Mouth breathing... But zero large leaks???

[gurp13]

Hi all, it's been a long time. Things were going pretty well. I had been using nasal pillows but recently switched back to my comfort gel nasal mask because I was getting bad TMJ pain. It has seems almost entirely gone away.

Now, my wife is telling me I am breathing through my nose with my mask on. Air is blowing out, I am evening snoring some. But, when i look at the stats on my machine, it reports ZERO large leaks. None! I have an AHI of 0.7 and 90% pressure of 12.3 on APAP. I feel okay, but a little sleepy during the day. Not like I used to, really. Is it possible I am breathing through my mouth most nights but still recording zero large leaks? Should I get a chinstrap? I can't tape my mouth because I have a goatee.

[Pugsy]

Do you have the software to actually see the leak graph or are you looking at the LCD screen?
Respironics large leak territory is around 90 L/min.. Until you hit Large leak...The machine reports 0% of time spent in large leak.. They can be pretty bad leaks and not get flagged. I have had leaks at 80 L/Min and the machine says nothing..other than 0 % of time in large leak.

It is possible to have open mouth with some mouth breathing and not have it impact the reports if the time involved was very short. I have had it happen to be..wakeup with desert mouth and mouth sometime in the middle of the night....next morning I go look at the reports and I don't see it. No where is a leak that is even exciting. I can only surmise that the open mouth time was minimal..so minimal it doesn't show on the reports.

So get the software and look at the leak line evaluate it. IF the leak doesnt show up....that mouth breathing is not going on for very long.

[gurp13]

Good idea, Pugsy, thanks. You're right, I'm only looking at the LCD. I don't have the software, but my psychiatrist is a sleep specialist and he does. He suggested that I needed a sleep study to my PCP and also got him to prescribe the CPAP. I will have to make an appointment with him so he can read the card.

In the meantime, do you think a chin strap is a good or bad idea?

Thanks for the help!

[Julie]

Sometimes, if the leaks are large enough, they won't register at all...

[cflame1]

If you can blow a "rasberry"... then you know a chinstrap won't necessarily help.

Why don't you download Sleepyhead and look at the data yourself?

[Pugsy]

Some people the chin strap is sufficient to keep the mouth shut and for others totally worthless.
Doesn't hurt to try though. I would go el cheapo first and try a 4 inch wide ace wrap. Get an idea if a chin strap will even work first.

Get SleepyHead so you can easily see for yourself though. Don't rely on wife being awake to hear something. She can't be awake all night.

[DiverCTHunter]

If you can blow a "rasberry"... then you know a chinstrap won't necessarily help.

Why don't you download Sleepyhead and look at the data yourself?

Here's the link for Sleepyhead 0.9.1

[gurp13]

Oh, wow! I didn't know about Sleepyheads, thanks! So, all I need is a card reader to get the data. Right?

[Pugsy]

If your computer has a SD slot already (like for digital photos) you don't even need a card reader.

If it doesn't have a SD slot then you will need a reader/adapter so you can use one of your USB ports.
Generic cheap one is fine. Doesn't have to be fancy.

They look like this.
https://www.cpap.com/productpage/generi ... eader.html

Check out the SleepyHead links in my signature line..especially the User Guide for hints on how to import the data from the SD card.

[gurp13]

I got sleepyhead, thanks for that! So, I checked it out and it does seem like I have some large leaks but it's hard to understand all the graphs and numbers. I'm going to keep checking it periodically. I also noted that some people say you can train your tongue to block the air so I'm trying that, too. I went ahead and ordered a chinstrap, just to try. Good sleep is worth it.

I looked at the Sleepyhead user manual but it didn't give instructions on how to interpret the graphs. Any suggestions on something I can look at for that?

[Pugsy]

Go to the SleepyHead Glossary (link in my signature) and scroll through the terminology and definitions. I think that will help you understand things a bit.
We don't have a set "these are normal values and these aren't" because normals for a lot of the stuff are so widely variable it is not practical to list them. Things like minute volume or tidal volume will vary between male and female..short or tall..even altitude will impact it.

Generally we look at AHI....the event breakdown into which category...leak line..pressure line if variable pressures are used.. maybe the snore line.
Some of the stuff we aren't ever given an "acceptable" number...like snores or RERAs.. so we don't really know what is "good" or "bad" in those categories.
AHI...generally we like to see it below 5.
Leaks...well we just like to avoid large leak territory and be sure you understand where large leak territory is. On the Respironics machine...around 90 L/min and on ResMed machines it is 24 L/min.

Anything else. Just post an image of what you are seeing and ask for clarification...that is the easiest way.