new with cpap... Air accumulating inside mouth ... why ??

Hi,

I'm on my first week with a Resmed Autoset II Apap, in auto-mode (from 4.6 to 13), Swift LT mask.

My first and only problem so far is that even in the ramp phase, when the pressure is still in the low 4.6,
I NEEEED to either swallow the air or maybe open my mouth to let it go out - the air just accumulates in my mouth causing a big disconfort...
It happens often, like every 10 minutes or so...

And this is causing me all known side effects... Chest pain in the morning and.... the others ...

Why do I have this need to swallow or let the air go?
Why can't i normally breath it ?

I'm almost giving up

Thanks for the help,
Dany.

Hi dany and welcome to the board!

Don't despair. The problem you're describing happens to many people, including me.

For some of us (you and me, for example) the tongue just doesn't naturally stay in a position that would block CPAP air from detouring into the mouth from the back. When that happens CPAP air flow in from behind, fills the mouth if we're awake and trying to keep the lips shut, or gushes out the mouth if we're asleep and the lips have relaxed open.

First thing to try would be a chin strap to keep the jaw from dropping down when in the total relaxation of sleep. For some people simply keeping the jaw "up" keeps the tongue up and lessens the amount of roominess in the mouth, too... allowing the tongue to maintain an airtight seal inside the mouth. If that works, that's the simplest solution.

A chin strap doesn't work for me, however. I've tried many brands of chin straps.

If a chin strap doesn't do it for you, you might want to try using a "Full Face" mask instead of the nasal pillows mask you have now. Despite the name, a Full Face mask doesn't cover the entire face. A FF mask covers just the nose and mouth, letting you breathe in cpap air through your nose or through your mouth. Doesn't matter if cpap air gushes out your mouth because it's still all "pressurized", so to speak, within the FF mask. You'll get your cpap therapy no matter whether you're breathing through nose or mouth. Leaking air out the mouth won't matter either. Even the "mouth leaks" are contained by the FF mask so the pressure can still keep your airway open.

Full Face masks come in a variety of designs. The traditional FF mask is a longer version of the well known cpap mask that covers the nose. The FF mask is longer to cover the nose AND the mouth. There are also a couple of full face masks that cover the mouth but have nasal pillows (like your Swift has.) Examples of Full Face masks that have nasal pillows instead of covering the nose are the Hybrid and the Liberty.

Many people do great with a Full Face mask. Finding the most comfortable Full Face mask for you can be quite a quest. Each person is different. One person's "Wow, I LOVE this mask!! It's the BEST!!" can be "This is the leakiest, WORST mask I've ever tried!" for someone else. You might have to try several (or many) Full Face masks and try the same ones in more than one size. But a Full Face mask, if you find one you can actually sleep comfortably in, will solve your problem.

No full face mask I've tried lets me sleep with the side of my face comfortably down on the bed pillow. I've tried practically all the FF masks, including the "hybrid nasal pillows" style FF masks.

So...my solution to stopping air from gushing out my mouth while I sleep is to wear the mask I find most comfortable for me (a nasal pillows mask -- the "Headrest" by Aeiomed) ...and... put tape over my mouth. Yep. Been taping my mouth for almost 6 years, every night. No problem for me. The air still does enter my mouth from the back of throat, but it's contained inside my mouth (dammed back by the tape outside my lips) just as surely as it would be contained by a Full Face mask.

To prevent the air that fills my taped mouth from puffing my cheeks out (chipmunk cheeks or "blowfish" effect) I use a chin strap simply to keep my cheeks flattened. That lessens the amount of air that detours into my mouth. For me, if my cheeks puff out too much, the sheer amount of air pushing against the tape from inside can loosen the tape as the night goes on. So, yeah, I use tape AND a chin strap.

Here's a link to more discussions than anyone could ever want to read... about controlling mouth air leaks in unconventional ways:

LINKS to: Mouth leaks - Air Leaks - Tape - DIY Guard
viewtopic.php?t=8011

Good luck, Dany!

Rested Gal;
I have afew people I would like have their mouths taped shut, any suggestions?

guest2 wrote:Rested Gal;
I have afew people I would like have their mouths taped shut, any suggestions?

Sure!

Just mppphhhff phmmpf mmmphpph pmmph mmp ffmmphpmf.

But be sure NOT to mmphhmph fmpmh mmphhh mph pfmmphhh!!!

Hi Rested Gal,

Thanks for your time and help.

Actually I keep my mouth shut I don't have problem with that...
But I do feel a big disconfort of having the air inside my mouth.
I JUSSST need to swallow it... I don't like the sensation of having it filling all space inside...
So I guess there's no solution for that ?

Thanks
Dany.

Lots of good points made. I had the same problem. Even with a chin strap keeping my mouth closed my cheeks would puff up and I kept swallowing air. I went with a full face mask. With a full face mask the pressure is the same between your nose, inside mouth, and outside mouth so there is no pressure differences and no build up of air in the mouth.

I tried a couple different masks and I am sure it is different for everyone. The full face mask that works best for me is the Resmed Ultra.

I can only sleep on my side.

I get a good nights sleep and I find that I can sleep on my side with it. I use one of those Memory foam pillows (it is fairly stiff, Temper-pedic type). With a soft pillow I sink in the pillow and can no longer sleep on my side because the full face mask hits the pillow and shifts position.

This solution works best for me, but you may find something else that works better for you.

Tom........

danyg wrote:Hi Rested Gal,

Thanks for your time and help.

Actually I keep my mouth shut I don't have problem with that...
But I do feel a big disconfort of having the air inside my mouth.
I JUSSST need to swallow it... I don't like the sensation of having it filling all space inside...
So I guess there's no solution for that ?

Thanks
Dany.

I know there was a post for something similar, but I couldn't find it. Some people suggest to have the same concept of chin strap but for your cheeks. It will go horizontal covering your back head, mouth and cheeks, instead of vertical trying to keep your jaw closed.

It will prevent the cheeks to inflate so if there is air inside your mouth, it will be very less. Some have reported to use the self wrap bandage used for sports. Look here http://www.amazon.com/Nexcare-Coban-Sel ... 10&sr=8-15. I am not suggesting that you should buy that brand, it is just to give you a visual aid what I am talking about.

I keep air from filling my mouth by keeping my tongue on the roof of my mouth behind my top teeth. I

Like Older Mom....I have learned to keep my tongue pressed to the roof of my mouth . It takes some practice to get it a routine event. I still use a chin strap to help keep my jaw from sagging, but I believe the tongue to the roof is the answer. Good Luck.

pap4life wrote:Like Older Mom....I have learned to keep my tongue pressed to the roof of my mouth . It takes some practice to get it a routine event. I still use a chin strap to help keep my jaw from sagging, but I believe the tongue to the roof is the answer. Good Luck.

Right. The tongue is what can maintain (or not, for some people) an airtight seal inside the mouth.

For some people, keeping the tongue placed against the roof of the mouth is the key. But that's IF the geometry of a particular person's mouth, tongue, soft palate, dentition...everything... is conducive to "tongue to roof" actually being able to fill the space inside the mouth enough to create that airtight seal. Doesn't for me. Not with months of practice. Not during the relaxation of sleep. And not even with a chin strap so tight my teeth were clenched.

Quite a few people on this forum have reported exactly what you wrote, pap4life...that they eventually were able to train their tongue to stay pressed against roof of the mouth. Mostly by practicing that tongue position during the day.

But again, for some no amount of practice will achieve that during sleep. Or, even if it does, for some people (me, for example) air is still going to detour around the back molars and puff right on out the mouth even with tongue pressed widely against roof of mouth. The back of my tongue just can't hold it back. There are a lot of variables in the structures in everyone's mouth.

It's definitely worth trying, though...practicing getting the tongue to stay pressed against roof of mouth... since some people here have been able to develop that into a habit that continues for them even during sleep. Proven by those with machines capable of showing leak rate and seeing a greatly improved (much lower) leak rate given some time and "practice."