Nasal mask mouth leaks, FFM ineffective

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Hello, World?
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Nasal mask mouth leaks, FFM ineffective

Post by Hello, World? » Mon Dec 18, 2017 8:10 pm

Hello again,

Still on the troubleshooting xpap journey. I've talked before about how my enlarged tongue, bad overbite, and deviated septum are the causes of my hypopneas and that it is unaffected by any pressures, so I've been unable to keep them from happening. I have a low AHI because I wake up before I have a full apnea event (UARS), which is why my AHI is so low in my data, but my sleep is extremely low quality. I've been using a ffm for the majority of my cpap use, but I've discovered that that is the reason I haven't been able to stop my hypopnea events, no matter what my pressure settings are. Turns out that research has shown that, for many, nasal masks are much more effective than ffm, possibly because of the angle of pressure. It does a much better job of keeping my tongue and jaw forward when the pressure goes through the nose than through the mouth, plus the ffm can push the lower jaw back, which worsens apnea.

Here is a link to a post discussing the statistics around nasal vs ffm effectiveness:

https://www.sleepapneagroup.com/threads ... apnea.150/

I went from having to keep my pressure at 18.0 with ffm with still no effect to being able to keep my pressure at around 12.0 with the nasal mask and my airway stays open much better. My new problem is that I can't get my mouth to stay closed because of the pressure build up with my nasal mask. Even when I force my mouth closed it still leaks out of my lips. I've tried taping my mouth closed, but very small amounts of air/saliva keep leaking so that the tape just comes off over the course of the first few hours of the night. I've tried folding my lips inward and then taping, which improved how long the tape stayed on, but not by much. I've looked into previous posts about this issue and haven't found much of a solution other than switching back to a ffm, which I don't want to do at this point. I'm going to look into trying a chin strap (though I doubt this will help much, since the air will still come out of my lips) but I'm open to any suggestions about the best chin straps.

Here is a screenshot of my data. Again, the low AHI isn't indicative of my sleep quality, since I wake up at the beginning of apnea events, rather than sleeping through them. The days with extremely large max leaks are times when I had to take my mask off for a second to drink water or something and left it on, the days with very low leaks are my ffm days, and the more recent days with moderate mask leaks are my nasal mask days.

(Wait, I made a screenshot but can't seem to find a way to attach files. How can I post an image that doesn't have a url? I'll edit the image in here after I figure it out)

Also, I've discovered that by setting my MAD device much higher and overcorrecting my overbite (making my lower jaw stick out as far as possible without jaw pain) has at least improved my events. Unfortunately, when I set it to the highest setting, it seems to keep my airway opened and tongue out of the way, but my jaw hurts WAY too bad to keep it there, so I had to dial it back some and keep troubleshooting my apap therapy.

Anyone else have a situation where nasal masks worked better for them but they couldn't keep their lips from leaking air? Any advice? Thanks

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Re: Nasal mask mouth leaks, FFM ineffective

Post by greatunclebill » Mon Dec 18, 2017 8:51 pm

i would say, print out your post exactly as written and go to see your sleep doctor. give it to the intake nurse so she can put it in your folder. that way the doctor will have read over it when he comes in the room and you can discuss how to proceed.

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TedVPAP
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Re: Nasal mask mouth leaks, FFM ineffective

Post by TedVPAP » Mon Dec 18, 2017 8:51 pm

MANY people have mouth leaking problems.
Solutions are use a FFM/hybrid
or
use a nasal/pillow mask and control mouth leaking.
Chin straps help some people avoid mouth leaking. Others must add taping or just use the Ultimate Chinstrap to control mouth leaking.

Those are the options.
My signature states my preference.

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Re: Nasal mask mouth leaks, FFM ineffective

Post by Hello, World? » Mon Dec 18, 2017 9:02 pm

greatunclebill wrote:i would say, print out your post exactly as written and go to see your sleep doctor. give it to the intake nurse so she can put it in your folder. that way the doctor will have read over it when he comes in the room and you can discuss how to proceed.
That's very good advice that I really wish I could follow. Unfortunately, my condition is so bad right now that I'm unable to work. I'm staying with family until I can get this sorted out, but I don't have and have never had health insurance (I'm 24 and was born into a not so well off family). The only reason I could even afford to get the sleep study was because the college I was going to provided subsidized health care through their medical school facilities. Now that I'm graduated with no more scholarship money, access to subsidized health care, or work to be able to get health insurance, going to the doctor is very difficult to afford.

If I had health insurance, I'd immediately get my deviated septum fixed so that I wouldn't have constant post nasal drip, which would improve my apnea. Then I'd get my overbite corrected and possibly consider laser surgery on my tongue to shrink it to a size that isn't going to suffocate me.

I feel really trapped in a situation where I can't make any real money until I'm able to sleep, but I also can't get my sleep fixed until I'm making real money. Not to mention how much more expensive health insurance is going to be for me now that I have sleep apnea as a preexisting condition :/

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Re: Nasal mask mouth leaks, FFM ineffective

Post by Hello, World? » Mon Dec 18, 2017 9:10 pm

TedVPAP wrote:MANY people have mouth leaking problems.
Solutions are use a FFM/hybrid
or
use a nasal/pillow mask and control mouth leaking.
Chin straps help some people avoid mouth leaking. Others must add taping or just use the Ultimate Chinstrap to control mouth leaking.

Those are the options.
My signature states my preference.
This one?

http://sleepapneasolutionsinc.com/?page ... category=0

Just want to make sure it's the right one before I drop $60 on it. It looks like it could really help though, since it also appears to cover the mouth. Definitely looks a lot better than the $15 dollar strap I tried from Amazon

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TedVPAP
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Re: Nasal mask mouth leaks, FFM ineffective

Post by TedVPAP » Mon Dec 18, 2017 9:56 pm

Hello, World? wrote:
TedVPAP wrote:MANY people have mouth leaking problems.
Solutions are use a FFM/hybrid
or
use a nasal/pillow mask and control mouth leaking.
Chin straps help some people avoid mouth leaking. Others must add taping or just use the Ultimate Chinstrap to control mouth leaking.

Those are the options.
My signature states my preference.
This one?

http://sleepapneasolutionsinc.com/?page ... category=0

Just want to make sure it's the right one before I drop $60 on it. It looks like it could really help though, since it also appears to cover the mouth. Definitely looks a lot better than the $15 dollar strap I tried from Amazon
That is it. It stops the jaw from dropping, cheeks from popping, and restricts mouth leaking to a low level. I have been using it for 7 years. I line it using a clean sock folded in half so that the strap stays clean. Replace the sock every four days and wash the strap every 4 months.

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Re: Nasal mask mouth leaks, FFM ineffective

Post by Pugsy » Tue Dec 19, 2017 6:49 am

You might try a Scunci
See how forum member JayAitchsee got it to work for him. Post #11 in this thread has an image.

viewtopic.php?f=1&t=112758#p1086296

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Re: Nasal mask mouth leaks, FFM ineffective

Post by zonker » Tue Dec 19, 2017 11:14 am

Pugsy wrote:You might try a Scunci
See how forum member JayAitchsee got it to work for him. Post #11 in this thread has an image.

viewtopic.php?f=1&t=112758#p1086296
to the original poster-i can't recommend this highly enough. it works for me with a bit of modification: i use two scuncis and an additional band to keep my lips closed. also, i use a foam cervical collar.

we are all different, though. what works for me might not work for thee.

but the scunci bands are dead cheap and though they stretch over time, the can be washed and brought back to life. won't cost much to find out if they work for you....
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Re: Nasal mask mouth leaks, FFM ineffective

Post by edfreeman » Tue Dec 19, 2017 11:24 am

Wearing a cervical collar solved my mouth leaking problem, keeps the chin propped up very well. Started with a Futuro adjustable one from Walgreens ($18) and have graduated to a Caldera from Amazon.

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Re: Nasal mask mouth leaks, FFM ineffective

Post by Hello, World? » Wed Dec 20, 2017 4:20 pm

Sweet, I'm going to order and try the scunci and cervical collar first and if they don't work, I'll go for the chin strap.

Thanks for all the suggestions. Here's hoping I'm almost to good sleep

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Re: Nasal mask mouth leaks, FFM ineffective

Post by EdNerd » Wed Dec 20, 2017 5:08 pm

You might want to look at a hybrid mask.
This one has a chin shelf to help keep the mouth closed.
https://www.cpap.com/productpage/RespCa ... -Mask.html
Be sure and read the reviews.

Ed

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Re: Nasal mask mouth leaks, FFM ineffective

Post by zonker » Wed Dec 20, 2017 6:10 pm

Hello, World? wrote:Sweet, I'm going to order and try the scunci and cervical collar first and if they don't work, I'll go for the chin strap.

Thanks for all the suggestions. Here's hoping I'm almost to good sleep
good luck to you! and please do come back and let us know if the suggestions worked for you.
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Re: Nasal mask mouth leaks, FFM ineffective

Post by Hello, World? » Mon Jan 15, 2018 9:40 pm

Hello, I'm back for a quick update. I found that I couldn't make the nasal mask work no matter what I tried, but it turns out that I have massive adenoids that are completely blocking my nasal passages, which is why I'm still having a lot of hypopneas no matter what pressure or mask I use. I'm about to make a post about surgery and all that.

However, the cervical collar was a life saver! I hadn't thought of using one, but as soon as it was suggested, I knew it would help because I find myself always trying to stretch out and straighten my neck while I sleep. It must help keep my airway straight and open or something, but all I know is that I'm finally dreaming somewhat and am definitely feeling better than before. I'm not completely out of the woods yet, but the cervical collar was a huge improvement, so thanks so much for the suggestion!

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Re: Nasal mask mouth leaks, FFM ineffective

Post by zonker » Mon Jan 15, 2018 10:27 pm

Hello, World? wrote: However, the cervical collar was a life saver!
thanks for the update. good to know the cervical collar worked so well for you.
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