A NEW solution for mouth leaks.

[GoodKnight]

I was diagnosed with severe obstructive sleep apnea in December 2004 with an RDI of 44. The doctor prescribed a CPAP pressure of 15 cm of H2O. Although CPAP helped alleviate many of my symptoms, from the beginning I had mouth leaks that continually awakened me during the night so in the morning I did not feel very refreshed. I tried full face masks but they leaked so much that my sleep was not any better(if only they made one that fit).

So, I my doctor prescribed an oral appliance that moves your lower jaw forward that is supposed to keep your tongue from falling back into your throat. This helped, somewhat reducing my RDI to about 35, and my required pressure to 11, but in my last sleep study the technician had a hard time maintaining therapeutic pressure because of the mouth leaks. Up to that time I thought they were just annoying and keeping me from having a restful night. I didn't realize they were reducing the effectiveness of the therapy.

So, the only solution I could find was using tape to close my mouth. Not a very satisfactory solution, but it worked, sort of. The tape would get wet during the night from the saliva and begin to leak, it was hard to get off in the morning and sometimes would tear up my lips.

I have found a solution that works very well for me, so for any of you out there that are taping your mouths, as I was, here is what I am now doing.

I am using a small modification to the Fisher & Paykel Oracle 452 oral mask. This mask was designed to fit into the mouth to provide CPAP to those that breathe through the mouth. In order to do this it must seal to the mouth and they have accomplished this with a silicone rubber piece that fits between your teeth and lips similar to scuba gear. There is a hard plastic piece that attaches to this and also to another silicone rubber piece that goes on the outside of your mouth. There is a screw like adjustment that allows you to adjust the tightness of these two pieces to obtain a proper seal.

Here are my modifications:
There is short piece that protrudes into your mouth between your teeth that I cut off. I used sharp scissors to cut off the protrusion on the silicone rubber piece that goes between your teeth and lips and a Dremel tool with one of their cut-off wheels to cut off the protrusion on the hard plastic piece(use the slowest speed so you don't melt the plastic).
In order to plug up the hole where the hose normally fits I used a cap on the disposable humidifier that comes with the pressure manometer that CPAP.com sells(Fisher & Paykel Water Column CPAP Manometer with HC325 Chamber). It fits perfectly into the hole when turned around.

It seals the mouth perfectly, comes of easily and quickly is comfortable and works.
I use it with my Swift nasal pillow mask and it fits under it without any problems. I have also used it with the Resmed Mirage Activa nasal mask. You have to put the Activa on first and then fit the modified Oracle under it. In this case it needs to go slightly lower than the center of the mouth, but it still works. It also works with my Aura nasal pillow mask. I have not tried it with any others.

I had my first great night sleep when I used this. It was so exciting. I am happy to share this with you.

[4Katie]

This board is so amazing. Where else could we learn this stuff???

::thinks someone should offer degrees in CPAP useage and accomodations::

[dsm]

<snip>

I am using a small modification to the Fisher & Paykel Oracle 452 oral mask. This mask was designed to fit into the mouth to provide CPAP to those that breathe through the mouth. In order to do this it must seal to the mouth and they have accomplished this with a silicone rubber piece that fits between your teeth and lips similar to scuba gear. There is a hard plastic piece that attaches to this and also to another silicone rubber piece that goes on the outside of your mouth. There is a screw like adjustment that allows you to adjust the tightness of these two pieces to obtain a proper seal.

Goodnight, That seems like a very good solution. As 4Katie has said, what an imaginitive way to deal with the lip sealing. I had wondered if a snorkel mouth bit might be modified in some way but your solution takes the prize. I wasn't fully aware of the mouth piece they made until you highlighted it.

Do you still use the strap to hold it in place or do you rely on your teeth ?

Cheers

DSM

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): oracle, CPAP, seal

[neversleeps]

As rested gal has said in the past regarding other fantastic innovations:

Excellent lab-ratting!

Could you put up a picture tutorial of the steps to make this device? I can't tell you how excited I am to try your invention! I really like the Activa but wearing the tape over my mouth every night is getting old so this sounds great. Thanks for your ingenuity!

[GoodKnight]

Thanks for the good words.

dsm,

I don't use the strap to hold it in place. It stays in place very nicely without it. You don't use your teeth either, the way it is designed the two silicone rubber pieces hold it in place using the screw adjustment. So it requires no effort during the night.

neversleeps,

Yea, the tape gets old really fast. I'll try to post photos, but can anyone tell me how? It says you can't post them directly, but can refer to them if they are on another server. I don't know how to do that.

Let me know how it works for you.

[fnorette]

GoodKnight --

I NEED this! Please, do post a picture or drawing (for those of us spacially impaired ). Thanks in advance!

[Craig]

Thanks for the good words.

dsm,

I don't use the strap to hold it in place. It stays in place very nicely without it. You don't use your teeth either, the way it is designed the two silicone rubber pieces hold it in place using the screw adjustment. So it requires no effort during the night.

neversleeps,

Yea, the tape gets old really fast. I'll try to post photos, but can anyone tell me how? It says you can't post them directly, but can refer to them if they are on another server. I don't know how to do that.

Let me know how it works for you.

email me the photos and I will post them and give you the address. My email address is kram29@comcast.net. Be sure to SUBJECT them as CPAP Pictures as I don't open from folks I don't know.

Craig

Craig

[Newsgrouper]

GoodKnight:
I have an Oracle mask I do not use and would love to create your device from it. I too would like to get away from the mouth taping. Please expand upon your description of the modification with some diagrams and/or photos if possible.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): oracle

[Guest]

Craig,

Thanks for the offer. I will take the photos today and email them to you.

[GoodKnight]

Opps,

That last post was mine. I've no idea what happened.

[GoodKnight]

Here are some photos of the device and the modifications along with descriptions of what I did. I hope this helps. I'll be happy to answer any questions. I am not sure I did a very good job describing it.




Photos #1 & #2 are different views of the device as it would look when in the closed position on your mouth. Note the blue cap inserted in the hole in the front. This is from the manometer kit that I described in the earlier post.



Photo #3 shows it in the open position ready for placement in your mouth. The flap on the left is called the Snapflap(TM) by F & P and is the flap that goes on the outside of your mouth. The flap on the right is called the Softseal by F & P and is placed between your teeth and lips.

After positioning, close the Snapflap(TM) and adjust the tightness by turning ring at the front of the device, shown on the left in photo #2.



Photo #4 shows the device disassembled.



Photo #5 shows the two pieces that I modified. The Centre Body, shown in the bottom part of the photo, is inserted in Softseal, shown in the upper part of the photo during use.



Photo #6 shows the Centre Body and the small piece I cut off of it with the Dremel Tool.



Photo #7 shows the Softseal and the small piece I cut from that with a sharp scissors. The flat end of the Centre Body is inserted into the Softseal. Be sure that the Sofseal is pulled up over the tabs of the Centre Body. It is this area where you have to be careful not to cut when you trim the Sofseal.

Many Thanks to Craig for posting these photos on his server.

[BrewSwain]

Thank you for these pictures. This looks like the solution I need. Bruce Wayne

[dsm]

Many thanks for the photos.

I spoke to my sleep studies person who said she thought she had a spare F&P 452 mask that she could give me. Turns out she had ditched it 2 weeks before in a clean up. But, she mentioned that that one was an older model that has a tongue gude (holds tongue down) & that new versions don't have that. The mask you show is the new one.

The thing to watch for if any of us buy a F&P mask to chop up, is to make sure it is the new one as shown.

I may have a cheap source for these (the guy is trying to find some that he believes he has) but I need to confirm they are the correct models once he locates them. If ok I will post his details (He is likely to offer them for $US 75 incl post (in US)).

Cheers

DSM

[BrewSwain]

DSM, let us know soon. I plan to buy one Monday. Thanks

[rested gal]

Joel, great analysis, great work on your Oracle, and great pictures!

Great lab-ratting!!!

I'm doing well with the "DYI" design frequenseeker came up with, but since I just happen to have two Oracles lying in the dead mask drawer, I think I'll get to work on one of them as a mouth leak stopper. Like having masks to rotate between, I think I'd like to have yet another way to handle the mouth leaks.

Thanks for the excellent post and pictures!