I've been experimenting with taping my lips together

So, sometime last week, I was taking a nap and as I woke up I became aware that I was exhaling though my mouth even though I had a chinstrap on. I was exhaling by letting my lips flutter without opening my mouth at all.

I'm not sure how much I've been doing this or how much it's contributed to leaking. My leak numbers haven't been especially high. But I've decided to do some experimenting and have been using the 3M Micropore tape and putting a single strip of tape lengthwise across my lips to hold them together. If you've never used this stuff, it's got some interesting qualities and is what doctors and nurses use all the time to apply bandages. It sticks very well to skin the first time it is applied and yet is pretty easy to remove. So you fold over a half inch or so at the end to leave a grip and tear off a strip longer than your mouth is wide and tape horizontally across your lips so they are held together. I have experimented with both one inch and two inch widths and they both seem to work for me.

From other threads I've read here, I guess some people cut a slit in the tape over the lips but I haven't seen a need to do that yet. I'm going to keep experimenting with tape but so far I think I like it as it takes care of both the lip flutter and the mouth opening in a way that chinstraps can't. Also, it seemed like my mouth was not as dry when using it.

Tape is yet another tool that we can experiment with to see if it works for us. But instead of duct tape or some other tapes people have said they used, try the real 3M Micropore stuff. It really is unique when it comes to sticking to skin without doing damage as it's designed specifically for that purpose. Amazon sells it at a reasonable price too and it's the best seller in First Aid Tape.

So far I find it reassuring to know that I'm not mouth breathing or lip fluttering and it seems that my mouth stays more moist when I use the tape. Feel free to post your comments or questions relating to taping and your experiences with it

In my early days, before FFM, I used Polident denture strips
to glue my lips shut. It worked very well. ....BUT, once you are
glued up, you are there for the night. Getting a drink of water is out.
Relatively easy to remove in the morning.
Just too much hassle to deal with.
FFM is much more comfortable and easy.
Just part of the evolution of your process.
I'll see you on the road.

Hey yaconsult, your post illustrates what I believe is one of the major misconceptions about chin straps. That they are effective at controlling throat leaking. I think there are two distinctly different conditions which might lead to trying a chin strap; mouth breathing (inhaling and exhaling through the mouth) and throat leaking (pressure loss and air flow from the mouth because the tongue fails to seal the back of the mouth (oropharynx, I believe) from the airway. In what I call throat leaking, inhale and exhale are primarily through the nose.

A chin strap might help prevent mouth breathing if there are no other physical factors involved other than the mouth simply falling open. But chin straps tend push the chin back which could exacerbate apnea. For those with a physical condition preventing nasal breathing, a FFM mask would probably be better.

However, as you've discovered, a chin strap does nothing to prevent throat leaking. this can be proven simply by clenching your teeth and exhaling through the mouth. No problem, right? So if your mouth is held closed by a chin strap it wouldn't prevent exhaling through your lips. The only way to prevent throat leaking is to seal the lips as with tape or train the tongue to seal the throat.

Now, the question is whether throat leaking needs to be entirely eliminated. It would be good, of course, if it were, but I don't think it needs to be entirely. I think in someone who normally breathes through their nose, some leakage can be tolerated. Excessive leakage might cause dry mouth, be disturbing, and might impact the ability of the machine to maintain therapeutic pressure as with any other type of leak. If these levels aren't reached, then I don't think its a problem and really doesn't amount to much more than exhaling at least partially through the mouth. Obstructive Apneas and Hypopneas, I believe, are still controlled as long as therapeutic pressure is maintained and inspiration is through the nose.

Anyway, the above are my thoughts based on my experiences and some reading. Mostly my opinion. For years I've used a FFM because I am a throat leaker. I didn't think I could do anything else. However, the headgear straps pressing on a nerve at the base of my skull began causing pain that I couldn't tolerate or relieve so, out of desperation, I switched to nasal pillows (P10). To my surprise, it appears that I am learning to keep my tongue in position to close my throat and leaks are gradually diminishing. It also seems that I am learning to keep my lips sealed or pursed in away that minimizes the airflow so as not to cause dry mouth . So far, I have not had to resort to tape (but would, if necessary). At this point, my leaks are seldom above Red Line (95%=19) and the average (7.0) is acceptable with a very low AHI of around 0.5. But the leaks are still somewhat disturbing, so I've got a ways to go. Surprisingly, Flow Limitation were substantially reduced by switching from a FFM to pillows allowing a reduction in pressure from a minimum of 9 to a constant 7 with an EPR of 3.

My primary purpose in posting is to give some encouragement to those throat leakers who, like me, think they are stuck with a FFM. I used to scoff at the idea of "tongue training", but I'm becoming a believer. One of the things I do, which I think helps, is, as I'm going to sleep, kind of practice with tongue placement so that my brain learns the necessary position.

What are the drawbacks to taping? The mask has vents and the tape is slightly porous so I don't think it's dangerous or anything. With the right tape, it's incredibly easy to do. And it lets me know that I'm not leaking through my lips. With the chinstrap, I caught myself at least once while I was waking up breathing out through my lips.

Does breathing out through your lips affect your therapy? Does it show up as a leak in the data?

At this point I'm starting to wonder why everyone doesn't tape. Is it because people find it uncomfortable? Too much trouble? Scary? Something else?

Mouth leak is still a leak and it will show up in the leak graphs and/or data if it is enough to matter.
It isn't always enough to really matter.
I once did an experiment to see how much it mattered because I woke up close to normal awake time and I was wide awake but mouth breathing so I just went ahead and continued to mouth breathe like I had been doing ...did it for about 15 minutes with the sole idea of wanting to see what it looked like on the leak graph.
...oh, my mouth was a bit dry.

I circled the known mouth breathing time. It's right at the end of the night.
As to why more people don't...some are scared that they will suffocate...others just don't want to mess with it. I sometimes see evidence of worse mouth breathing than here below but it never lasts long and often doesn't even make it to large leak territory...so I just don't want to mess with tape because it does disturb my sleep a little just having it on my face and I just don't see the need to fix a maybe sometimes big leak.
The earlier (around 3 AM) big leak plateau may or may not have been mouth leak but it was barely in large leak and not all that prolonged and I slept right through it. I just don't want to mess with taping for a maybe short lived leak no matter what the cause since I slept right through it.

yaconsult wrote:Does breathing out through your lips affect your therapy? Does it show up as a leak in the data?

Assuming we are talking about reasonable levels and it is not disturbing, I do not think it affects the therapy. It does show up as a leak in the data, and on the graph with a characteristic plateau shape. As far as I can tell, as long as inspiration is through the nose, there is no difference in therapy between a throat leak and mask leak. But I have no "proof" of that other than an examination of my own data.

yaconsult wrote:At this point I'm starting to wonder why everyone doesn't tape. Is it because people find it uncomfortable? Too much trouble? Scary? Something else?

Probably all of the above. I have in the past. I am not "scared" of it, but I would rather not if I don't have to - for me it is just a bit uncomfortable (but not nearly as much as FFM headgear has become). Also, it does tend to provide a disturbing factor of it's own - "chipmunk cheeks" where the pressure causes the cheeks to inflate, but I think that can be alleviated somewhat by using EPR. And, I don't think everyone would be a good candidate. I don't believe a natural "mouth breather" (inhales considerably through the mouth - awake or asleep) would.

So, I did a little experiment with taping, too. The top chart is no tape the bottom with tape. The top has a lower AHI, 0.15, the bottom is 1.38. Both leak averages are a little higher than I've been experiencing lately, but they are close to the same. Yeah, I got the legends reversed. The top 95% is 20.40 and 38.4 max. not the 30.0 and 37.2 shown.
Obviously, I think, the bottom has no mouth leaks since it was taped so all we see is mask leaks (maybe time to change the pillows).
The top chart, however, is a little more difficult. I think the leaks with the sharp leading edge and flat tops like those at 23:45 and 01:15 are mouth leaks. I think the ones that have a sloping leading edge like the one at 04:30 are mask leaks. Interesting how the latter part of each night has leaks with similar shapes. And the one on the bottom has leaks that appear to be mouth leaks but that is the one with tape.
So, it is interesting, but what is tells me is I can't be sure looking at the graph whether it is a mask or mouth leak.

For 50 years I was a mouth breather at night. After my nasal surgery I was finally able to close my mouth but habits are hard to break. I tried lots of things. I used a piece of tape, sometimes two, vertically to hold it closed finally and it worked. I wanted to be able to rip it open in my sleep if my nose clogged again and I had to mouth breath. [It still does once in a while.] It took a long time to learn to sleep with my mouth closed so I could use a nasal mask.
Lee

Leea wrote:For 50 years I was a mouth breather at night. After my nasal surgery I was finally able to close my mouth but habits are hard to break. I tried lots of things. I used a piece of tape, sometimes two, vertically to hold it closed finally and it worked. I wanted to be able to rip it open in my sleep if my nose clogged again and I had to mouth breath. [It still does once in a while.] It took a long time to learn to sleep with my mouth closed so I could use a nasal mask.
Lee

I think I would still lip flutter if I taped vertically but taping across worked fine. By folding over the end before applying, I have a nice handle for easy removal. I think the tape used is the key - the official 3M Micropore tape works like magic. I guess that that's the reason that the doctors use it. In fact, the stuff I'm using is left over from the doctor giving it to me.

yaconsult wrote: I think I would still lip flutter if I taped vertically but taping across worked fine. By folding over the end before applying, I have a nice handle for easy removal. I think the tape used is the key - the official 3M Micropore tape works like magic. I guess that that's the reason that the doctors use it. In fact, the stuff I'm using is left over from the doctor giving it to me.

I use 1 inch 3M Transpore vertically from under nose to under chin and a piece on each corner. I then cover it horizontally with 2 inch Micropore. Taping can work well if it suits one's situation and preferences.

Best,

Mike

Wow, Mike - that seems like a lot of tape, but whatever works for you... I started with a single strip of two-inch about four inches long horizontally taping the top and bottom lips together. The last couple of nights I have done the same but with one-inch wide tape and it seems to work just as well. Folding an end over makes it much easier to get off and I hope everyone who tries taping does that.

yaconsult wrote:Wow, Mike - that seems like a lot of tape, but whatever works for you... I started with a single strip of two-inch about four inches long horizontally taping the top and bottom lips together. The last couple of nights I have done the same but with one-inch wide tape and it seems to work just as well. Folding an end over makes it much easier to get off and I hope everyone who tries taping does that.

Yes a lot of tape However, it's just where I ended up one night feeling better, and I'm too superstitious to change it

Best,

Mike