Cottonmouth--ugh

[Carmen]

I've been using CPAP with nasal pillows for over a year with no particular adjustment problems and loved being able to breath through my nose and loved not waking up with a dry "cotton" mouth and a sore throat.

Fast forward to this year when, after spending most of a month in the hospital with a medical crisis, I find myself waking up waking up nightly with dreaded cottonmouth and can't figure out why. The main physical differences since before being hospitalized are that I lost about 20 pounds (it was not a good month) and that I now have oxygen added to my CPAP at 2 liters. I don't seem to be mouth breathing as I sleep--this has never been an issue for me since starting CPAP--although I do wonder if the seal formed by my tongue against the roof of my mouth is leaking somehow because of my weight loss.

[Sheriff Buford]

I'm betting you are breathing thru your mouth. There is really nothing wrong with it. You just have to compensate for it for proper treatment. How have your numbers (leak rates and AHI) been?

Sheriff

[gasp]

You may want to rule out new medications and/or dehydration (even mild).

[2 B Sleeping Soundly]

Carmen,

I must agree with what Sheriff and gasp posted above as it does seem that you are losing air through your mouth and medications can also be big contributors to dry mouth. You might also think about using a chin strap of some sort in combination with using the tongue technique. I have used them both together for my PAP treatment very successfully.

John

[Pugsy]

Take a close look at your software leak report graph lines. See if you are spending much time (if any) in larger leaks.
I have woke up in the middle of the night with my mouth open (so I know there are times with some mouth breathing) with the dreaded cotton mouth but when I look at the leak lines I don't see horrible massive leaks like we might think there would be and often I can't even spot the time I woke up with mouth open.
So....it doesn't always take a massive prolonged time of mouth breathing to dry the mouth out. The mouth can dry out from even a short lived episode of minor mouth breathing. So while it is annoying....dry mouth doesn't always mean that all your therapy pressure is exiting the mouth and it doesn't mean that the other parts of the night are trashed.

For me 10 minutes of maybe large leak from some mouth breathing doesn't make me want to go right out and get a chin strap or whatever or worry about it ruining my therapy. I don't really want to add more "stuff" to my face. unless I really, really have to.

Now if you see lots of it on your reports and you are waking up often from it (it disturbs sleep) then you might want to investigate into things that might limit the possible mouth breathing.

If meds can't be blamed for dry mouth...then that pretty much leaves dry mouth being blamed on mouth breathing but it sometimes only takes a tiny amount of mouth breathing to cause the dry mouth. It's very possible that your weight loss has maybe lessened the seal with the tongue but it may not be as horribly impacting the overall therapy as it might initially seem.
I have woke up with dry mouth (middle of the night and mouth open) and not seen any leak line change at all on my reports so I must not have been doing the mouth breathing very much or very long. Certainly not enough to have it impact therapy overall.
So look at the leak lines to see just how much it might be impacting therapy and then evaluate what you want to do about it (if anything).

[purple]

The test questions might be, do you have GERD? Is it worse now than before? Do you have Aerophagia worse now than before?

These might point to your having a weak valve at the top of the stomach, which your breathing, in a sump pump fashion, is pulling stomach acid up, which can lead to an ugly tasting mouth, or a drippy sinus.

Many of us have developed this gasping as part of our sleep apnea problem. We gasp because we do not pull enough air without doing so. After we start xPAP, hopefully that part is gone, but the weak valve at the top of the stomach can remain.

[Carmen]

You may want to rule out new medications and/or dehydration (even mild).

This may be a good first move--I'm on a whole collection of new medications and should probably check to make sure my fluid intake is high enough.

[TheDuke]

Here in West Kentucky, when we say "Cottonmouth" we are referring to a rather formidable poisonous snake (Cottonmouth Moccasin) that thrives in the region, especially in swampy areas and sluggish streams. When I saw your header, I thought you had been invaded by a ughey varmint.

I too have experienced mouth problems with my BiPAP with nasal mask, but have found that PAP Cap or a broad chin strap helps greatly.

TheDuke

[qmx]

Oxygen is VERY DRYING. It might be the variable accounting for your dry mouth. DEAN

[gw812]

Was just about to blame the O2 myself - it needs to be humidified, possibly separately from the humidifier on your machine.