New CPAP user -- do I need a chinstrap?

engersal · Post by **engersal** » Tue Jan 31, 2006 5:12 pm

Hey all:

I started with my CPAP a couple nights ago (a Fisher & Paykel 234 machine and a Mirage Swift mask). I think that I am historically a mouth breather, so the tech also hooked me up with a chinstrap. I gotta tell you -- while the mask is not too bad, the chinstrap is awful. So awful, in fact, that last night I pulled it off. And guess what -- I think I managed to avoid mouth breathing without the strap. But I am not sure. It seems to me that when my mouth (or more importantly my throat) is open, I can feel and hear a whoosh of air bring pushed through my nose and out my mouth. I am guessing that this is what a chinstrap is supposed to prevent. However, even without a chinstrap, I seem to be able to keep my throat closed and keep the pressure from shooting out my mouth. So tell me: Does this mean that I really do not need to use the chinstrap? Is this normal / acceptable / OK? I sure hope the answers are YES, because I am not sure that I will be able to deal with this if I need to strap my jaw shut every night.

Goofproof · Post by **Goofproof** » Tue Jan 31, 2006 6:42 pm

Only you will know, I use a FF Mask, and have no problem, but if your mouth isn't sealed, you are loosing the air pressure that you need for treatment, making the treatment ineffective.

If you use a XPAP that reports your progress you can better follow your treatment.

HappyHoser · Post by **HappyHoser** » Tue Jan 31, 2006 7:15 pm

Also note that if you do need the strap, it doesn't need to be cinched up like a halter. Just enough to guide your jaw and stay in place etc... is probably enough. Like Goofproof says, if you have the ability to monitor your results with and without you may discover that it isn't necessary but it's likely that your results will be better while usng it. Good luck!

chrisp · Post by **chrisp** » Tue Jan 31, 2006 9:29 pm

Try tape . Its much cheaper and actually seals your mouth. You can still leak with a chin strap.

:twis ted:

rested gal · Post by **rested gal** » Tue Jan 31, 2006 11:39 pm

Hi engersal,

Here's some interesting reading:

Nov 05, 2005 subject: Attention all Tapirs

Mar 26, 2005 subject: Mouth tape..

Oct 01, 2005 subject: MOUTH TAPING

Aug 12, 2005 subject: F u ll face mask users

Feb 09, 2005 subject: Respironics Chin-strap??

Dec 24, 2004 subject: Just diagnosed with moderate obstructive sleep apnea

The next two discussions were on two different message boards. Even though it was same subject, the many pages of responses were different.

Sep 15, 2005 subject: Time for the big Tape Arguement Join In on the ASAA board

Sep 15 2005 subject: Time for the big Tape Arguement Join In on the TalkAboutSleep board

The last link is to a long discussion about frequenseeker's "DIY" (Do It Yourself) mouthguard:

Topic started by frequenseeker Dec 01 2004 subject: mouth leak solution, cheap DIY oral appliance

Linda3032 · Post by **Linda3032** » Wed Feb 01, 2006 12:16 am

Hi Engersal,

If you just began therapy, you don't really know if you are a mouth breather. Just because you used to be one, doesn't mean you will be one now. If you start therapy without a chin strap, you may teach yourself to keep your mouth closed.

I used to snore alot, and slept with my mouth open - mainly due to stuffy nose and sinus problems. But with CPAP, I was aware of a rush of air coming out of my mouth (plus I talked funny) I was able to keep my mouth closed. Plus, once that humid air blows up my nose, it becomes unstuffed so I don't feel the need to open my mouth to breathe.

My advice would be to wear your mask and CPAP while you are awake - maybe while watching TV. Keep your mouth closed. Maybe, you can program yourself.

But, if you have to use tape to help at first, be sure to use the Paper Tape. It's much more gentle than adhesive or Duct tape.

Good Luck, and keep us informed on how you're doing. Keep reading the forum, it's full of good information and great people.

Linda

engersal · Post by **engersal** » Wed Feb 01, 2006 4:36 pm

Thanks for the advice so far. I guess the real question I need answered is: what kind of "leakage" is the chin strap (or tape, or full face mask etc...) supposed to prevent? Am I to be concerned about some subtle pressure issue that is beyond my ability to detect with my own senses? Or am I to be concerned about that whooosh of air that comes out through my mouth as the CPAP machine pushes the air into my nose? If it is the later, than I probably do not need a chin strap, a taped mouth or a full mask because I can just breath in and out through my nose and keep the pressurized air from shooting out my mouth whether my mouth is open or closed. More thoughts on the bad leakage would be appreciated.

rested gal · Post by **rested gal** » Wed Feb 01, 2006 4:48 pm

engersal, being able to keep the cpap air from going out your mouth while you're awake is one thing. Having that not happen when your muscles are fully relaxed in the unconscious state of sleep is quite another.

Some mouth breathers and mouth air leakers have been able to become fulltime nose breathers and non-mouth-air-leakers. But some of us will always puff air out through unsealed lips no matter what. It has to do with where the tongue ends up when fully relaxed in sleep.

People who use a machine with software to monitor their nightly results can get an idea what's happening by looking at the leak graph the next morning. If they are wearing a mask that they're absolutely sure isn't springing huge leaks during the night, then big leaks on the graph are usually from mouth air leaks. Or, an observant bed partner who is awake a lot might notice that air is puffing out the apneac's mouth -- if there's enough light to see what's happening.

Just takes a lot of trial, error and checking on it for an inveterate mouth air leaker to know if one method or another is controlling the leaks effectively.

sthnreb · Post by **sthnreb** » Wed Feb 01, 2006 7:44 pm

I had some minor problems with leakage with the bipap machine. Over time I've overcome it and I think most do. I prefer not to use a chinstrap if possible personally. A small leak is not to bad and a large leak wakes me. I can wet my lips and the sort of stick to gether then. You can use knee braces, wristbands or whatever, but if not needed, why use them? Give it a good try to adapt first, then if you don't succeed, get a chin strap and see if that works.

2SleepDeprived · Post by **2SleepDeprived** » Thu Feb 02, 2006 4:07 pm

I don't like the chinstrap. I can't find a good position for it and it invariably winds up off of my face and dangling off the hose. So it has retired to my bedside table. Now that the CPAP is keeping my airway open, my husband says I make absolutely NO noise at night and my mouth is staying shut. You might prefer to try the tape (I never went that route); I just felt the chinstrap was a waste of money for me.

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