How probable is it to reform a mouth breather?

[cathyf]

I have slept with my mouth open for as long as I can remember, and now that I've been diagnosed with OSA I am paying attention to it.

1) One of my significant sleep disturbances is waking up with a terribly dry mouth. Sometimes I have to get up and get a drink, other times I sit there awake and groggy for 15-20 minutes trying to get the saliva going.

2) I am not a mouth breather while awake - just sitting here reading my mouth is shut and I breathe easily through my nose. I open my mouth to talk, sing, and shove food in (all of which I do too much of!) but otherwise breathe through my nose.

3) When I lie down to sleep, if I am not sleepy, I still have mouth shut and breathe easily though my nose. As I get sleepy, it feels like my nose closes up, and before I'm actually asleep I have to start breathing through my mouth or I don't feel like I'm getting enough air. Just nose breathing is really noisy as well as feeling smothered, so I think my nasal passages really are narrowing.

I think I may finally be getting my APAP (resmed A10) today. (Yeah! They arrived at the DME on Wednesday, and I'm hoping that I can get in sometime today to take it home.) Last week I asked for a full-face mask because I'm a mouth breather, but I'm also wondering what my chances are to becoming a nose-breather while asleep? Is there anyone else out there who has experienced a nose that narrows while they are asleep, and does the PAP fix that? Theoretically, that's the sort of problem that the increased pressures are supposed to fix, right? The full-face mask covers nose and mouth, right, so if the pressure does splint my nasal passages enough to breathe easily through my nose, then if I keep my mouth shut it will just work, right?

Given that I wake up several times a week from dry mouth, I would really like to figure out if I can sleep with my mouth shut...

[Pugsy]

You won't know until you try.
I will share this....prior to cpap therapy I would wake with dry mouth and sore throat...thought I was a "mouth breather" at night despite not needing to mouth breathe during the day.
I didn't want to go the full face mask route...various reasons which are as good as any.
Come to find out my "mouth breathing" was most likely simply habit from gasping for air during the night associated with the apnea events. Fixed the apnea events and the mouth breathing mostly went away. I say "mostly" because I know I still do it on occasion as old habits are really hard to break. I end up on my back and my mouth flops open...it's just gravity and habit. I don't have nasal issues that are forcing me to mouth breathe.

I did tape my mouth for about 2 months when I first started therapy as the habit was pretty bad then but over time the habit lessened. While I know I still do the mouth open thing on occasion...it doesn't last very long when I do and often I don't even go into large leak territory so I really don't care if I mouth breathe for 15 or 30 minutes out of 7 hours of sleep.
I sleep right through it and I know that using tape or a chin strap or a full face mask would cause me more problems than it fixes.

So....at least give yourself the opportunity to try a nasal only mask if that's what you want to do.
Full face masks don't prevent dry mouth for everyone. They only prevent loss of therapy pressure by keeping a closed circuit. It's the mouth breathing that dries the mouth out and the humidifier simply can't always rehydrate the mouth well enough even if at maximum humidity. The oral cavity is just too big for the humidifier to get the job done. It is designed to help hydrate the nasal cavity which is much smaller.

As long as there is no physical need (bad nasal congestion that you can't get cleared up) there is no reason not to try the nasal masks if that is what you want to do. Just "wanting to" is a good enough reason in my book (so is "not wanting to" ) to do or not do anything.
Yeah, you may have a bit of a habit to break but it isn't impossible to break. I am not alone with the breaking of that mouth opening habit.

You won't know until you try though and it may take a bit of time to break the habit if that is what is going on with you but it can be done.

Have you ever tried nasal rinses or saline spray at night to maybe help prevent that "narrow" feeling you get as you drop off to sleep? That's something that wouldn't hurt to try if you haven't already.
I find that the moisture helps a lot and usually do a couple squirts of simply saline type of nasal spray every night right before bed.
Nasal passages should not physically narrow with just sleep only. If they are related to reclining they would narrow while you are awake. Makes me wonder a bit if what you are feeling just when you are nodding off is related more to the OSA and the airway tissues themselves. Now if you said...I lay down and my nose closes off while awake too..then I would worry but to be able to lay in bed for any length of time and not have any congestion issues UNTIL sleep onset....that's unusual as I can't thing of anything physically that would do that.. If you lay in bed for an hour and breathe just fine through your nose...and then it gets clogged up with just sleep onset...that doesn't sound like laying in bed causes it

Anyway...make sure you get a nasal mask of your choice to try. If you don't you will always be "what iffing"....like what if it would work for me.
I personally prefer nasal pillow masks myself...less surface area to have to mess with in terms of getting and keeping a good seal.
Plus my nose gets congested from just the weight of any mask that sits on my nose bridge where the turbinates are.
Even my sunglasses causes my nose to get congested. That's another reason I didn't want to go the full face mask thing...they pretty much all have to sit on my nose where it gets congested if anything sits on it.

[Wulfman...]

The things that worked for me have been:

Using a full face mask.
Doing nasal cleansing before bedtime (or other times during the day when I felt congested).
Using cool, "passover" humidification. (HH is turned off)
Training my tongue to stay on the roof of my mouth while I sleep.

I had been a dedicated mouth-breather for my whole life. Now, I'm not......and especially when I sleep.


Den

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[drbuck]

You can always try the digeredoo. I saw it on the Doctors. Also Vitamin D at appropriate levels will help you breath appropriately at night.

[Wulfman...]

You can always try the digeredoo. I saw it on the Doctors. Also Vitamin D at appropriate levels will help you breath appropriately at night.

Please cite any CREDIBLE evidence to THAT!


Den

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[cathyf]

I take 8000 IU of vit D per day, and manage to keep my blood levels at low-normal. For four years.

[Wulfman...]

I take 8000 IU of vit D per day, and manage to keep my blood levels at low-normal. For four years.

Me, too.


Den

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[49er]

I take 8000 IU of vit D per day, and manage to keep my blood levels at low-normal. For four years.

What do you consider to be low normal?

Mine came out to 60 at 3000IU. PCP wanted me to cut back because she felt 30 was sufficient. I don't feel very well at less than this amount and according to data I have seen, 80 is an acceptable upper limit.

49er

[cathyf]

What do you consider to be low normal?

According to my lab printout, "normal" is 30-100. I generally come in at 40-45 -- although I saw a 55 once a couple of years ago.

According to my endocrinologist's lab tech, since they started testing every patient they find about 80% are below 30. This isn't a random sample, though, mostly diabetes and thyroid with a sprinkling of more exotic endocrine problems.

[jencat824]

Cathyf,

I'm a reformed mouth breather. What did the trick for me was having to wear my new Invisalign braces at night. They are basically a plastic tray molded to the shape of my teeth, meant to gently move the teeth. To achieve the same effect you could get one of those boil-n-bite jobs at the drugstore & follow the instructions. Having something in my mouth to bite on seems to be keeping my mouth shut. My family would love to try that while I'm awake.

Another approach might be the Tap Pap mask. You might ask Pugsy's opinion on this, I've never used that mask, but it seems the general principal would work the same. Mouth full + teeth biting = mouth closed.

I previously had tried chinstrap, cervical collar, mouth taping & a sweatband over my mouth. I had some success with some of this, but once I started my orthododtic work, my mouth clamped shut. My leak line went from jagged to almost flat. My leaks scored low in SH & 0% in Encore.

I don't know why this worked for me, but it did. You might find a boil-n-bite worth a try. They are usually less than $20.

Jen

[49er]

What do you consider to be low normal?

According to my lab printout, "normal" is 30-100. I generally come in at 40-45 -- although I saw a 55 once a couple of years ago.

According to my endocrinologist's lab tech, since they started testing every patient they find about 80% are below 30. This isn't a random sample, though, mostly diabetes and thyroid with a sprinkling of more exotic endocrine problems.

Thanks cathyf, that is interesting what the tech said about how many people are so low. Regarding your OP, when I started pap therapy at the beginning of 2012, I would have sworn I was a mouth breather since I estimate that my nasal breathing capacity is about 60% during the day. As a result, I went through what I call FF mask h-ll for several months in trying to find one I could wear without having to massively tighten it to avoid leaks.

Finally, thanks to a good friend who provided me the cloth mask that is listed in my profile, I decided to move away from FF masks. My leak levels have been decent to great although unfortunately, sleep didn't improve. But I wonder if I had started off with this mask right off the bat if perhaps I would have done better with my sleep and not wasted so many months struggling with FF masks and seeing things deteriorate.

I think one reason I didn't realize the cloth mask might work is I had tried a plastic nasal mask on initially when I went to a mask fitting session at the sleep lab that had done the home study test and felt like I was suffocating from lack of air. But I now realize that was due to the pressure not being high enough and unfortunately, on this basis, made the assumption that I couldn't wear a nasal mask.

Of course, I don't know for sure but my point is to everyone, particular newbies is to not make any assumptions about what masks you can wear, particularly if you're struggling with a particular class like I did with full face masks. Don't make my mistakes and be willing to experiment quickly if things are going South on you.

49er

[archangle]

You can always try the digeredoo. I saw it on the Doctors. Also Vitamin D at appropriate levels will help you breath appropriately at night.

The percent of people who are significantly helped by either of these things is very low. Take a reasonable level of vitamin D but don't go overboard. Vitamin D is one of the vitamins that can be toxic if too much is taken. Many of the over the counter pills exceed the recommended maximum dose.

https://en.wikipedia.org/wiki/Hypervitaminosis_D

As for mouth breathers, some people are cured once they start CPAP, presumably because opening the mouth is one of the ways their brain fights lack of air. Some people learn not to open their mouth. CPAP pressure may cause you to open your mouth. Some people like me seem to be incurable except by a chin strap.

[raftergirl]

I've been on cpap for two months. I use a nasal mask. At first I didn't think I was opening my mouth at night, but after the first week I was waking up with a terrible dry mouth. Sahara desert dry, like my tongue was painfully glued to the roof of my mouth dry. I thought that perhaps my higher pressure settings (15-17) were the culprit, but I also was fairly congested with the cpap as well. So I tried a FF mask.....8 different ones to be exact. I couldn't find one that fit my small face without terrible, loud, and unacceptable leaks. So I went to the chin strap. I also got advice here on the forum. and lowered the temp. on my heated hose. Turns out my nose likes cool, moderately moist air the best. After wearing the chin strap for a little over a month, I decided to try without it again. Much better now. Still alittle dry when I wake up, but more like normal "morning mouth," not painfully dry desert mouth. My leaks are minimal, my AHI is great, and I sleep more comfortably without the chin strap. The chin strap wasn't terrible, and if I need to use it in the future I will. I think that between getting used to my pressures and cpap in general, plus getting my heat and humidity dialed in, plus maybe "training " my tongue to stay on the roof of my mouth, I was able to improve.