mouth leaking during sleep

[Andy_texas]

Dear ALL,
I just start to use the CPAP with nasal mask. I am suffering mouth leaking during sleep.
When I start to sleep, I can close my mouth.
However, I cannot keep my mouth closed when I go to deep sleep. Then, we can be waked up by mouth leaking with vibration and noise in my throat.
Does somebody have solution to it?
Do I have to use the full face mask? How about it? Is it comfortable?
Thanks for your help,
Andy

[Julie]

There are many FF masks and you'll find one to fit you as long as you see qualified sellers who know how to adjust them, in your size, when you're lying down (your face changes a lot then). The hard part is finding those people and finding ones who have more than a couple of styles available to try out, which is why some online dealers (like Cpap.com) let you try out different ones for 30 days if you pay a small return fee for insurance. There are masks popular with many people, but what fits you, when sleeping, is what you need to find. Some of us go through a number of masks when starting out til we find the right one, others get lucky right away, but not many. You can look at what's out there on the website, see pix, read reviews, etc. etc. and see what sounds likely.

[sleepydc]

I have the same problem, and tried different types of masks and also chin straps. I've found a partial taping/full face mask (FFM) solution that works really well for me:

For my FFM (full face mask) use I found it started working a whole lot better when I started using tape. For me, the "partial tape method" solves most of the issues with "mouth breathing" and "draw drop," which interrrupts the seal of a FFM (full face mask) because my face changes shape when that occurs and the seal is broken. It's not for everyone, but here's what I'd suggest:

Some people end up using chin straps with FFM's. I tried and disliked chin straps. I have now been using surgical tape for about a year now, and it has worked wonders and works very well for me. I use silk surgical type tape you can get off of Amazon, 2" wide. There's also a 1" wide version. If you gently pull it off in the morning, there's usually no problem. Just type something like "3M-Durapore-Silk-Tape 2 inches x 10 yards - box of 6" or the like on the Amazon site. For me, it works very well with a full face mask (FFM) -- the FFM helps prevent pressure problems if my jaw does open slightly, and the tape substantially prevents my jaw from dropping and also thereby keeps my face largely in the same "position" as I fall asleep (thereby avoiding the inevitable leaks that can occur when your facial shape changes from the point of initial placement/tightening of the mask). .

I was actually worried about not being able to breath with the tape if there was a shut-down. I've found that this set-up, however, offers very few worries:

For the silk tape, apply a 2inch wide strip vertically from a spot just above your upper lip (the indentation just below your nose) down to just under your chin (with your lips closed and your jaw in a comfortable place). As you bring the tape and press it underneath your chin, "fold" the edge back on itself (maybe a 1/2 inch or so) so that the edge hangs a bit from your chin -- makes for easier removal in case of emergency. Because it's only 2 inches wide and vertically placed, your entire mouth is actually not taped -- you can, in a pinch, breath around the edges -- and the silk tape itself I've found by accident (in opening my mouth with it being placed) will also let a little air in if you open your mouth forcefully. In short, it doesn't take too much force to maneuver or breath around the silk tape, but at the same time the tape seems to mostly keep my jaw from dropping when I relax and fall asleep, which is the whole point. [The setup also seems to work best when combined with the technique, described elsewhere on this site, of learning to relax with the tip of your tongue against the roof of your mouth as your mouth is closed, which "seals" the mouth from the nasal passage and helps prevent dry mouth]. (In placing the tape, I've also found it helpful to focus on firming the contact with the skin at the point below the nose and under the chin more than the lips, which seems to leave a little area of the lip region feeling less taped, if that makes sense). [To remove with less "tear", try pulling up vertically from underneath the chin till you reach your lip, then pull across "horizontally" for the remainder.]

The usual caveats about making up your own mind about this, considering safety issues, etc. apply, of course. But frankly, I'm surprised more people don't do this.

[Macpage]

Dear ALL,
I just start to use the CPAP with nasal mask. I am suffering mouth leaking during sleep.
When I start to sleep, I can close my mouth.
However, I cannot keep my mouth closed when I go to deep sleep. Then, we can be waked up by mouth leaking with vibration and noise in my throat.
Does somebody have solution to it?
Do I have to use the full face mask? How about it? Is it comfortable?
Thanks for your help,
Andy

You got some great advice from Julie and Sleepydc. You can use a full face mask (ffm) and/or work on keeping the mouth closed. I started out with a ffm and have found it to be very tolerable. Of course, you do have to put in some work on the fit and related mask issues. However, this is usually true of all interfaces unless you are one of the fortunate ones who finds a perfect match. I do think it is a good idea to at least learn to tolerate a ffm because then you have a therapy option if you have nasal congestion or a medical condition that precludes a nasal interface.

I used Sleepydc's advice and taped to optimize therapy with my ffm. It worked great for me and is really comfortable. It also allows me to try other types of interfaces as well. Of course, it has to be comfortable to you, and you have to be well versed in all aspects of risk. You can work on strapping as well. I have seen many techniques and devices beyond the typical chin strap. You can do a site search on "mouth leaks", etc., and read about many. You can also practice keeping your tongue in a position that seals the mouth better for therapy.

Keep in mind that some mouth leaking is ok. If you are monitoring your therapy with software like Sleepyhead, you can look at the leak data to see if mouth leaks are problematic. Of course, if it's often waking you up as you mention, you will need to solve the issue.

In regard to the newer minimal ffm's, I have not found them to be much less comfortable than traditional nasal masks or nasal masks with traditional headgear. Now, if you are currently using a small nasal mask with lightweight headgear or nasal pillows, you may have more of an issue getting comfortable with a ffm. Many posters are having success with these newer ffm designs including the Resmed Quattro Air, Resmed F10, and F & P Simplus. The 2 Resmeds use the same cushion with the Quattro having a forehead strap/stabilizer, and the F10 having a clean line of sight. Both have user friendly features, lightweight headgear, and lightweight frame/cushion. The Simplus also has a lightweight frame/cushion with a forehead strap/stabilizer and a traditional 5 point headgear. These are a good place to start, but there are many other models and hybrid designs that could be your perfect match. You have nothing to lose from trying, especially if you use the return insurance from our hosts at cpap.com or the trade policy from your equipment provider. Good luck!

Best,

[Tino2You]

Andy,
I have been on CPAP for a couple years now, when I started I had the same problem. I purchased a Ruby Adjustable chin strap. I started out putting it on fairly tight. It worked. I was also told to try to put my tongue behind my front teeth and on the roof of my mouth. With it there, your airway is sealed. The trick is to train your brain to keep it there. After a few months, I did not tighten the chin strap as much. After about 4 or 5 months, I put it on loosely as a reminder for my brain. About 6 or 7 months into it, I forgot to take it home from a trip. I was panicking when I got home. I went to sleep that night and discovered that I kept my tongue in place for most of the night. That was well over 18 months ago. I, on occasion, wake up with my lips fluttering or air escaping from an open mouth but it is relatively rare.

YMMV,

-tino

[sleepydc]

Andy,
I have been on CPAP for a couple years now, when I started I had the same problem. I purchased a Ruby Adjustable chin strap. I started out putting it on fairly tight. It worked. I was also told to try to put my tongue behind my front teeth and on the roof of my mouth. With it there, your airway is sealed. The trick is to train your brain to keep it there. After a few months, I did not tighten the chin strap as much. After about 4 or 5 months, I put it on loosely as a reminder for my brain. About 6 or 7 months into it, I forgot to take it home from a trip. I was panicking when I got home. I went to sleep that night and discovered that I kept my tongue in place for most of the night. That was well over 18 months ago. I, on occasion, wake up with my lips fluttering or air escaping from an open mouth but it is relatively rare.

YMMV,

-tino

Tino's advice is another example for me of how there can be many roads to a variety of solutions. The thing is to keep trying, and figure out what works best for you. Some people wouldn't be able to tolerate even the idea of partially taping one's mouth. I had a really hard time with the chin straps, even with falling asleep while using them -- and I've found that the partial taping I do eliminates even the occasional "mouth open, now I'm awake" scenario. But to each, his/her own. This is a great place to come for advice, and there are lots of good people out there who are paying it forward -- like Tino and Macpage and Julie in this thread and many others. Best wishes, and good luck!

[SilverIce]

I'm about 2 months into therapy and had mouth leak issues as well. Even with a FFM, I'd wake up with a dry mouth/throat and even have a bit of drool pooling around my chin. I tried a chin strap but really didn't like all of the gear on my head at bedtime. About a week and a half ago, after reading about it on here, I tried tape. Just a single strip of medical tape across my lips and it's been working really well. I'm even able to use a nasal mask with good results.

[cwillis]

I don't mean to hijack this thread and realize I've been asking a lot of advice on this forum, but I have to ask: what is the purpose of taping mouth when wearing FFM?

[tan]

I don't mean to hijack this thread and realize I've been asking a lot of advice on this forum, but I have to ask: what is the purpose of taping mouth when wearing FFM?

To minimize jaw drop, with "partial" taping (1' wide vertical strip from right under the nose to the chin)

[cwillis]

I don't mean to hijack this thread and realize I've been asking a lot of advice on this forum, but I have to ask: what is the purpose of taping mouth when wearing FFM?

To minimize jaw drop, with "partial" taping (1' wide vertical strip from right under the nose to the chin)

So this could be the reason of my lower mask leak in morning time?

[jpjim]

I was actually worried about not being able to breath with the tape if there was a shut-down

[Macpage]

I'm about 2 months into therapy and had mouth leak issues as well. Even with a FFM, I'd wake up with a dry mouth/throat and even have a bit of drool pooling around my chin. I tried a chin strap but really didn't like all of the gear on my head at bedtime. About a week and a half ago, after reading about it on here, I tried tape. Just a single strip of medical tape across my lips and it's been working really well. I'm even able to use a nasal mask with good results.

I really happy for you! It's great being able to try some new interfaces! It really gives me an extra boost of optimism about the therapy. I'm waiting on nasal pillows to try at the moment.

Sleepydc's advice was just what I needed. I had never thought about taping with a ffm until reading it. I'll always be grateful for all the help from the posters!

Best of luck going forward!

Mike

[Macpage]

I don't mean to hijack this thread and realize I've been asking a lot of advice on this forum, but I have to ask: what is the purpose of taping mouth when wearing FFM?

To minimize jaw drop, with "partial" taping (1' wide vertical strip from right under the nose to the chin)

So this could be the reason of my lower mask leak in morning time?

It could be. It certainly was in my case. My leak lines were much better after, and I never woke up with the lower seal of the F10 in my mouth. Good luck!

Best,

Mike

[Macpage]

I was actually worried about not being able to breath with the tape if there was a shut-down

I kind of figure after not breathing for minutes at a time over the years and not waking up that I have a built in margin of error!!!

All joking aside. You have a vailid concern to consider for yourself. As has been mentioned, you have to be well aware of the risks and the conditions that preclude taping. Ultimately, it has to be comfortable to you.

I do find that with Sleepydc's vertical method and 1" tape that "I" can open my mouth fairly easily. I can talk, drool, burp (aerophagia), etc. Some types of tape like the medical perforated plastic let a little more air through than the medical paper or household types of tape.

It's really pretty comfortable to "me". Only you can decide for yourself. Good luck!

Best,

Mike

[SilverIce]

I really happy for you! It's great being able to try some new interfaces! It really gives me an extra boost of optimism about the therapy. I'm waiting on nasal pillows to try at the moment.

I started with pillows. In addition to mouth leakage, the direct pressure up my nose caused my eyeballs to be sensitive/sore. Luckily I found a good DME that was willing to work through my mask woes with me until I wound ones that worked.