Mouth exhalation

DenotenatorPlus · Post by **DenotenatorPlus** » Sat Dec 09, 2006 10:14 am

I completed my sleep study and started using a RemStar Plus M series set at 13. My problem is mouth exhalation. A chinstrap does not prevent the lips from pursing and exhaling. The noise wakes me up.

1.The first question I have, besides the noise, what is the drawback of exhaling through the mouth?

2.I used duct tape to seal my mouth but the adhesive damaged my skin. Otherwise, with my mouth sealed, I was able to keep the mask on all night and sleep most of the time. I was not rested but I felt I was making progress.

3.Is there another solution to mouth exhalations? Assume that I can’t wear a full-face mask.

I am having my second session sleep study tonight. The doctor wants to increase the pressure, which I agree with. And, I want to learn more so I can monitor myself by using the software I have read about here. The doctor is talking about using a BiPAP and I have been thinking about an APAP as the best solution.

What is the advantage of the BiPap over the APAP? The nurse said the BiPAP is the Cadillac of machines – the price seems to be twice as much as the CPAP.

Any comments will be appreciated.

curtcurt46 · Post by **curtcurt46** » Sat Dec 09, 2006 10:29 am

They may want to give you an respironics auto bipap and they are great machines.

You don't want to mouth leak as this reduces the effectiveness of the therapy.

There have been many postings here about mouth leaks and how to correct. If taping is for you you might try 2" 3m micropore tape. There are other good tape that are not quite as harsh as the duct tape variety. Some folks even use poligrip strips with good success. It's a matter of what you find to your liking.

Good Luck!!

DreamStalker · Post by **DreamStalker** » Sat Dec 09, 2006 10:33 am

I think you are referring to "mouth leaks". You must be able to control them or your treatment will be ineffective. The purpose of the treatment is to maintain pressure (like a balloon) in order to keep your airway open. If it leaks (balloon goes flat) ... your airway closes ... you have apnea ... your life is not good.

Mouth leaks are controled by:

1) full face mask
2) nasal or pillow interfaces with taping or polligripping mouth closed
3) if your pressure is not too high and you have the appropriate physiological throat structure ... you may be able to train yourself not to leak air from your mouth

There are many threads on taping if that is your preference.

Best of luck!

snoregirl · Post by **snoregirl** » Sat Dec 09, 2006 12:10 pm

Duct tape!! I love it for lots of things since it sticks to virtually anything (even did my hand with it one time on the 3rd day of a 3 day marathon canoe race due to some unexpected bad blistering) but I can see why it would damage the skin on your mouth.

Try a gentle paper tape. I like the 3m one (nextcare), others have their favorites. Bandage section of the pharmacy. I did think the Johnson and Johnson one was a little harsher than the 3m.

Duct tape while it will indeed stick to anything is overkill on the adhesive for your face and lips.

Make sure you turn under the ends to make tabs for quick removal.

Another sleeps study. Yes since you have the base model machine that can't collect data. A better machine could tell you alot without the $$ of another sleep study. Might want to go there first. Especially since it probably won't occur until the next calendar year. I don't know your insurance situation and deductables and copays an the status of the machine you are using now.......If you are going to bust the deductable next year anyway, maybe another sleep study is worth it. Is there any particular reason the doc wants another study? If it is to check titration there are much cheaper ways to do it. If he has particular medical reasons then maybe it is the right thing. Understand why he wants it.

Pro m series would be ok to collect date, but APAP is quicker and better for checking your titration. If you at 13 you could set it 10 - 15 or 16 in in a week have some data without having to tweak slowly on a fixed pressure.
An apap also would allow you to run lower possibly much of the night (reducing the mouth leakage problem. 13 is not super high but it is getting up there (also my pressure)

At 13, if you are only having trouble with keeping the leakage down I am not sure why a bipap if there are no other issues.

If insurance pays for the bipap, you can actually use it as cpap later if you want so I guess I say why not. Try to go for the top of the line Respironics Auto Bipap if you go that way. Lots of people here really like that one.
But it does seem like a jump from the Plus CPAP to a bipap with your pressure (just my non-medical opinion).

Also try a chinstrap and the tape. I do both. I use a homemade one 3 inch ace bandage. not too tight. Just to give a little support. Which interface are you using? My ace bandage also provides some extra support to stabalize my swift. THen the gentle tape does the rest to keep the lips shut. CHapstick (or whatever brand of goop you like) in the morning as soon as you take the tape off is the finishing touch).

Keep us updated. Especially interested on why another sleep study and why a bipap.

I am editing this since I reread your post and wondered if you are having a second sleep study tonight, where did the 13 come from?

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, bipap, swift, Titration, CPAP, auto, APAP

Born Tired · Post by **Born Tired** » Sat Dec 09, 2006 12:56 pm

I tried taping, but tended to drool with it (which doesn't make much sense because I don't drool without it ). And occasionally my allergies completely block off my nasal passages causing me to wake up in a panic until I can untape my mouth.

But I have found that if I place the homemade chin strap (1.25" elastic strap connected with a safety pin) so that the fleshy part of my chin is pushed upwards, my bottom lip presses against my top lip enough that I don't leak and don't have to tape. My pressures are very low though so it might not be enough if I had higher pressures. Of course some people don't require any tape or strap and they have higher pressures.

Hope you find what works for you.

Esther
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JeffH · Post by **JeffH** » Sat Dec 09, 2006 1:16 pm

I feel for you DenotenatorPlus. I am fighting this battle right now. Last nite about half way thru the night I had my mouth taped. I woke up because my cheeks were swelling out due to mouth being taped, but no leaks. The cheek puffing woke me up. I changed then to my DIY mouth piece that is supposed to keep the tounge up to block off mouth leaking. Not real sure how well it works, thought. Never got back to sleep real deep after changing.

I'm going to try taping with headband around my lower part of my head (to keep cheeks from puffing) tonight and see how that works.

Hope you come up with a solution.

JeffH

Offerocker · Post by **Offerocker** » Sat Dec 09, 2006 1:54 pm

DID SOMEONE SAY DUCKTAPE???

...couldn't pass that one up, because that was my first visual conception after reading about mouth taping.

The micropore is great. Some use a single strip down center of mouth, and others use it sideways - sealing whole lip area. Whatever is needed to do the trick.

Good luck.

Mask

Additional Comments: Equipment isn't correct, S9 ASV w/H5i