Am I sleeping with my mouth open? And how do I fix it?

I have had an APAP machine since May of this year.
Within a few days of starting it, I noticed definite improvements over not having a machine.
However, even 8 months later, I still have never really felt "great" or as "rested and energized" as I feel I should.
I often wake up feeling exhausted and low on energy, can barely get myself out of bed, you know the story.

I use a nasal pillow mask, and have the humidifier on the highest setting.
Sometimes I wake up with a really dry mouth and throat.
I have started to theorize that maybe I am sleeping with my mouth open most of the time.
If that were true, then the APAP machine would not be forcing air into my lungs, it would just be coming out my mouth.
That would explain the dry mouth, dry throat, and feeling as if the darn thing isn't working for me.

I also have a full mask, which covers my mouth as well as my nose. Unfortunately, I cannot use it.
It fits well and is comfortable, but when the air comes on, it does something weird with my nose.
I have a deviated septum. When the machine is blowing air, I can feel my nostril "sticking" to the bone in my nose, then it pulls away, then it sticks to it again.
It is extremely irritating and uncomfortable, to the point that it drives me insane and I have to take the mask off. I've tried it 5 different times, and it's always the same.

So, does it seem like I'm sleeping with my mouth open?
What advice do you have?
Has anyone else had an annoying nose sensation with a full mask?

I am desperate to figure all of this out and hopefully find that the therapy improves so one day I can feel rested when I wake up.

Thank you for any help.

The best thing to do is follow the three links below so we can see your data.

You may or may not be mouth breathing or having your mouth open enough to negatively impact your therapy.
Use available software and evaluate the leak rate. Mouth leak is a leak and it will show up if you are doing it.
You might be like me and get a dry mouth from as little as 5 minutes of mouth leaking/breathing. Doesn't necessarily mean you are doing it all night.

BTW...these machines don't blow hard enough to force anything into your lungs. What goes into your lungs comes from your inhale.
All the pressure from the machine does is stent the airway open so that when you do inhale the air can go to your lungs.
Your machine isn't a ventilator. It can't force anything.
Now there are some machines that do act like ventilators but yours isn't one of them.

Don't know about the software
https://sleep.tnet.com/equipment

Thanks to both of you for the replies, and for clarifying about how the cpap works. That makes sense and they explained it when I got the machine, but it's been a while.

I have installed sleepyhead and took screenshots for the past week or so. I am hoping you can review my data and let me know in your opinion if there is an obvious problem with my treatment.

The screenshots are in a google drive folder. You can view them here: https://drive.google.com/drive/folders/ ... sp=sharing

Please let me know your thoughts. Thank you

If you are opening your mouth it sure isn't much or enough to register as a large leak of any duration.
Mouth breathing isn't the cause of your not feeling so great.

Sub optimal therapy is the more likely cause of your not feeling so great. Your pressure is sub optimal.

Your best AHI was 6 ish....your worst well into the teens.
Your minimum pressure of 8 cm worked sort of okay some nights with not much pressure changing going on and some nights the pressure wanted to go well into the teens. I suspect you may have been on your back for some of the times where the AHI is higher and the machine wanted to go a lot higher. Might also be REM stage sleep related. It was really hard to get a feel for what the pressure wanted to do because the graph was so tiny.
So couldn't really get a feel for REM or maybe supine sleeping or maybe both...and the end result is you need more minimum pressure anyway whatever the reason for the higher pressure needs.
Not sure how much more...but I suspect around 10 cm starting point minimum would help clean up the flags and hopefully would let you sleep and feel better. Need to give the machine a better head start on dealing with things. It just can't react fast enough from the 8 cm starting point.

Next time you want to share the images from SleepyHead...don't try to get so many graphs in one image. We don't need all those graphs and with so many the graphs are so tiny it is hard to evaluate. We only need these 4 graphs
Events
Flow rate
Pressure
Leak...
omit the snore, resp rate and the tidal volume.
There is no need to redo these graphs though. I can see well enough to know that leaks aren't the issue and if leaks aren't the issue than mouth breathing isn't an issue.

wannasmile wrote:Thanks to both of you for the replies, and for clarifying about how the cpap works. That makes sense and they explained it when I got the machine, but it's been a while.

I have installed sleepyhead and took screenshots for the past week or so. I am hoping you can review my data and let me know in your opinion if there is an obvious problem with my treatment.

The screenshots are in a google drive folder. You can view them here: https://drive.google.com/drive/folders/ ... sp=sharing

Please let me know your thoughts. Thank you

As usual, Pugsy's advice is perfect.
Mouth leaking is not a problem; too low of a minimum pressure is.
We look forward to seeing your improvement, as I am sure you are.

THANK YOU so much!!! I really appreciate the help from both of you.

This is incredibly exciting to discover - it gives me hope that perhaps with a simple adjustment I may begin to feel a little better.

The interesting thing is that I had a feeling the pressure was too low. In fact I noticed on my machine's screen in the section with my info, it looked like the average pressure was around 10 or so. I just didn't know it would so dramatically affect things.

I always sleep flat on my back because I have back and posture problems and I simply cannot sleep on my side. However I just bought a full length foam wedge for my bed so my upper body is raised. I haven't put it on the bed yet but will soon and am hoping it helps with a few issues such as stuffy nose, acid reflux, and maybe apnea?

I actually know the "secret" to changing the machine pressure. But I'm assuming that if I change it myself, I would get in serious trouble with the doctor and with the insurance company. I'd hate to lose insurance coverage or have to repay them for anything, which I'm assuming might happen if they discover that I'd changed it myself. So, unfortunately, I suppose I'll need to schedule an appointment to have them update the pressure setting, and do that whole thing.

PS - I followed a tutorial about sleepyhead charts and the charts and stuff were shown pretty much how I had them. Maybe that tutorial could be updated or it could be linked to a more updated one with the chart height and chart selections specified as you suggested.

Thanks again!!

First of all your insurance won't care or even know if you change anything. They only care that you use the machine the required number of hours to prove to them they aren't wasting their money. So forget that concern totally.

Now the doctor...he may or may not notice and may or may not even care. If he cares a lot the worst he can do is tell you not to do it and slap your hands. Most docs don't care though as long as you are doing well.

Now the DME...they like to be on power control trips but they can't do anything except try to tell you that it's against the law for you to change anything...but if you ask them to show the "law" they can't because there isn't one. Now the DMEs can't change anything without a doctors order but there is no such rule or regulation concerning the patient changing something.

I changed my settings...went for the 3 month post starting cpap follow up and explained why I changed things and actually was told "good job, you did what I would have suggested but just sooner" "no need to come back unless you run into a problem you can't handle as it sounds like you have a good understanding of things".
This was 8 years ago this past August and I still haven't been back.

OK thank you for sharing your knowledge and experience about these things.

It sounds like the worst that could happen if I change the pressure myself is that the doc would say "don't do that"

I'm a bit of a worrier but in this case I feel like "living on the edge" and just changing it. I just want to feel better and I think this might help.

If I posted more data screenshots in a couple weeks could you review them again and share your opinion on whether the pressure change has helped me?

Sure. Anytime you want to post your screen shots we will be happy to look and offer our thoughts.