Mouth Breathing

[GuestStar]

It has been three days since my SO started using a CPAP. I'm wondering about mouth breathing. He is prone to do this while sleeping, so we got a chin strap (mask is nasal pillows). However he still worries about it and this morning told me he woke up and was pretty sure he was mouth breathing at some point last night. Is this detectable in the data, and if so what would be indicative of this?

As someone without sleep apnea and who has never used a CPAP machine, I don't know what it feels like or if mouth breathing is even significant, but I want to optimize things as much as possible for him. I figured he always slept with his mouth open as a reflex to deal with bouts of not breathing, if that makes any sense. Thanks.

[mummmz]

He might need a full face mask. Please put the equipment used in your user profile then download SleepyHead and post last nights screenshot. You'll need to upload the screenshot to Imgur to post it. Lots of posts about how to do it. Also read the pinned post at the top about SleepyHead.

[Pugsy]

Mouth breathing will show up as a leak if there's enough of it going on to create a loss of therapy pressure out the mouth.

Use the software available (hopefully his machine gathers and reports leak data) to see exactly what the leak situation is.

Sometimes it's pretty bad and something needs to be done but it might not be all that bad and not need anything to be done about it.
It all depends on how much large leak is going on...how far into large leak territory he may be going and how long he stays there.
Not all mouth breathing automatically means a person just has to go to a full face mask or even use a chin strap.

I mouth breath on occasion. I know I do because I wake up with my mouth open and it dry as the Sahara but when I look at the actual leak graph it might be only 5 minutes of just barely into large leak territory and 5 minutes out of 7 or 8 hours isn't going to harm the overall therapy that much.

So it's best to learn to evaluate the amount of large leak and what it means before going into panic mode about mouth breathing.
5 minutes isn't nearly the end of the world...now 50 minutes might mean a different discussion depending on just how far a person goes into large leak territory.

So...exactly which brand and model machine and mask is he using?

Information on software can be found here
https://sleep.tnet.com/equipment

If you use the software and don't have a clue what you are looking at and wish to have someone here review it
see this thread for examples of what we need and instructions on how to post the images
viewtopic/t103468/Need-help-with-screen-shots.html

Alternately...depending on the machine model there may be enough information about leak on the LCD screen to give us sort of an idea if leaks are problem or not and thus would need more investigation using the software.

[GuestStar]

My display is small, so I cannot fit all the data in one image. So first two are last night, second two are the night before. The mask is a "Nuance". I hope this is adequate information.

Images here

[Pugsy]

Respironics DreamStation Auto CPAP machine in Auto mode.

If you are doing any mouth breathing it sure isn't very much and there's no large leak flags on either of these 2 nights (LL in the events graph means Large Leak).
I wouldn't worry about mouth breathing if this is what you are seeing most of the time.
Large leak territory for you will vary since your pressures vary but somewhere up around 80 L/min and you never get close.

If you hit LL territory the machine will flag it up on the Events graph and unless you see large prolonged flagging....I wouldn't worry about it.
Your choice if you wish to continue using a chin strap or not.
For sure don't need a full face mask though...unless you just want to use one.

When using SleepyHead it defaults to ResMed 24 L/min red line threshold and it possible for the % of time over red line statistic to be incorrect and look worse than it is because of this calculation.
I suggest you change that 24 L/min to something around 75 L/min so that SleepyHead won't tell you that you are leaking when you aren't.
Go to Preferences/CPAP tab and look on the right and change the red line number from 24 to 75 or 80 or remove the check mark to just turn off that calculation.
The most important data point to watch...the events graph where LL flags would show up.

[Holden4th]

I know that I do some mouth breathing, probably while supine, as I experience some of the dryness that Pugsy mentioned.

When I first went onto CPAP I couldn't get to sleep because of this issue. I tried a chinstrap and while it worked it wasn't very comfortable. I then discovered that a soft cervical collar could do what the chinstrap could and much better.

Some days my data shows large leaks that could be mouth breathing but could just as easily be mask leakage. I don't worry about it as it's minimal.

It sounds as if your SO has no real issues.

[GuestStar]

Thank you so much for looking at the reports and commenting. I'm glad everything seems normal, it is very reassuring to have experienced people look at the data.

Last night his AHI was 3.2. I hope over time this number will be below 2 consistently. In a couple days we will not be home and so we are debating bringing the humidifier or not. He's so new to the therapy it seems unwise to experiment without the humidifier but I know most people don't travel with it.

[Pugsy]

He's so new to the therapy it seems unwise to experiment without the humidifier but I know most people don't travel with it.

I don't know that "most people don't travel with it"....I never travel without my humidifier. I learned a long time ago that my nasal mucosa didn't like getting dried out and it was a pretty miserable learning experience. In fact I am getting ready to fly to Vegas tonight and my humidifier is already cleaned and packed along with my blower in the travel case.

A lot of people do travel without the humidifier but they probably don't use much added moisture in the first place. Either that or space is at such a premium that they give it up for something else.
For me...something else would have to be left behind if space was that critical for me. I don't do well at all without my humidity and it takes days for my nasal mucosa to get back to normal just from one night of getting too dry.

Unless your space is really at a premium and you know for sure hubby could get by without humidity...take it along. Don't ruin the trip by changing things until you know what might happen.

[Jdansti]

I have "open mouth syndrome" and tried full face masks, but couldn't get a good seal. Then I tried a chin strap, but air escaped through my flapping lips even though my jaw was shut. The noise kept waking my wife. The final solution was to take an old necktie, cut it to length, and sew Velcro onto the ends. I wrap it around my head and across my lips. It puts just enough pressure on my lips to seal them. I can still open my jaw and breathe through my mouth if we lose power and my machine shuts off, if I need to sneeze, or to say something to my wife. This may seem like a crazy solution, but it works very well for me. I can't sleep without it.

My doctor recommended sealing my lips with paper medical tape, but it was really rough on my lips. I started losing lip skin after a couple of nights. It also meant that I couldn't sneeze through my mouth or talk to my wife without removing the tape and reapplying it.

[palerider]

I have "open mouth syndrome" and tried full face masks, but couldn't get a good seal. Then I tried a chin strap, but air escaped through my flapping lips even though my jaw was shut. The noise kept waking my wife. The final solution was to take an old necktie, cut it to length, and sew Velcro onto the ends. I wrap it around my head and across my lips. It puts just enough pressure on my lips to seal them. I can still open my jaw and breathe through my mouth if we lose power and my machine shuts off, if I need to sneeze, or to say something to my wife. This may seem like a crazy solution, but it works very well for me. I can't sleep without it..

another very similar thing I've heard is to take a terry cloth sweatband that'd you'd normally wear on your forehead, and pull that down over your lips... same thing, encourages them to stay closed, but isn't cumbersome or painful to remove like tape. get several, just toss 'em in the wash.

[Jdansti]

another very similar thing I've heard is to take a terry cloth sweatband that'd you'd normally wear on your forehead, and pull that down over your lips... same thing, encourages them to stay closed, but isn't cumbersome or painful to remove like tape. get several, just toss 'em in the wash.

Great idea about the sweatband!

[Holden4th]

There are also these

http://www.snoringdevicesthatwork.com/c ... ip-review/

I haven't tried them but am interested.

[Jdansti]

There are also these

http://www.snoringdevicesthatwork.com/c ... ip-review/

I haven't tried them but am interested.

The Chin-ups look like they might work for someone who doesn't blow air through their lips while their jaw is closed. My problem is I blow air though my teeth and lips when my jaw is closed, so I need something that covers my lips.

[Jay Aitchsee]

Here's an alternative:

Here's an item I suggest rather than tape. It's a stretch headband made from a thin, soft cotton like material similar to that of a T shirt. It is double thickness (a tube), but still thin. The material is stretch and inside at one edge there is a narrow elastic band. It doesn't unravel when cut. It is about 2.5 inches wide and fits nicely between the nose and chin. I think it would fit most without being too tight or loose. Wear it just like a headband only pulled down over the mouth and ears. I cut holes for my ears. It does not interfere with a P10 or Dreamwear nasal mask. When it is worn with the internal band down, it tends to keep the bottom lip closed. It is porous so that chipmunk cheeks are less likely to form, but at the same time, it restricts the flow and reduces mouth leaks considerably. It also softens the noise of mouth leaks and discourages mouth inhalation. I've worn it for about two months and it has reduced my average nasal mask leaks (mouth) from an average of about 12L/m to about 5 rarely exceeding the large leak mark. I've see them sold at various places including grocery and drug stores. They cost about $5 for a set of five and are washable. One set should easily last a year. Here's some at Amazon.



P.S. I put the head band on and marked it with a pen to determine where to cut the ear holes.