Can't sleep through the night with my new machine and mask

[Guest]

First, a big THANK YOU to all of you who responded to both my pre-prescription and initial machine setup questions. Though it's clear that they're are lots of opinions on every subject, it's also nice for a newbie to know that he's in good company and has a place to turn for helpful suggestions.

I've been using the machine for exactly a week now -- yes, I know, it takes time and patience to get used to it -- but I have still yet to sleep through the night without waking up two or three times and removing the mask for at least a few minutes. On several occasions, I've taken off the mask and mistakenly fallen back asleep before I could put it back on! I'm pleased to say that I'm past the point where I feel like I'm fighting the mask in order to breathe (although it's still a bit of a shock when I open my mouth inadvertently and "break the vacuum) but my waking now seems to be tied to a very dry throat and inability to swallow without a drink of water.

As some of you may remember, I'm an opera singer, so a dry throat is a real issue for me. It's definitely not coming from mouth breathing and, despite the warm weather, I've jacked up the heater on the humidifier to the middle setting, but I'm still bone dry and in need of water a couple of times each night.

I'm committed to making this whole thing work for me and to wearing the mask and using the machine every night for as long as necessary, but I'd appreciate any words of advice, empathy or encouragement that you guys who have been through this can provide.

Many thanks,

Kurtchan

[TerryB]

Kurtchan,
I wonder how you are so sure that your dry mouth and need for a drink of water is not from mouth breathing? If you have not physically prevented your mouth from opening and you are getting this symptom, then I am willing to bet that your mouth is opening to some degree during sleep and this is drying your mouth and throat and stopping your therapy in its tracks. You need to take steps to prevent your mouth from coming open when you are sleeping. I recommend the use of the denture adhesive strips. Although a bit of a mess to deal with they mean the end of mouth breathing/leaking.

TerryB

[steview]

Don't give up the fight! I've only been on the machine for a couple of weeks, and I also found it weird the first few nights, but WOW, what a difference its made. For the first time in years, I'm not getting up to take a bathroom break once or twice a night - this alone makes for a better sleep. And I think I'm now getting some REM, since before the machine I was having an AH incident every minute during Rem. I am definitely feeling more rested during the day. Other then getting the mask to fit right, it's actually gone quite easy for me. I also have turned down the humidity on my machine (a Fisher & Paykel 604), since I felt it was a little too moist.
Stick with it, it's going to pay off!!!

Steve

[kurtchan]

I appreciate your supportive suggestions. I will definitely stick with the machine and the mask as I know they are both medically necessary.

As to the mouth breathing as a cause for the dry mouth, unless things are dramatically different when I'm sleeping, I can almost guarantee that mouth breathing is not the problem. When I open my mouth even the slightest bit while the CPAP is on, it causes such a rush of air that it makes me choke, cough and sputter -- certainly enough to wake me up, if nothing else. I think I'll crank up the humidifier all the way to the max and see if that doesn't help tonight.

Stay tuned... and thanks again!

Kurtchan

[littlebaddow]

Kurtchan

I think you have already demonstrated two important things that will get you through this - perseverence and a great attitude. Do keep going, it will be worth it.

Your experience reminded about my early days, follow the link below which maybe will offer you some encouragement

viewtopic.php?t=1177&highlight=diary

[krousseau]

There are a couple of reasons you can get the rush of air out your mouth; one is that your jaw may drop when you get deeply relaxed/at deeper levels of sleep and the air just takes the path of least resistance once that tongue/palate seal is broken and the air can push your lips open if they had not done so already. Another is that the mouth opens to mouth breathe with the same result, the seal is broken and the air rushes through the mouth. It won't seem like it is happening due to mouth breathing because it is impossible to breathe in against the rush of air going out. IT DOESN"T MATTER WHY-the end result is a very dry mouth. Turning the humidifier to the max will not keep your mouth moist. You have to figure out a way to keep your tongue seal against the palate that works for you.

Taping and polident strips-see the threads on those subjects.
viewtopic.php?t=8011&highlight=taping

Full Face mask or the new hybrid that is supposed to be out in the next few days.

Chinstraps-one that provides pressure under the chin-sort of supporting the base of the tongue. Respironics Premium does it. The Tiara does it for me but it also cups the chin so for some people may end up pulling the jaw back a little and down. I'm using an elastic velcro strap I got at Lowe's-it also sticks to the mask headgear which helps it stay in place. I've seen other things mentioned here like a scarf or the leg cut from panty hose to tie around the head (mumps style) ACE bandage wrapped arount the top of the head and under the chin. It has to be sturdy-forget the flimsy chinstraps.

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, humidifier, hose, seal

[brasshopper]

You know, I tried something - I dropped my tongue to the floor of my mouth - so that the CPAP pressure was contained by my lips - and it ballooned up my cheeks - I felt like a trumpet player.

The seal I make to keep from blowing air out of my mouth is at the back of the palate, almost, or so it feels - I can separate my lips and not lose the seal.

Taping my lips would do little good - except as a reminder to keep my tongue seal maybe?

Honestly, it sounds like you have air "short circuiting" for part of the night - in your nose, out of your mouth. It has happened to me - too bad you can't look at your data and see if your leak is going up and down.

[krousseau]

Same for me Brasshopper-the seal is made with the tip of the tongue behind the upper front teeth and the back of the tongue up against the palate. That is the reason the "mumps style" chinstrap works best for me. It pushes up & supports the base of the tongue against the palate. If I seal my lips-my cheeks just puff out! I don't understand why taping the lips works so well for so many people.

[path2others]

Did you ever think how your years of voice training as an opera singer may be interfering with what you are asking your tongue and throat to do with the CPAP? It might take some time for your body to learn that this is the time for sleep, not singing. I have been using a relaxation technique where you place your tongue lightly on the roof of the mouth just behind the teeth. When I feel the bubble of air in my throat I squeeze my cheeks and tongue back and let it pass with the next breath without swallowing. I have been using a chin strap and some nights find that I have removed it in the night but my Swift is still in place.
I have had my machine about a month and have noticed some improvement with a the energy but I still want to take a nap. When I do I always "hose up" ... I must be catching up for all those years without good sleep. Good luck! What roles have you sang in opera? Don

[ozij]

I don't understand why taping the lips works so well for so many people.

For me, it keeps my jaw from dropping open when I relax. I've had air rushing out of my mouth with part of my tongue glued to the palate because it dried, and the air was blowing around it. Somehow the tape, by not let my mouth drop open, keeps everything in place. Granted, my pressure is very low - 6-8.5 presently.

O.