The best chin strap and why I need to use one ...

[CoastalSun]

Well, the Dry Mouth issue has been addressed numerous times on this board but I have discovered what seems to be causing mine:
I tried taping my mouth but still woke up with an extremely dry mouth several times a night. Leak rates were great. AHI great. So when my recent dental checkup showed gum inflammation (which I have never had) and a new cavity, I decided to do a test. I rigged up a chin strap - helps that I am a seamstress - - and what do you know? My leak rate was almost nil, the AHI still pops around between 0.4 and 2.4 but stays mostly below 1.0. I wake up a few times a night to change position, and I have to go the washroom. I have a dx of nocturnal polyuria and numerous doctors can't figure out why. (This is a new topic I sure!)

... and the best part .... with the chin strap I had fewer wake ups with a parched mouth. I surmise that my tongue must be dropping during sleep, allowing air to come in 'the back door' because the dry mouth wasn't improved even with taping my mouth.
I tried a few nights without the chin strap, and back came the extremely dry mouth ... like an extremely arid desert ha ha!
So back to the chin strap. It works but I need to improve the design or find one that fits really well and doesn't slip.

My local DME has ONE chin strap to choose from and it's a joke! I won't name it but it cost $40 for two tiny flimsy pieces of material that almost looked like a paper product. And it didn't fit. And it didn't hold my chin in place.

So .... any recommendations for the best chin strap that works for you if you share a similar problem with dry mouth?

Note: some folks have recommended that I go to a FFM but I have dry mouth/eye issue (Sjogren's) and a nose that is very sensitive to pressure. I need to sleep on my side b/c of persistent pain condition. Also, apneas/hypopneas were worse with supine position when I did my sleep study.

Thanks for your input.

[Julie]

You may never have been told, but frequent bathroom breaks overnight usually clear up with Cpap as they were due mostly to OSA issues to begin with (whether they call it poly- or dysuria or anything else) impacting your whole system including kidneys, etc. And if you have Sjogren's I'm not sure how a chinstrap could be better than taping or a FFM, but if it works for you, terrific!

[Pugsy]

I'm not sure how a chinstrap could be better than taping or a FFM, but if it works for you, terrific!

When taping the lips of course will be closed so the air doesn't escape out the lips but it can still enter the mouth via the dropped tongue (who opens the door to the oral cavity when it drops down out of position). I think it is the air entering the mouth this way that dries out the oral cavity. Someone with Sjogren's is likely simply going to get a dry mouth easier than others.

I suspect the chin strap helps the jaw position keep the tongue in place so that it doesn't fall back and open the backdoor to the oral cavity. What some of us can do naturally on our own (keep that tongue up in the roof of the mouth area to block that backdoor) is helped with the aid of the chin strap.
At least that's how I think it would help.

Full face masks aren't going to do anything to prevent the air from entering the oral cavity via the backdoor and could potentially make the drying of the oral cavity even worse in the situation where Sjogren's is involved.
Full face mask even with max humidity delivery can't fix all dry mouth issues even if Sjogrens isn't involved.

[Sir NoddinOff]

It's good your chinstrap is helping, (I used to like the Ruby chinstrap) but if you want to enhance your results here's a tip. I tend to get dry mouth, tho maybe not as bad as yours. Even with a FFM I dry out more than I like and my humidifier is dialed up pretty high. To counter that, I use the Orajel product linked below and like it the best since it usually lasts all night, plus it tastes good. I tried Biotene but it only lasts for about half the night, or at least that's my experience... it's a drag to have to take off your mask and/or tape and reapply it. Here's the link to Orajel's moisturizing gel:

http://www.amazon.com/Orajel-Mouth-Mois ... B000GGKQMU

[avi123]

It's good your chinstrap (I used to like the Ruby chinstrap) is helping but if you want to enhance your results here's a tip. I tend to get dry mouth, tho maybe not as bad as yours. Even with a FFM I dry out more than I like and my humidifier is up pretty high. I use the Orajel product linked below and like it the best since it usualy lasts all night, plus it tastes good. I tried Biotene but it only lasts for about half the night, or at least that's my experience... it's a drag to have to take off your mask and/or tape and reapply it. Here's the link to Orajel's moisturizing gel:

http://www.amazon.com/Orajel-Mouth-Mois ... B000GGKQMU

Comment,

The Oragel that you stick to the roof of your mouth or to the inside cheeks above your teeth, unless you tie it with a thread to the mask frame for example, can become lose during sleep due the CPAP flow and next you inhale it, and then a Pulmonologist like my sleep Doc knows how to remove it from your lungs. Such things he does almost daily.

[library lady]

Interesting comment, Avi, about Orajel.... glad I don't use it.

Coastal Sun, I use a FF mask, have dry mouth that I call cottonmouth because that's what it feels like. My solution was to get a big double-walled plastic mug with its own cover and straw (connector is directly in line with my mouth, but if it were off-center, I could use a flexible straw). If I wake in the night I pop the connector off my mask and take a sip of water, pop the connector back on and go back to sleep. As soon as I get up in the morning, I have water just a few steps from my bed. This was my routine until about 6 weeks ago when suddenly I wasn't needing water as much. I suspect that the dry mouth hasn't really cleared up, but I've gotten so used to it that I don't notice it much. Now I sleep through the night, only rarely waking up.

[Sir NoddinOff]

It's good your chinstrap (I used to like the Ruby chinstrap) is helping but if you want to enhance your results here's a tip. I tend to get dry mouth, tho maybe not as bad as yours. Even with a FFM I dry out more than I like and my humidifier is up pretty high. I use the Orajel product linked below and like it the best since it usualy lasts all night, plus it tastes good. I tried Biotene but it only lasts for about half the night, or at least that's my experience... it's a drag to have to take off your mask and/or tape and reapply it. Here's the link to Orajel's moisturizing gel:
http://www.amazon.com/Orajel-Mouth-Mois ... B000GGKQMU

Comment,

The Oragel that you stick to the roof of your mouth or to the inside cheeks above your teeth, unless you tie it with a thread to the mask frame for example, can become lose during sleep due the CPAP flow and next you inhale it, and then a Pulmonologist like my sleep Doc knows how to remove it from your lungs. Such things he does almost daily.

Avi123. I know what you're talking about but Orajel moisturizing dry mouth gel isn't the same thing - a company named Quantum makes what you're talking about. I think you're right though… a stick-on patch does not sound that safe and I’ve never used anything like that to moisturize my mouth.

The product I recommended is definitely not a stick-on patch. This is a gel about the thickness of the average gel toothpaste. You put a half inch of the product on the tip of your tongue and smoosh it around, including behind your teeth. There is absolutely nothing to swallow or inhale into your lungs. Feel free to deep breath. Library lady: some people don't want to add more water to their already over-active bladder problems. One problem with one's mouth drying out, even if they get used to it, is that it promotes rapid tooth decay and gum problems... at least that what my dentist told me last visit. Both Orajel and Biotene heavily advertize that their products help the mouth keep a neutral pH balance.

[archangle]

Full face masks aren't going to do anything to prevent the air from entering the oral cavity via the backdoor and could potentially make the drying of the oral cavity even worse in the situation where Sjogren's is involved.

Mouth breathing with a FFM will tend to dry out the mouth, but using a nasal mask and leaking air out through your mouth could dry you out a lot more.

Some people also forget that you can use a chin strap even with a FFM.

I take a 3 inch non-adhesive Ace brand bandage and loop it around 3 or 4 times and fasten the ends together with safety pins. Then I run that under my chin and back up over my head. Not as fancy as some others, but cheap to try and works for me.

[CaptPat]

I use a ruby chin strap, no more dry mouth.

[avi123]

Dry mouth has dozens of causes. In my case it's the medicine that I take. I have dry mouth if I use my chinstrap or not. I use my chinstrap primarily to avoid mouth leak when my mouth open WIDE during sleep. But, even if I sleep without the chinstrap my S9 Autoset is robust enough to diagnose my events regardless of leak.

Here is my recent post on it:
We all know that a chinstrap could reduce the leak level b/c of Mouth Breathing. But to wear those chinstraps is nuisance. I have discovered that I could forgo wearing my chinstrap and the S9 Autoset would continue to treat me as well as without wearing the chinstrap. Take a look:

The following leak graph belongs to a night in which I did NOT wear a chinstrap. Notice that twice the leak values exceeded the red limit line of 24 L/Min. All those M shapes in the leak curve are b/c of Mouth Breathing. Regardless, the machine managed to identify all my left- over events.



The following leak graph belongs to a night in which I did wear a chinstrap. Notice that there is much less leak, and that the machine did a good job. There were still mouth leaks, b/c I don't tighten the chinstrap, but they all had smaller acceptable leaks.
If the S9 could not identify an event then it would have shown it as Unknown and colored yellow.



So I assume that I am OK to forgo wearing the chinstrap.

However, after a second thought I am back to it.

I am using the chinstrap which I specified below. It does a good job of staying on the face and head by applying the right elastic force but its surface is very rough. It's definitely not for a sweet lady with a smooth skin face. I wished that they would smooth up the surface of the strap.

As to the Dry Mouth issue, to overcome my dry mouth I rinse my mouth with faucet water twice a night when I also go to the bathroom. I rub my eyes with the faucet water to remove the sandy feeling, as though there is sand in my eyes. This is b/c of those vent holes in the mask which are too close to my eyes. The stream of air regardless of its moisture content aggravate my eyes. When I told my Ophthalmologist MD about using faucet water on my eyes he made a grimace and asked "what about those amoebas in the faucet water?" So I asked him what if I rub my eyes with distilled water which I also use for the humidifier. He replied that then it would be Ok but pushed a small bottle of Refresh Liquigel eye lubricant into my hand with $3 coupon to go with it (two such coupons). But I prefer Systane instead b/c the Liquigel leaves irritating pieces in my eyes. There is a fierce fight between eye lubricants makers these days.

[CoastalSun]

Thanks for everyone's suggestions:
Julie - I do know that nocturia can be a sign of sleep apnea. When I first started CPAP over a year ago, my nightly visits to the bathroom went from 3 down to 1 and I even had a couple of nights when I didn't get up at all. THAT was a welcome surprise because it had been a several years since I had slept through the night. Since January of this year, I am back to getting up twice, sometimes three times a night to go to the washroom. I can't figure out why. It's not because I drink lots of water in the evening. And I definitely have a full bladder each time. My Sleepyhead date looks great. Low AHI. Low leaks. I do have flow limitations during certain stages ... I'm thinking it's REM.

Pugsy - my Sjogren's diagnosis is 'presumptive' based on clinical symptoms and a lip biopsy that came back with 'no salivary glands present' ... both the ENT (who said he took a rather large piece of tissue because he couldn't visually see salivary glands) and the Internist were surprised but said it supported the Sjogren's dx. I have less of a problem with dry mouth during the daytime.

Sir NoddinOff - I have tried the Biotene gel and didn't find any improvement. I also tried the gel discs that you stick to the inside of your gum near the upper teeth. There wasn't enough improvement for me to continue because I don't like the super sweetness! If only these could be just plain peppermint without the extra sweetness!

library lady - I too, have a glass of water beside my night table and I use a straw. It's easier and drier to sip water with mask on. But thanks for the suggestion of a cup with a lid. Brilliant!

CaptPat .... I have been looking at the Ruby red mask and it looks like a great design. My own 'homemade' chin strap is very similar actually. I'll have to find a supplier here in Canada.

Cheers.

[Julie]

Have you told your MD about the bathroom revisits? You might want to run it by him/her. Or, your system might just have gone in a slightly more 'senior' mode if you know what I mean and one wake-up might not be a big deal. Did you start any new meds at all (even herbal) in Jan?

[CoastalSun]

Julie,
No, no changes in meds. My nocturnal polyuria has been an issue for several years and I have been investigated by a urologist, internist and nephrologist. No answer. Just a puzzle and scratching of heads.
I am too 'young' to have senior issues ha ha, but thanks for the suggestion.
Best.

[SleepyToo2]

CoastalSun, as I am sure you realize, there are many causes. Try looking up polyuria on wikipedia. Some of them may be a bit obscure, and some you can rule out based on the symptoms you have. Some I would take a look at include foods that can cause diuresis, and hormonal changes. The hormonal changes might be difficult to detect if the changes only occur at night. Also, have you checked to make sure that you are not getting hypoxic during the night? If your machine is not set up quite correctly, that could be a source of the waking up.

Regarding the chin strap, I find that I need one - I have just tried going without for a few nights, and my AHI was climbing. Last night I woke up several times because of the leaks: only one bathroom break and that was quite "late" in the night (my usual wake-up time, except at weekends). I also had a dry mouth, with what seemed like "bubbles" of air coming into my mouth (and then out through my lips). Maybe a bit of dehydration during the day yesterday contributed - I have blocked-up sinuses today. Many questions, and no one answer that fits all. We just have to keep looking and tweaking.

[Newbie Woman]

I have a small head and the chin straps I tried on swallowed me. I think perhaps the Ruby would have fit me, but I never got that far. I made my own chin strap from 2" stretchy suspenders. I use the slide so it's adjustable, but it's really just a circle that goes around my head. Sometimes I pull it over my chin and sometimes I leave it on my jaw. Either way, it closes my mouth and helps hold my mask straps against my cheeks. It also seems to "remind" me to keep my tongue in the right position.