Questions Regarding Retrying CPAP

[ArtNJ]

I am committed to retrying CPAP therapy. I own a 10ish year old Resmed Autoset II, and one of those nose plug only masks. The machine, mask and tubing are all at least 10 years old. Nothing additional would be covered by insurance because its been so long since I failed therapy. I'd need to go in for another sleep study. Thats my current understanding anyway. But I wouldnt mind buying new tubing or mask out of pocket if thats allowed.

Can I use the old tubing and mask? I know I should be able to use the auto-adjusting feature of the machine to avoid worrying about the settings -- I did that when I last tried. I have my old sleep study somewhere and it showed mild CPAP with some restless leg. I failed on two restless leg meds due to side effects.

I know I have to tape the mask in place because otherwise when I move around it comes off.

I did get used to it somewhat when I originally tried, but I couldnt figure out why my mouth was always dry. That was what killed my attempt -- mouth always dry when I woke up after 1-3 hours. The machine does have a humidifier built in, but it wasnt helping. The humidifier was on and seemed to be operating as intended, but it just didnt stop the dryness.

Does this mean that I need a mask that covers the mouth?

[Cathyann]

I'm just recommitting after 10 yrs too. I called my ENT, the dr who first ordered my sleep study and they had no problem rewriting my prescription because they said it was a life long condition. I haven't even seen that Dr in 8 years so I thought it was pretty cool that he faxed my rx to an online cpap store.

With that said, I'm no expert on masks or machines, however, in my search I discovered plenty on Craigslist without needing an rx. I didn't end up buying that way though.

Best of luck to you.

[Pugsy]

Mouth dryness is most often associated with mouth breathing of some duration but it doesn't always mean that the duration is long enough to greatly impact your therapy.
I can get some pretty nasty dry mouth from mouth breathing for as little as 5 or 10 minutes (per what the leak graphs show with elevated leak during that time frame). Some people just find that their mouths dry out more easily than others...maybe related to overall hydration or meds or whatever.

5 or 10 minutes of mouth breathing/leaking isn't the end of the world but half the night spent doing it will be a different story.

I would suggest a new mask if at all possible...a 10 year old mask is likely to have some issues with silicone if it has been left open exposed to the air all this time. Might be less likely to seal or be more stiff or generally more uncomfortable. Besides...mask improvements have come in leaps and bounds in the past 10 years.

If you want to be absolutely sure that any mouth breathing that might be happening isn't degrading your therapy then you want to maybe use a full face mask. That way you are covered from potential loss of therapy pressure via the open mouth.

Now mouth dryness from mouth breathing isn't always fixed by using the full face mask and humidifier even at maximum because the humidifier can't always put out enough added moisture to re hydrate the oral cavity which is much larger than the nasal cavity. Again a lot of it depends on how easily your mouth dries out from the mouth breathing. We have full face mask users all over this forum complaining of dry mouth and using some sort of product designed for dry mouth.

Do you normally breathe easily through your nose during the day or do you have some sort of chronic nasal congestion issue where you just have to breathe through your mouth to get enough air.
Sometimes the mouth breathing is out of necessity due to nasal congestion issues and if that's why you mouth breathe then you should start with a full face mask.
Now if the mouth breathing is more out of habit and not physical need then you could perhaps start with some sort of nasal interface only mask and then evaluate things. I think your old machine should at least have some sort of leak number available on the LCD screen....have you checked it out to see what data might be available on the LCD screen?

Do you know the exact model of the mask you have now? 10 years old...it may not even be still offered for sale.

There are ways of getting masks if you don't have a RX handy.
If you want to just try a full face mask I think I have a couple and depending on size might work for you.
Free...they were donated because they didn't work out for someone but that doesn't mean it wouldn't work for you. I don't have any nasal interface masks at this time. They go out the door about as quickly as I can get them. I think I have one of the Hybrid types where there's nasal pillows and something that covers the mouth as well. If interested send me a private message and we can chat about what I have in the donation stash.
I don't sell them but I do ask for postage reimbursement if at all possible which usually amounts to around $6 to $8 or so for full face masks. These are all donated but not used up and still look good and not brittle from age or anything like that.
If you want to try some sort of nasal interface mask that I don't have...there are ways to get those types of masks without a RX if you know where to look and what to look for.

[ArtNJ]

Thanks very much Pugsy, and also for the suggestion of pushing my PCP Cathyanne.

I currently have a Swift LT mask that looks like noseplugs - as I mentioned, best guess is something over 10 years old.

Wife points out that I often get up at night to have a drink with dry mouth. I dont have any particular nasal issue that I'm aware of, but I guess I do mouth breath a fair amount.

I move around a fair amount at night, and sometimes grind my face into my pillow. I had to use a fair amount of tape on the nasal mask.

How should I go about this? Try a full face mask or what?

[Pugsy]

Full face masks have more surface area touching the skin that requires sealing so tossing and turning in bed is going to create more potential for that movement of the mask for it to leak.
The nasal pillow mask has the least amount of surface area touching the skin so less chance for leaks to happen from mask movement when tossing or turning or burying the face in the bed pillow.

Do you have facial hair of some sort?

A lot of people think I am anti full face mask and that's not the case...my job is to help you use whatever mask you feel like you need/want to use and not for me to tell you what to use.
I just point out the pros and cons and let you make an informed decision.
They all have pros and cons...even the mask I choose to use. For me any mouth breathing I might do is minimal and doesn't really hurt my therapy all that much because it is rare and of short duration when it happens.
For me to try to use a full face mask just to cover 15 minutes of maybe big leak isn't worth it because I have issues with my neck and most masks that have a lower back strap like the full face masks need to use.
So I opt to just accept a little sometimes big leak over not sleeping well because of neck pain from a mask that would mean I might not be losing 15 minutes of precious therapy with mouth breathing.

Your dry mouth...we don't know how much of it is really from mouth breathing of the magnitude to trash therapy or if it is maybe just minor and doesn't really impact the therapy. This is where the software reports come in real handy so we can see for sure just how much that mouth breathing might be impacting therapy.
I once woke up mouth breathing...dry mouth for sure but since it was my usual wake up time I just continued to breathe like I was doing through my mouth with no air just gushing out...and I did it for about 15 minutes or so because I wanted to see exactly how much leak that mouth breathing generated...below is a snap shot of that report and I circled the known awake time at the end of the sleep cycle when I woke up and continued to mouth breathe on purpose so I could see the leak.
As you can see it barely registers and is well below where ResMed says it can't compensate.
So I was mouth breathing for sure but the impact on the therapy itself was nil.

So I have circled and noted the known awake time with the mouth breathing...
Now the big leak 3 AM...slept right through it so have no idea if that is mask movement or more mouth breathing but worse.

[ArtNJ]

No facial hair.

I'm pretty sure the dry mouth was waking me up after 1-3 hours so thats the issue I need to solve. Seems to me that whether the mouth breathing impacts therapy is a down the road question?

For sure the nasal plug mask (pillows I think?), the style I have now, is going to be better for a face grinder like me ... but I have to solve the dry mouth, because I think that might have been what was waking me up.

So what is the advice for dealing with the dry mouth from mouth breathing from a waking you up perspective, not an interfering with therapy perspective? Is it something that will decrease with time? Will a room humidifier meaningfully help?

[Mudrock63]

Someone was raving on here (in a good way) recently about Oragel. Putting a dab on end of tongue and then spreading it through the mouth with the tongue. Might be worth a try for you.

[Pugsy]

Do you take any meds that might cause dry mouth tendencies to become worse?

To eliminate dry mouth from mouth breathing...you have to eliminate the mouth breathing and that can be easier said than done but you are correct in that you need to get the sleep first and keep the mask on more than a couple of hours and deal with perhaps changing to a full face mask once the need in terms of therapy is proven.

So first you have to figure out why you are mouth breathing and address any physical cause like nasal congestion and if the nose can't be blamed then figure out some way to keep your mouth shut.
It's unlikely that adding a room humidifier will fix the issue because it's doubtful that you can add that much water to the air without creating some very damp conditions in your bedroom.

Do you have any idea what the humidity is in your bedroom to start with?

How do we keep our mouths shut?......chin straps might help...taping the lips closed might help...adding a cervical collar might help if the mouth is just dropping open because of a slack jaw.

So you make sure that the dry mouth isn't from meds and then you try to figure out why you are mouth breathing if you can't blame the dry mouth on meds and try to fix whatever is causing you to mouth breathe.

And you figure out how to check the data that is available on your machine to see what the leak stats say.
Those old S8 machines used L/sec instead of L/min so the number you want to be below on that LCD screen is 0.4 L/sec which is equal to 24 L/min.

[OkyDoky]

Someone was raving on here (in a good way) recently about Oragel. Putting a dab on end of tongue and then spreading it through the mouth with the tongue. Might be worth a try for you.

That's Orajel for Dry Mouth not the gum numbing kind.

[cancun]

Someone was raving on here (in a good way) recently about Oragel. Putting a dab on end of tongue and then spreading it through the mouth with the tongue. Might be worth a try for you.

That's Orajel for Dry Mouth not the gum numbing kind.

Also very hard to find in the store, you usually need to find and order it online.

[manoflamatzah]

I actually tape my mouth shut.. I use 3M paper tape, micropore, the extra wide which I think is 2 inches. The plastic tapes and cloth tapes should be avoided. And no, it does not cause much of a problem to remove it. Also - the chin straps to me are useless - the air still comes out of my lips unless taped shut

[yaconsult]

For some of us, a piece of tape can stop the mouth breathing. I "caught" myself one morning while I was waking up breathing in from the cpap but exhaling through my mouth. I found that a simple piece of 3M Micropore half-inch tape going from under my nose to above my chin was enough to keep me from exhaling through my mouth. I could still do it if I wanted to, but it was enough effort to keep me from doing it unconsciously.

You should also know that both masks and machines have continued to improve a lot in recent years. The current most popular nasal pillow mask is the AirFit P10. It's a tiny thing that seals well and is comfortable. I bought a used P10 from another poster here as a backup for $30. The nice thing about cpap.com is that some of their most popular masks, like the P10, come with free return insurance so that if it doesn't work out, you can return it and get a full refund.

The newer machines are smaller, quieter and work even better than the older models. There are often used machines for sale from regular posters and secondwindcpap.com and craigslist are also sources for used machines. Before I finally got a new machine through insurance, I was able to pick up a nearly new Respironics 550P for $100 on craigslist but this requires a lot more diligence on the part of the buyer.

Sometimes people find that they can buy a machine cheaper from our sponsor, cpap.com, than the copay though their insurance! It all depends on your insurance and coverage. It pays to shop around carefully before spending money.

[Thatgirl]

I take two medications that cause dry mouth. If I'm not careful, my mouth is desert like. I have to be religious about staying hydrated, keeping my blood sugar in range, and doing oral care. Biotene mouth rinse makes a big different for me. I keep a water bottle at my bedside so I don't need to get up to get a drink.

[jagzoo]

I also take 2 medicationsthat cause dry mouth - 24 hrs a day. At night I often use xylimelts lozenges ( they stick to your gums and release during the night) along with biotene mouth spray and a child's water bottle with a built-in straw( so I don't have to move my nasal pillow mask) for when I still might wake up a with stuck-together dry mouth. Good luck!

[otrpu]

ArtNJ,

Been using FFM's since starting CPAP in 2003. If you can swing it, get a newer autoCPAP. I replaced my 2003 machine Aug 2015. Old machine still worked great. . .but, sounded like a vacuum cleaner. I won't wait that long again.

When I have problems getting good seal with my regular FFM I switch to the RespCARE Hybrid FFM. It's a combination mouth seal/nose pillow FFM. Has a built in chin flap that keeps mouth closed. Don't need a chin strap. Might be worth taking a look at.

Cheers,
otrpu