Nasal Pillow Users -- 50 ways to seal your mouth

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
WhiteNoise
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Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Fri Aug 20, 2010 8:38 pm

I've done a lot of reading here as I continue to search for an "interface" that works for me. "Traditional" Full face is now being ruled out as I can't get around the leaks, tight straps (on my face) and nose bridge pain/abrasions. Dry mouth and throat without a chin strap isn't possible for me either. "Hybrid styles" seem to be a great compromise having nasal pillows and a mouth covering combined so the pressure is equalized to nostrils and mouth for a breathing "choice" for those with restricted or temporarily congested nasal passage ways, but once again I can't get away without a chin strap due to the dryness despite humidification. It works but hurts my upper lip due to significant overbite protrusion. Chin straps slip so I bought the "PapCap" which does work for me with the Hybrid style Mirage Liberty, but I made the "mistake" of testing out a Swift LT light weight and snug sealing nasal pillows only interface and I fell in love with the simplicity, and comfort. I of course quickly realized that only those blessed with perfect teeth and mouth shapes that allow their lips to seal in some magic way at night, could use them and now wonder,,,,,,,

1. How many folks are able to get away without their completely sealing their mouths shut with any one of a 50+ different and ingenious methods of taping, polidenting, chinstrapping, etc at night to prevent the pressurized air from leaking out?

2. It so far appears to me that many do in fact find a way to seal their mouths for the privilege of this elegant manner of tolerating positive air pressure applied to the inside of their heads. If this is this is the case, then why wouldn't the makers of these fine devices also provide an accessory to do so along with it as an option?

3. Last night, I began with the Blue painters tape but it blew out (8 to 14 pressure) and then wrapped a grippy ace bandage around my head and neck under my ears to hold it in place, but was awakened by air seeping through anyway. I then woke fully up and stripped it all off and repeated with the addition of the papcap chinstrap which did get me through the last 1/3 of my night without leaks. I now seriously consider the picture someone posted of the S&M style mouth ball gag with straps, thinking it could work. Every step of the way through cpap land has been a continuous struggle and I simply WANT to use the cpap to be healthy and to sleep. My sleep doctor (#2) says "get a mask there are thousands of them out there" as though this is a piece of cake. (but touching the air pressure myself is breaking the law and using tape is "dangerous") The PT folks are more realistic but offer little additional advice that helps much beyond "try another mask". I'm motivated, creative, in for the long haul, and hopeful, but crap,,,, this is like a full time job and without this forum I'd have given up like the 50% who try cpap long ago. I want to give up but I can't and it drives me crazy!

It's 8:30 as I write this and I go to bed at 9:30. I figure I'll settle with the full get up as you see in my profile pic and get a few nights ok sleep and begin to read and think again. There must be some simple way to use one of these beautiful nasal pillow devices, right?
Customization and support keeps me trying 10 years, not there yet.

greg-g
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by greg-g » Fri Aug 20, 2010 8:53 pm

I guess I'm very lucky as I have no trouble with mouth leaks.
I've found there are actually three possible places where the nasal passage is sealed from the mouth.
The first, and the one that actually stops my air leakage is a flap or something in the back of the throat.
The next is my tongue pressed against the top of my mouth.
Lastly there are your lips.
I can actually open my mouth, move my tongue, and even talk in a restricted way without leaks.
It would be very interesting to know from those better informed if there are any exercises, or other methods to enhance these other seals.

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jazzer4
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by jazzer4 » Fri Aug 20, 2010 8:54 pm

I'm too new to give you advise, but I can tell you I really really feel bad for you. Hang in there till morning and others will help you for sure.

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elena88
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by elena88 » Fri Aug 20, 2010 9:30 pm

I failed at chin straps too, and jury rigged ace bandages..

so I used superband all purpose sports tape, its latex free, and I got a ton of them at the ninety nine cent store..

This stuff REALLY stays on, and it doesnt hurt when you take it off, but I dont have any facial hair either..
well, I HOPE NOT!

I used to cough it off, so I put an itsy bitsy cut in the middle about a quarter inch, and that keeps it from coming off..
AND, I can take it off, and put it back on at least three times during the night and it still sticks..

I have noticed, that taping my mouth is sort of training my trap to stay shut.. my teeth dont line up either, and I dont even know
how I manage to keep my mouth shut, it sure doesnt fit right!

So, anyway, this has worked for me pretty well.. and some nights i forgot to tape, and my brain thought I did, and I didnt open
my mouth.. no sahara desert in the morning, or my tongue stuck to my gums. OUCH!

I will tell you that I have woken up with the tape on, and my nose plugged up from swelling, and I wondered why I felt so crappy..
Its nice to know if you are taping that your nose is in good working order.. I highly recommend that!

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PetrusKy
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by PetrusKy » Fri Aug 20, 2010 9:35 pm

WhiteNoise, I just want to say that your avatar is the best!

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WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 8:31 am

I ended up doing the swift LT (after donning the liberty setup first and feeling trapped and tight) blue tape on the moth covered by the tacky ace bandage like wrap around my mouth/neck holding the tape followed by the papcap chinstrap and though I feel this seals my trap and the LT feels comfortable itself, the wrap is isn't. I suspect it pulls my jaw back too which adds to the apnea throat closing I've observed from experimentation while laying down and moving my jaw forward and back. Can definitely feel some resistance in the throat when the jaw is back vs forward a bit. I wake up every night around 4am and must take some tryptophan or Iay awake so after taking the moth sealing off gave up and slept the rest of the night without the cpap. I need 9+ hours of good sleep to make it through the day.

Ahi was up to 10.5 for the shorter night of use. I am so enthusiastic about the comfort of the Nasal pillows concept my DME me loaned me a swift FX and and OPUS 360 to try but my excitement is fading as I can't see any light on how to make this work. The sports tape is an idea for which I'm always grateful but I do have facial hair and it sounds painful to try and doubly for my middle of the night removal to drink some sleep aids.

Those goggles are for my extreme dry eye problem where my eyelids don't fully close and the moisture leaves the old eyeballs in searing pain without them. Obviously this also makes full face masks a problem trying to work them under the whole get up as once in place I can't see and they have to go on before the mask.

Regarding the tongue seal lips closing, in my case it just doesn't happen. As the night wears on and I become increasingly deeper and relaxed the mouth gradually opens wider and I begin to mouth breathe more. I know what you mean about the tongue seal and do this during the day but can't hold it at night even after purchasing a 190 dollar custom made oral appliance others have tried here with limited success. It fits to the top teeth and has a shelf to place the tongue to "teach it" but my tongue just falls off the shelf and the saliva build up just seems to complicate things further.

So we have one person so far who simply uses the pillows without problems. That must be great!

My sleep deprived brain finds this all so hard to deal with but I will try. Not sure of my next step though.
Customization and support keeps me trying 10 years, not there yet.

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ozij
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by ozij » Sat Aug 21, 2010 10:05 am

I had to give up on my beloved Headrest with taped mouthe, after 5 years, because the air entering my mouth blew my cheeks up and woke me. It was the tongue nose seal that was my undoing.

The seal however kept:
3M micropore tape wider than my mouth, with tabs folded in on either side, to make pulling to off easiear.
Somekind of lip protection.
Then:
Lips folded in while mouth is stretched
Tape pun on
Lips relaxed.

After trying a number of full face masks unsuccessfully, I learned to use the Hybrid. It took many nights of learning, and a hose hanger holding the hose from the side became a must.

Good luck
O.

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WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 11:07 am

ozij wrote:I had to give up on my beloved Headrest with taped mouthe, after 5 years, because the air entering my mouth blew my cheeks up and woke me. It was the tongue nose seal that was my undoing.

The seal however kept:
3M micropore tape wider than my mouth, with tabs folded in on either side, to make pulling to off easiear.
Somekind of lip protection.
Then:
Lips folded in while mouth is stretched
Tape pun on
Lips relaxed.

After trying a number of full face masks unsuccessfully, I learned to use the Hybrid. It took many nights of learning, and a hose hanger holding the hose from the side became a must.

Good luck
O.
Thanks O. As a 5 year veteran with over 7000 posts it does help me to learn that as bad as you wanted to use the pillows you ultimately ended up with the other mask equivalent to my mirage liberty. But, it sounds like you were successful quite a time and that is promising. Your taping routine is noted too. I think that different tapes have different results for different folks. The "3M micropore" is the "Nexcare Gentle Paper tape" right? (am looking at the tape which is only 3/4" width) I'd begun using that awhile back to tape my eyelids closed at night before discovering my goggles which are like artificial eyelids for me. Though I have never experienced any kind of allergic reactions to anything before, it caused a dry flaking redness for 6 months on the one lid but I figured this is delicate skin so did try it on my lips too with the cpap. I didn't have a system though and was putting it on dry lips and it it tore skin with it's excellent adhesion qualities. (not sure what the "gentle" part means in the name) Perhaps I need to begin further experimentation with taping routines and brands. I haven't tried using the 3m micropore to tape my full mouth (only a 3/4" strip vertical which was painful to remove) yet as it was so aggressive the way I used it. I can see why so many use this method. Cheap, convenient to apply and remove at night and with the right tape effective too.

I hate the confinement of chin straps and other than than the papcap they slip and change in the night. The papcap does too a bit sometimes, but it is what it is. An improvement but with the detraction of much more gear on the head. I'd love to NOT use it!
Customization and support keeps me trying 10 years, not there yet.

WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 11:27 am

While I'm thinking of it,,,,,,,,,,,

Has anyone seen any posts where some sort of chin support lifts it up and attaches to the mask (whether nasal or otherwise) device itself. Aside from silicone flaps like on the Hybrid (that I found pull down the mask when my mouth opens and re-directs the nasal pillows away from my nose for leaks) it would seem that this would be an area to be explored with perhaps a combination of materials.

I still don't get why such an obvious problem as proven here has not been addressed by the manufacturers beyond chin straps that don't work and are cumbersome.

There has to be some way to keep a chin up or the lips closed with minimal gear !

I had tried cpap 10+ years ago and gave up and was told my sleep doc 2 about "all the improvements since then" Well, I see there are more masks and the machines are now top notch, but the most important part,,, where the air enters the person,,,, this area still appears so PRIMITIVE compared to what I would have expected. I'm so determined to make this work but so frustrated at how much We users have to DO to have any chance at it.

I sometimes wonder whether the MFG really want us to find the perfect mask with all the profits from replacement cushions, and add ons just to make it tolerable.
Customization and support keeps me trying 10 years, not there yet.

Janknitz
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by Janknitz » Sat Aug 21, 2010 11:51 am

I'm one of those fortunate ones who does not need to do anything to keep my mouth shut. I have far from the perfect facial structure. I have a genetic facial anomaly, with a very small and receding chin, narrow and highly arched palate, and very crowded teeth. But once my therapy pressures stabilized and cleared out my chronic nasal congestion, I've been fine. I put a little bit of chapstick on my lips to make them slightly tacky and I'm good to go. It's a good thing, too. With a nearly non-existent chin, chin straps slip right up to my lips and only serve to push my lower jaw back farther.

For you, though, how about a mouthguard? I've read here that some people are very successful with an inexpensive boil and form mouthguard from the sporting goods store, perhaps combined with some tape or a chin strap if needed. This might be worth a try.
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WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 12:24 pm

Janknitz wrote:I'm one of those fortunate ones who does not need to do anything to keep my mouth shut. I have far from the perfect facial structure. I have a genetic facial anomaly, with a very small and receding chin, narrow and highly arched palate, and very crowded teeth. But once my therapy pressures stabilized and cleared out my chronic nasal congestion, I've been fine. I put a little bit of chapstick on my lips to make them slightly tacky and I'm good to go. It's a good thing, too. With a nearly non-existent chin, chin straps slip right up to my lips and only serve to push my lower jaw back farther.

For you, though, how about a mouthguard? I've read here that some people are very successful with an inexpensive boil and form mouthguard from the sporting goods store, perhaps combined with some tape or a chin strap if needed. This might be worth a try.
So despite "facial anomalies" it works out the mouth closes and the lips end up close together, NICE! I share some of them but I guess it's my overbite that throws me off at night.

Ahh the mouthguard,,,,,,,, I read all the old posts by frquentseeker and snorkl (sp?) and thought YES that is the answer. Put the guard in, keeps the tongue up and the lips sealed, and on with the sleep. I elected to go the "easy route" with money and ordered this http://www.nosebreathe.com/snoring.html The clear one in the middle on the left. The concept is great to create a "lip seal" with an air dam on the front and a plate to place your tongue to create the tongue mouth breathing seal. So far doesn't work for me, but it has a 30 day money back trial and the orthodontist named Dr. Sue in Hawaii is pretty email responsive. So far no go and the drool factor is high but he says to keep at it as the saliva is created because the mouth thinks its food. dunno, but suspect it's not the magic bullet I was seeking.

I just got back from rite Aid and saw the other posters "sports tape" but am going to try the Nexcare flexible clear tape (has some flex) with some Aquaphore moisturizer before application. If this is tolerable I may tape above and below the lips as anchors which will remain the night and figure out some way to join them that is removable to allow me to drink my pills when I awaken in the night.
Customization and support keeps me trying 10 years, not there yet.

WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 12:49 pm

Did some testing with the Nexcare flexible clear tape which has quite a grip on clear skin (I keep a thin beard to cover scars) but standing the mirror with 3 strips across it slowly separates within a couple minutes of allowing mouth to hang and some slight pressure to simulate air. I feel like I've tried everything short of the ball gag which I WOULD try if it were not for the embarrassment of getting and keeping one around my house

In the movies,, it's always duct tape!

No please no,,
Customization and support keeps me trying 10 years, not there yet.

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ozij
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by ozij » Sat Aug 21, 2010 12:58 pm

I think the 3M micropore iis the Nexcare gentle paper, but I'm not sure.

Chapstick on lips is crucial.
Some people found Milk of Magnesia kept the tape for sticking too strongly.

I used a 1" stap horizontally across my mouth -- my jaw could drop, but my lips remained sealed.

Removing the tape had to be done slowly and carefully. Baby oil helped, others found warm water helpful.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
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Janknitz
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by Janknitz » Sat Aug 21, 2010 1:18 pm

BTW, I'm not a taper, but don't clench your jaw shut when you try tape. Maybe you know this already?

Your jaw will open naturally and that will pull on the tape. Make sure that your jaw is in a somewhat relaxed position--but your lips are sealed when you apply the tape. Otherwise, I would think you wouldn't stand a chance of having the tape hold. Put your tongue in that "magic spot", too.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
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Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

WhiteNoise
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Re: Nasal Pillow Users -- 50 ways to seal your mouth

Post by WhiteNoise » Sat Aug 21, 2010 2:05 pm

Actually, I would say that I probably have been clenching before tape application. Sitting here and finding my natural nose breathing position (tongue in place) I find my mouth is open (lips apart) about 1/4 inch and note that the front teeth are aimed outward (over bite) about the same so that space always exists even with lips closed for air to find its way out. I've read about taping much more than tried it as I've never been successful. (maybe 10 tries) I'll try being more conscious about relaxing so as to minimize the eventual drop of the jaw which as you say is just going to pull apart the tape.

Thanks noted, Chapstick (or other moisturizing?) before taping too.

As I imagine we can all relate to the difficulty coping with our day to day while sleepless, I found in the beginning it was crucial to find anything that worked even remotely so as to get some decent repeated sleeps. Like resting at base camp before climbing this allowed a more efficient start of the trip (improvising further) and I find I have to do this after an overnight trial which tends to make sleep worse and my day much more challenging. I agree wholeheartedly, with the one thing at a time approach!

As my current setup in the pic does work I have to go back to that even though the compromise is significant discomfort and even pain throughout the night. As I awaken easily, any discomfort has a negative affect. I've read "all" the sleep books and do everything short of eating dirt to claw my way towards sleep land.

Though I am in the mild to moderate apnea phase sleep is the only thing that I have any control over which most significantly affects the quality of my life. I do so appreciate this group and the folks who take their time to lend support if not outright help up and out of the "hole". The "professionals" are missing a huge piece of this cpap thing.
Customization and support keeps me trying 10 years, not there yet.