Night Guard every night and it works great for sore jaw relief from teeth grinding and it also helps position your jaw in the proper alignment. They are meant to be molded to the upper teeth. I do it a little different, I cut off about 3/16" from each end with a sharp razor knife and then mold it to my lower teeth which I like best, however, upper or lower jaw, you should make it fit your needs. You can remold it three times and after that you're finished with that mouthpiece. Buy two so you can experiment.

https://www.amazon.com/Doctors-NightGua ... ight+guard

Follow up with a chinstrap like the CareFusion Ruby plus the teethguard if the above doesn't solve your problems.

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zonker
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Re: Newbie with Jaw Pain after CPAP Use

Post by zonker » Sun Jul 24, 2016 4:42 pm

hi, teddybfan!

you are in capable hands with pugsy's help. not much more i can add, except-

you said-"--My mouth becomes very dry but I can tolerate that."

my response is to you and others regarding dry mouth. when i first mentioned to my dental hygienist that i was starting cpap therapy, she said that she had heard that this therapy could cause dry mouth. she cautioned me about this because dry mouth, over an extended period of time, can actually promote tooth decay. she showed a brochure of products to help prevent this. the one i ended up using is called Xylimelts. this a one of many products that stimulate saliva. it's a tiny pill like lozenge that you wedge between tooth and cheek and then you can forget about it. it really does the trick in keeping my mouth moist over night.

i don't know if these are available nationwide. i pick them up at my local rite aid store. and they are produced here locally.

anyway, for what it's worth....
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TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 8:05 pm

zonker wrote:hi, teddybfan!

you are in capable hands with pugsy's help. not much more i can add, except-

you said-"--My mouth becomes very dry but I can tolerate that."

my response is to you and others regarding dry mouth. when i first mentioned to my dental hygienist that i was starting cpap therapy, she said that she had heard that this therapy could cause dry mouth. she cautioned me about this because dry mouth, over an extended period of time, can actually promote tooth decay. she showed a brochure of products to help prevent this. the one i ended up using is called Xylimelts. this a one of many products that stimulate saliva. it's a tiny pill like lozenge that you wedge between tooth and cheek and then you can forget about it. it really does the trick in keeping my mouth moist over night.

i don't know if these are available nationwide. i pick them up at my local rite aid store. and they are produced here locally.

anyway, for what it's worth....
Hi Zonker,

Thank you for this information. I did not know that dry mouth can lead to tooth decay. I am seeing my dentist for another matter tomorrow and will ask if I can use the product you use or maybe another one.

Thanks again.

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Okie bipap
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Re: Newbie with Jaw Pain after CPAP Use

Post by Okie bipap » Sun Jul 24, 2016 8:10 pm

[quote="TeddyBfan"]

I will try to make a liner before purchasing one. A liner probably will keep the mask cleaner, no?

If you want to make a liner, this is a link to the pattern I used to make mask liners with. It will work with medium or small masks. It can be enlarged for large masks: http://montfordhouse.com/cpap/diy-cotton-mask-liner.pdf I made mine from an old well-used tee shirt.

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TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 8:18 pm

Okie bipap wrote:
If you want to make a liner, this is a link to the pattern I used to make mask liners with. It will work with medium or small masks. It can be enlarged for large masks: http://montfordhouse.com/cpap/diy-cotton-mask-liner.pdf I made mine from an old well-used tee shirt.
Thank you. I will check this out. I use a medium mask. So this should work for mine. I will let you know how I make out.

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TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 8:26 pm

Sir NoddinOff wrote:After you've tried taping and adjusting for leaks etc try this:

I use Doctor's Night Guard every night and it works great for sore jaw relief from teeth grinding and it also helps position your jaw in the proper alignment. They are meant to be molded to the upper teeth. I do it a little different, I cut off about 3/16" from each end with a sharp razor knife and then mold it to my lower teeth which I like best, however, upper or lower jaw, you should make it fit your needs. You can remold it three times and after that you're finished with that mouthpiece. Buy two so you can experiment.

https://www.amazon.com/Doctors-NightGua ... ight+guard

Follow up with a chinstrap like the CareFusion Ruby plus the teethguard if the above doesn't solve your problems.
Thank you for the suggestions. My dentist told me that such a product might work to reduce the pain of teeth grinding. I was concerned that the night guard might affect my breathing, but I will try it and will let you know how it works out.

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TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Sun Jul 24, 2016 8:38 pm

Nin6 wrote:I had been having trouble with sore front teeth in my lower jaw, and also with the dry mouth. I wear a full face mask and assumed that the sore teeth were from the pressure of the mask on the teeth. But then because I didn't like the dry mouth from mouth breathing and air leaks, I tried a small piece of tape to keep my lips together at night. The dry mouth went away because I wasn't mouth breathing, but also, surprisingly, the sore teeth lower went away too. So I'm thinking that the dry mouth and flow of air over the teeth were causing the pain in the teeth. I should probably try a chin strap, but the little tape (not across the whole mouth, just a vertical strip to keep my lips together) has made things a lot better.
I'm sorry that I did not see your post earlier. To the bolded, that is an interesting thought. I will keep that in mind. I will be doing a lot of experimenting in the next few weeks. I may tape my lips to force myself to breathe exclusively through my nose. I will see if that reduces the jaw pain.

Thank you for the feedback.

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mjdindc
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Re: Newbie with Jaw Pain after CPAP Use

Post by mjdindc » Mon Jul 25, 2016 7:01 am

If you are having problems with dry mouth I highly recommend Biotene toothpaste and mouthwash. I have had dry mouth for years because of a reaction to some meds. Dry mouth is terrible for your teeth./. Talk to your dentist and doc about it. There are a lot of mints that help with dry mouth, but be aware of any artificial sweeteners used.

TeddyBfan
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Re: Newbie with Jaw Pain after CPAP Use

Post by TeddyBfan » Mon Jul 25, 2016 7:19 am

mjdindc wrote:If you are having problems with dry mouth I highly recommend Biotene toothpaste and mouthwash. I have had dry mouth for years because of a reaction to some meds. Dry mouth is terrible for your teeth./. Talk to your dentist and doc about it. There are a lot of mints that help with dry mouth, but be aware of any artificial sweeteners used.
Thank you for the suggestion. I have dry mouth only when I am using the CPAP (at night). During the day I don't have dry mouth. But I have a dentist appointment today and I will talk with him about this.

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Re: Newbie with Jaw Pain after CPAP Use

Post by 49er » Mon Jul 25, 2016 7:46 am

TeddyBfan wrote:
mjdindc wrote:If you are having problems with dry mouth I highly recommend Biotene toothpaste and mouthwash. I have had dry mouth for years because of a reaction to some meds. Dry mouth is terrible for your teeth./. Talk to your dentist and doc about it. There are a lot of mints that help with dry mouth, but be aware of any artificial sweeteners used.
Thank you for the suggestion. I have dry mouth only when I am using the CPAP (at night). During the day I don't have dry mouth. But I have a dentist appointment today and I will talk with him about this.
XyliMelts are perfect for use with the CPAP at night.

https://www.amazon.com/XyliMelts-Dry-Mo ... s=xylomelt