Still mouth breathing and tired, even after sinus surgery!

[scarny]

I've been using my CPAP for about 4 years, and lately I've been very tired and waking up every morning with a dry mouth. Here's my history, and please post if you have any helpful suggestions or comments.

Here’s a timeline of my health problems:

Nov, Dec, 2013– I was getting daily headaches (in the front of my forehead), I was very tired all the time, and my sinus breathing (especially through my right nostril) was getting worse. I had a CT Scan of my head, and it came back normal. Finally I saw the ENT doctor, who said I have sinusitis.

January, 2014 – The ENT doc performed a turbinate coblation (out-patient surgery in which he removed a little sinus tissue via laser) on my sinuses, and the headaches immediately stopped.

June, 2014 – I’m still very tired all the time, with dry mouth in the morning, and the headaches have started again. I saw the ENT doc again on 6/16/14, and he said he did not see any significant sinus blockage that would require another sinus surgery.

I saw my regular doc on 6/13/14, and he had my blood work done. My blood work was normal, except that my testosterone is very low (167), which could be an indication that the CPAP is not working effectively. I wake up every morning with an extremely dry mouth, despite putting the humidifier at a 5 level (the highest), and despite taping my mouth shut/using a chin strap. As a matter of fact, my mouth is more dry after a night of having my mouth taped (probably due to back-air-flow through my throat). My AHI results on my CPAP machine are 1.0 and the leaks are 0%, which are good numbers, but there's got to be something more happening here that is making me so tired. I also tried the Quattro full-face mask to combat my mouth breathing, but I have to have it so tight to avoid leaks into my eye, that it’s painful.

I have an appointment with my sleep doc on 7/14/14 (I can't believe I have to wait that long). I will ask for a prescription for the Hybrid mask, which I’ve heard can be helpful with mouth-breathers. The only other thing I can think of is to ask for another sleep study from my doc. Any suggestions??

[Wulfman...]

I've been using my CPAP for about 4 years, and lately I've been very tired and waking up every morning with a dry mouth. Here's my history, and please post if you have any helpful suggestions or comments.

Here’s a timeline of my health problems:

Nov, Dec, 2013– I was getting daily headaches (in the front of my forehead), I was very tired all the time, and my sinus breathing (especially through my right nostril) was getting worse. I had a CT Scan of my head, and it came back normal. Finally I saw the ENT doctor, who said I have sinusitis.

January, 2014 – The ENT doc performed a turbinate coblation (out-patient surgery in which he removed a little sinus tissue via laser) on my sinuses, and the headaches immediately stopped.

June, 2014 – I’m still very tired all the time, with dry mouth in the morning, and the headaches have started again. I saw the ENT doc again on 6/16/14, and he said he did not see any significant sinus blockage that would require another sinus surgery.

I saw my regular doc on 6/13/14, and he had my blood work done. My blood work was normal, except that my testosterone is very low (167), which could be an indication that the CPAP is not working effectively. I wake up every morning with an extremely dry mouth, despite putting the humidifier at a 5 level (the highest), and despite taping my mouth shut/using a chin strap. As a matter of fact, my mouth is more dry after a night of having my mouth taped (probably due to back-air-flow through my throat). My AHI results on my CPAP machine are 1.0 and the leaks are 0%, which are good numbers, but there's got to be something more happening here that is making me so tired. I also tried the Quattro full-face mask to combat my mouth breathing, but I have to have it so tight to avoid leaks into my eye, that it’s painful.

I have an appointment with my sleep doc on 7/14/14 (I can't believe I have to wait that long). I will ask for a prescription for the Hybrid mask, which I’ve heard can be helpful with mouth-breathers. The only other thing I can think of is to ask for another sleep study from my doc. Any suggestions??

You're going the wrong way with your humidifier setting. Try turning it down or off.


Den

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[library lady]

Having your mask so tight that it's painful creates more leakage. Have you tried mask liners? I couldn't control my leaks during my first week of therapy, and after I found out about mask liners I bought some, and they were a game changer for me! I still do have some leakage, very few large leaks... but the important thing is they no longer keep me awake, and only rarely do they wake me in middle of the night. When they do wake me, a quick adjustment to the mask or the position of my face on the pillow allows me to go right back to sleep. Google "cpap mask liners" - there are several.

Your dry mouth issue: I have that too, and I have a covered plastic mug with its own straw. I fill that half full of water and set it on a small stool a few feet away from the bed (not on the same table that the machine is on, in case it spills if I set it down wrong). Whenever I wake with dry mouth, I know that I can pull the connector of the mask and get a few sips of water... in my case, the connector is directly opposite my mouth, but if your mask is not aligned that way, then a flexible straw is needed.

Some people might suggest just taking the mask off, but I try to never do that. Once it's on at bedtime, it stays on until it's time to get up, except for something more urgent than using the toilet or getting a drink. I started that habit in an effort to keep from taking it off and then going back to sleep without putting it back on when I first started cpap.

[Goofproof]

Full face masks, give mouthbreathers real treatment for sleep apnea in mouthbreathers. You also need a machine that collects full data and the software, so you can tell how well your treatment is going and correct problems.

Basically without full data, you are trying to drive your car without a steering wheel. Jim

[flyingwithoutwings]

I totally agree with Library Lady regarding mask liners. That was a game changer for me too. Leaks are minimal and not enough to wake me up. I love my Quattro Air and I'm not even a mouth-breather.

[Sclark08]

Liners are definitely the way to go!

[kteague]

I have an appointment with my sleep doc on 7/14/14 (I can't believe I have to wait that long). I will ask for a prescription for the Hybrid mask, which I’ve heard can be helpful with mouth-breathers. The only other thing I can think of is to ask for another sleep study from my doc. Any suggestions??

Along with sorting through the mask issues, since the machine you have listed does not collect much information, there are a couple options short of a sleep study. When I was in this situation, I chose to pick up a used machine on my own that would give me the data I needed to determine if my treatment was actually effective. Before that, I had my doctor order me a home trial (2-3 weeks) on an auto titrating machine so we could get a detailed picture of what was going on.

[Nozzelnut]

Is your low T a symptom or a cause? Have you talked to your Dr about retesting or treatment?

[scarny]

Thanks for all the suggestions and comments. I will try the mask liners. The sleep apnea is causing the low-T (it was 167 last month, when a normal reading is 240 and up). My doc said I could go back on the Androgel if I wanted to, but I don't want to. Some studies suggest that the Androgel makes the apnea worse.

For the last 2 nights, I used the Quattro FX full face mask. I did sleep a little better and with no dry mouth! But no matter how loosely or tightly I fit the mask, I get air leaking into my eyes. I also don't like the feeling of the mask on the bridge of my nose. Does the Airfit mask also fit on the bridge of the nose? If so, I don't think that's for me.

I actually prefer the feeling of the nose pillows, but I need my mouth covered. So I think a good option for me is one of the Hybrid masks. Today I will call my DME to see if they will allow me to bring my CPAP into their office and try different masks with it. Has anyone done that before? That way, I can do a "test drive" before I decide on my new mask. Comments?

[musculus]

Do you still have nasal congestion? Sometimes the CPAP cannot blow past the congested nose so you ends up with mouth breathing even with CPAP.

[kaiasgram]

scarny, I'm confused -- I thought your machine only records compliance hours, but you're reporting AHI and leak numbers. I'm not as familiar with the PR machines, but is your "Plus" machine giving you this AHI and leak info?

Edit: I just read your earlier thread where Pugsy confirmed that this machine only records hours of use. Are you using a different machine than the one you have listed?

[scarny]

@ musculus: Yes, I still have some nasal congestion, which is why I'm breathing thru the mouth and need a full-face or hybrid mask. But my ENT does not think it's serious enough to warrant a second sinus surgery.

@ kaiasgram: I'm using the same machine that I have listed. It records hours of use, AHI, periodic breathing, and large leaks only. And it doesn't have a data package that I can access online, or anything like that.

My DME therapist came to my house today and helped me fit my Quattro FX mask on my face. He said this mask needs to have the cushion replaced every two weeks, so he ordered some cushions for me. He also let me try the Liberty Mirage hybrid mask with my machine. It felt really good. And since my HMO allows me to order a new mask every 3 months, I can order the Liberty on 7/24/14. Hooray!

[Pugsy]

If you have AHI, leak and PB on the LCD screen of your machine then you don't have the machine you have chosen in your profile because that machine doesn't record AHI, leaks or PB.

You might want to look on the bottom of the blower unit for a 3 digit model number so you can figure out exactly what machine you are using. If you can't figure it out just tell us the 3 digits and we can tell exactly which model you have.

Right now you have chosen the PR System One Plus CPAP with CFlex and that would be model 250...and model 250 only records hours of use..The 60 series 260 doesn't do anything but hours of use either.
Must have model 450 or higher to have any useful data beyond hours of use.

If you have AHI, leak or PB available then you have either the 450/460 or 550/560 model and those are different choices in the equipment menu.

You can use SleepyHead software and get more detailed data than you are seeing on the machine's LCD screen.
See the new SleepyHead thread on the main page of the forum for where to get SleepyHead....there's a Mac and Windows version.

[scarny]

Thanks, Pugsy. It says Remstar Pro 450P.

[Pugsy]

It says Remstar Pro 450P.

That would be the PR System One Pro CPAP and the link to that machine is broken in the equipment drop down men because it is a discontinued model

Just manually add it to your comments section in the equipment profile section.
For simplicity just say PR S1 Pro CPAP model 450