Dry mouth in a.m. with FFM

[robblaw]

I have been using a FFM & macine (ResMed Mirage with a RemStar Plus C-Flex machine by philips) w heated humidifier since March. I don't know if this is just because I have noticed it lately but my mouth is very dry in morning. I am an open mouth sleeper. The C-Flex is set to 3 and I've tried all the humidifier levels to see i that makes a difference & it hasn't. my "CPAP max/median level" or whatever it is termed is at 10 and my ramp time starts at 4 or 5. Any ideas or suggestions as to what could be causing this or what to try so my mouth isn't bone dry in the morning? Is my median level now incorrect or could it have changed since my sleep study 6 months ago? Just looking for a solution. Thanks in advance.

[Sheriff Buford]

I am also a severe mouth breather. I have gotten used to it, but I do use Biotene rinse before I go to bed... when I am not too lazy to get up and do it. Biotene comes in a rinse or spray. I have noticed that my mouth is not as dry in the morning when I use the rinse.

Sheriff

[Wulfman...]

I have been using a FFM & macine (ResMed Mirage with a RemStar Plus C-Flex machine by philips) w heated humidifier since March. I don't know if this is just because I have noticed it lately but my mouth is very dry in morning. I am an open mouth sleeper. The C-Flex is set to 3 and I've tried all the humidifier levels to see i that makes a difference & it hasn't. my "CPAP max/median level" or whatever it is termed is at 10 and my ramp time starts at 4 or 5. Any ideas or suggestions as to what could be causing this or what to try so my mouth isn't bone dry in the morning? Is my median level now incorrect or could it have changed since my sleep study 6 months ago? Just looking for a solution. Thanks in advance.

Mouth-breathing, even with a full face mask will still result in "dry mouth". Generally speaking, you need to try to get your nasal passages open so you can breathe through your nose and not breathe through your mouth. Too much humidity can actually cause more nasal congestion. Turning the humidifier setting down (or off, using "passover" humidification) may help. I've been using "passover" humidification year round since I started therapy over eight years ago (I tried "heated" a couple of nights and found out that it wasn't for me).
Doing nasal cleansing before bedtime may help. If you can't breathe through your nose before you mask up, you may have problems after you do.
Try keeping/pressing your tongue to the roof of your mouth.......behind your top front teeth. Pretend you're sucking on a lemon drop.

Do NOT use nasal sprays like Afrin! They cause rebound and make things worse after about 3 days of use.

You might also try turning off the Ramp and just let it go right to your therapy pressure.


Den

.

[Posey]

I feel your pain. Do you know why you mouth breathe? Is it allergies,nasal polyps, etc.? I have enlarged turbinates from allergies so I use allergy meds- both pills and Nasonex spray for that. It helps if I breathe through my nose some. Biotene seems to work but I haven't used it regularly. Thanks Sheriff for the tip!
How is your room humidity? It is parched in my part of Texas. My room humidity is running about 35%. I am going to hook up a room humidifier tonight and see how that works. Last night my Resmed humidifier went dry (unheated hose) and I can assure you that is NO fun.

Does anyone know the most comfortable % humidity for room air? I am thinking 50%.
Best wishes for good results.
Posey

[purple]

MIght not be the problem you think it is. MIght be the dry mouth might be from stomach acid fumes being drawn up from your stomach by a sump action when you inhale. While the pressure of the machine is chosen to stent the airway open, it is true that for some of us, we have such a restricted airway that we get really strong wind speeds when we inhale, that causes the sump action.

What you are describing might be treated by increasing the pressure of your machine, if that does not give you centrals. I use a bi level machine to keep air being pumped into my stomach, Aerophagia. The bi level machine, the higher pressure on inhale, also stops my drawing stomach acid up (sump pump effect). The stomach acid fumes also cause my nose to drip, for the fumes to go into my lungs, both of which make me cough. Do you have a drippy nose or coughing in the morning?

[Julie]

If someone is mouth breathing, increasing pressure will make it worse.

[Pugsy]

Which model Remstar Plus machine? Is it a PR System One machine? If so there is a way to add a little more moisture output by the humidifier...it may or may not help the dry mouth but worth a try.
The default humidification system for the PR System One machines is this new fancy mode where some sensors are used in an effocrt to reduce rain out... that mode can be turned off in the clinical setup menu and thus the humidification mode reverts back to "Classic" mode which uses more heat and more water. The chances of condensation in the mask and hose are greater.
I don't know if it will help much because the humidifier just isn't designed to hydrate the oral cavity well for people who do a lot of mouth breathing. Worth a try though.
Don't know about the clinical menu and how to get to it?
http://www.apneaboard.com/pr-system-one ... structions

On the bottom of the blower unit is a 3 digit model number...probably 250 or 260 if you have the PR System one with CFlex..
if it is a 260..there is an additional option of a heated hose which could allow for more moisture being added to the air without as much chance of rain out.

Your CFlex settings don't affect the humidity.
Your pressure settings and leaks will affect the humidity delivered...unfortunately the PR System One Plus cpap machine doesn't offer anyway to monitor leaks...so we don't know how much of an impact leaks are making.
More pressure and more leaks will dry out the mouth more...along with mouth breathing in general.

[avi123]

I have been using a FFM & macine (ResMed Mirage with a RemStar Plus C-Flex machine by philips) w heated humidifier since March. I don't know if this is just because I have noticed it lately but my mouth is very dry in morning. I am an open mouth sleeper. The C-Flex is set to 3 and I've tried all the humidifier levels to see i that makes a difference & it hasn't. my "CPAP max/median level" or whatever it is termed is at 10 and my ramp time starts at 4 or 5. Any ideas or suggestions as to what could be causing this or what to try so my mouth isn't bone dry in the morning? Is my median level now incorrect or could it have changed since my sleep study 6 months ago? Just looking for a solution. Thanks in advance.

A major cause of DryMouth is age. But you have not revealed it. So I can't respond.

[avi123]

I feel your pain. Do you know why you mouth breathe? Is it allergies,nasal polyps, etc.? I have enlarged turbinates from allergies so I use allergy meds- both pills and Nasonex spray for that. It helps if I breathe through my nose some. Biotene seems to work but I haven't used it regularly. Thanks Sheriff for the tip!
How is your room humidity? It is parched in my part of Texas. My room humidity is running about 35%. I am going to hook up a room humidifier tonight and see how that works. Last night my Resmed humidifier went dry (unheated hose) and I can assure you that is NO fun.

Does anyone know the most comfortable % humidity for room air? I am thinking 50%.
Best wishes for good results.
Posey

Comment,

I try to keep my BR at 60% humidity. The CPAPs humidifiers are too small to supply adequate moisture to the inhaled air. If your BR is below 50% then most of the moisture from the humidifier air is absorbed by the room air. If your BR there in Texas is at about 35% then my guess is that you need a couple gallons (or more, see the 9 gallons Honeywell unit below) of water to be sprayed into it to raise its humidity to 50% for over an 8 hr nightly sleep. Even then , if you suffer from any of those unique causes of DryMouth such as drugs, age, Diabetics, etc., then the 50% plus the XPAP's humidifier and a FF mask, still, may not be able to stop the DryMouth. Ask Sheriff Buford about some water spritzers devices that you attach to the mask directly.

http://www.westsidewholesale.com/honeyw ... 1b2166c2c0

[VikingGnome]

I have excess saliva all the time when awake. But after a night of mouth breathing through FF mask with pressure at 20/16, my tongue is stuck to the roof of my mouth. I tried increasing temp on humidifier from 70 to 85 thinking warmer air carries more moisture. My humidifier tank went dry half-way through the night so that's not a solution. At least in my case, my dry mouth seems to be related to the level of air blowing from my VPAP through my mouth. The higher the pressure, the drier my mouth. I can't imagine using any oral device at this pressure.

I NEVER had dry mouth over the previous 12 years with a nasal mask and CPAP at 10. I guess my tiny nostrils can't handle the volume of air I need now so I have to open my mouth or not breathe. Now when I use nasal mask with chin strap and mouth-taping, my AHI sky-rockets. This tells me that my mouth breathing is NECESSARY when my nose can't handle it (obstructed or stuffed up). So no more mouth taping for me when I have to use a nasal mask instead of FF mask.

I tried the Biotene gel. It seems to work for a couple hours but doesn't work the entire night. I typically don't start mouth breathing until hours 2-3 of sleep so Biotene is useless for me.

Today I bought a small digital thermometer/hygrometer at WalMart for $9. I wanted to see exactly what the ambient humidity is in my bedroom. It's 42% with A/C and it's 80% outside.

Some people have suggested that having a room humidifier might be helpful. I don't totally understand how the humidity works on CPAP. Is it relative to the room humidity or actual humidity at the mask?

[bosstow]

I don't totally understand how the humidity works on CPAP. Is it relative to the room humidity or actual humidity at the mask?

The S9 (with Climateline Hose and H5i humidifier), and when climate control is left on Auto, maintains a relative humidity (RH) of 80% at the user-selected air temperature.

Like you were saying, warm air can carry more moisture. So even comparing two temperatures with 80% relative humidity, the absolute humidity (AH) at 75F would be higher than the absolute humidity (AH) at 60F.

This white paper below explains exactly how the S9 climate control was developed and how it works. It's pretty interesting (to me anyway).

The S9, when climate control is on auto, will maintain both air temperature AND relative humidity throughout the treatment session, regardless of changes in room climate.

Resmed Climate Control white paper

[avi123]

I have excess saliva all the time when awake. But after a night of mouth breathing through FF mask with pressure at 20/16, my tongue is stuck to the roof of my mouth. I tried increasing temp on humidifier from 70 to 85 thinking warmer air carries more moisture. My humidifier tank went dry half-way through the night so that's not a solution. At least in my case, my dry mouth seems to be related to the level of air blowing from my VPAP through my mouth. The higher the pressure, the drier my mouth. I can't imagine using any oral device at this pressure.


I NEVER had dry mouth over the previous 12 years with a nasal mask and CPAP at 10. I guess my tiny nostrils can't handle the volume of air I need now so I have to open my mouth or not breathe. Now when I use nasal mask with chin strap and mouth-taping, my AHI sky-rockets. This tells me that my mouth breathing is NECESSARY when my nose can't handle it (obstructed or stuffed up). So no more mouth taping for me when I have to use a nasal mask instead of FF mask.

I tried the Biotene gel. It seems to work for a couple hours but doesn't work the entire night. I typically don't start mouth breathing until hours 2-3 of sleep so Biotene is useless for me.

Today I bought a small digital thermometer/hygrometer at WalMart for $9. I wanted to see exactly what the ambient humidity is in my bedroom. It's 42% with A/C and it's 80% outside.

Some people have suggested that having a room humidifier might be helpful. I don't totally understand how the humidity works on CPAP. Is it relative to the room humidity or actual humidity at the mask?

Comment,

With the nasal mask you could mouth- breathe somewhat as long as it does not cause LEAK above 24 L/Min. I use a Chinstrap and tighten it to let me breathe thru the mouth but only that much. So it does not affect my AHI.

As to DryMouth I do have it about 25% of the time. But b/c I go to the BR 3 to 4 times a night I then also rinse my mouth with faucet water. I should do it with Biotene rinse (not Spray) which would be more effective. But I am too lazy to take the time for it, same as Sheriff Buford. SO, MOUTH BREATHING IS NOT AN ISSUE WITH ME.

I use the central house air condition/heating plus the central house humidifier to keep my BR at 60% to 65 % humidity and at 80 to 82F during the night, no matter what it is outside. I do not use any Climate line and don't depend on the CPAP humidifier to prevent the DryMouth.

You could use the Thermometer/Hygrometer gadget that you bought to test the air going into the mask. I would just place my nasal mask over it and over a surface for a minute or two and read the results. Try to do it for a week with different humidifier settings and note the affect on the DryMouth. Next, do it with having your room humidifier set to keep the humidity in the room at 50% to 60% and see if there are better results in avoiding DryMouth than by using the XPAP's humidifier only.

About taping the mouth, what's your take about the following:

Does taping mouth lips prevent a Dry Mouth?

Taping your lips don't stop air from entering your mouth from the nose and throat, i.e. from the "back side" (pharynx). When you swallow your saliva which is generated in the salivary glands around the mouth, and then secreted into the mouth and subsequently you swallow it (also during sleep), air must come in from the back to replace the swallowed saliva's volume because your lips are taped closed and air can't come in from the front to do it. So this air circulation, from the "back side", will dry your mouth in spite of taping it. It could be to a lesser degree than from an untaped mouth also b/c the air from the pharynx is moister. But, it is clear that taping your mouth to prevent a Dry Mouth, completely, is not true. It seems to be a myth (some Russians are pushing this myth). There is no way to prevent some air circulating thru your mouth.

You better off with a Chinstrap which would prevent opening the mouth very wide but would allow some lips opening to let air to be breathed from the front. However, using a Chinstrap instead of a full face mask would cause the XPAP's treatment to be affected by the mouth leak.

[Posey]

Follow up: I started using a room humidifier and it runs almost constantly to get to 40%. However, it helps. I have not had the tank run dry since.

Funny: on Monday I had an appt at the sleep center for a check up. The little nursy perosn suggested for dry mouth to try Biotene, increasing humidity, using Chapstick etc. When I told her I'd done all of that then she suggested I turn down the humidity to a lower number. Later the physician came in and when I related those ideas to him he rolled his eyes and said not to turn it down. He uses a CPAP so I think he has the right ideas.

[MagsterMile]

Regarding expensive Biotene Dry Mouth Rinse, you can get a cheaper version which works just as well IMO. I buy the Walgreen's Dry Mouth Rinse for several $'s cheaper and feel that the results are the same. It does help me to use the rinse just prior to bedtime. Try to use it several time throughout the day if possible.

I tried the neti-pot type rinse last winter and ended up with a problem in my left ear.

[avi123]

I am experimenting now with Oramoist patches. See this thread:

viewtopic.php?f=1&t=84832&p=853536#p853536