First night -- need help with a problem

laurie2025 · Post by **laurie2025** » Sat Nov 25, 2006 8:45 am

Last night was my first night, and it didn't go all that great, but it wasn't terrible either. It was hard adjusting to sleeping with 'gear' on my face and head, and I was a little paranoid about keeping the seal. I woke up a number of times, and I think most of the sleep I got was very light. But all in all, the only big problem was that every now and then, even though I had my mouth taped, my mouth and my cheeks would fill with air; I felt like a chipmunk storing nuts for the winter. I had to lift off a tiny bit of the tape to let the air out, and then reseal the tape. Anyone know why that would happen? I can't figure it out, or how to prevent it. I'd also like some recommendations on different tapes to try.
(I knew I needed tape because my mouth kept opening during my 2nd sleep study with the mask).
Thank you,
Laurie

oldgearhead · Post by **oldgearhead** » Sat Nov 25, 2006 9:06 am

I'd also like some recommendations on different tapes to try.

It sounds like you're off the a good start. Just keep at it. it will get easier and the sleep will become deeper.

The "Blowfish" face is quite normal. I think its a function of the inhale/exhale/C-Flex timing. The first thing to try is all of the four C-Flex settings. I seem to have less "Blowfish" attacks with a setting of 1. But I think this is a very individual thing.

I use 3M (Nexcare) Micropore paper tape, and don't forget the ChapStick for your lips. The Mocropore tape will allow air to pass through it. So, when I catch the "Blowfish" I part my lips a bit and force the air pressure out. So far, the "Blowfish" hasn't attacked me after I fall asleep. If this continues to be a big problem, about the only cure is a full-face mask. Of course the FF mask comes with its own set of challenges.

Sleep well,

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX

laurie2025 · Post by **laurie2025** » Sat Nov 25, 2006 9:32 am

The CFlex function isn't setup on my machine.

Thank you for the information,
Laurie

Goofproof · Post by **Goofproof** » Sat Nov 25, 2006 10:08 am

[quote="laurie2025"]The CFlex function isn't setup on my machine.

Thank you for the information,
Laurie

jum001 · Post by **jum001** » Sat Nov 25, 2006 10:11 am

Unfortunately, using a full face mask isn't the solution either. I use the UMFF and still get the "blowfish" (tho I've been calling it chipmunk cheeks) when sleeping on my back. I don't have a solution except to sleep on my side which makes the orthopedic doctor happy.

Guest · Post by **Guest** » Sat Nov 25, 2006 10:22 am

I'm not so sure that the "chipmunk cheeks" or "blowfish" occurence IS the result of attempting to mouth breathe. I assume it probably occurs occasionally when I am sleeping too, but I've had it happen on occasion when I am fully awake. I can be breathing comfortably thru my mask w/no leaks and all of a sudden I can feel my mouth starting to fill w/air and voila: "chipmunk cheeks". I do agree tho that tongue position seems to have a lot to do w/it. And that tongue position seems to just come to you automatically after awhile. On the other hand, when the "chipmunk cheeks" have occurred I've not been aware of any change of tongue position. I've even learned how to swallow w/o choking on air w/my mask on. Amazing what we can ultimately adjust to!

tooly125 · Post by **tooly125** » Sat Nov 25, 2006 12:42 pm

Give it some time your chipmunk cheeks just might go away on their own.
Mine did.

Goofproof · Post by **Goofproof** » Sat Nov 25, 2006 12:53 pm

Mine was just every now and again, when I learned to park my tongue it want away. the reason the FF mask helped was the lower straps held my cheeks in. A strap could be fashioned todo the same thing.

Swallowing the air can end up being painful, worse than Chipmonk Jaws. Maybe a couple of tablespoons of peanutbutter in your jaws, would hold them deflated, It used to work for my Dog. Jim

IORHHI · Post by **IORHHI** » Sat Nov 25, 2006 1:01 pm

I get inflated cheeks sometimes even with the full face mask. But it's under my (your) control.
The difference is a slight amount of mouth suction -- what I use to keep my mouth shut and my teeth together.
Experiment without the mask -- close your mouth, notice what keeps your jaw up and your cheeks uninflated, then exhale some air into your mouth. Allow it to inflate your cheeks, and then make it go away. Notice what you do differently so that an exhale doesn't inflate your cheeks.
I think it's suction, plus keeping your tongue on the roof of the mouth and the cheeks sucked in in the back to make a seal. If you allow the back of your cheeks to separate from the teeth/jaw the seal breaks and the cheeks inflate.
When I am on my back (not my usual sleeping position) I sometimes allow my cheeks to fill with air to stop the stupid mask from farting.

Barbara

Guest · Post by **Guest** » Sat Nov 25, 2006 1:04 pm

Ah, loverly blowfish. I had the same problem, I am on night three and I finally figured it out.

Oh, and if you have the time, take naps during the day with the CPAP to get more frequented testing in.

The first thing you need to know is how to adjust the airflow. Look in the manual or maybe it is a one page card.

My doctor had the technician set it to 12cm! But that gave me blowfish all night. So... I found the manual and put it down to 10cm that was still too much, so last night I put it down to 7cm and it worked like a charm. So, now, I cam creep back up to the prescribed amount of 12 cm but will do it over a week or more.

This is the problem, when you first start using a CPAP device your lungs cannot expand enough to take in all of the air, but it is like working out on a tread mill, you need to get used to it. So, you lungs will actually become more flexible the more you use the CPAP device.

I tried not to be mad at my doctor, but I was wondering why they didn't give me this honest advice, probaby 'cause of liability?

The technician did tell me, "hit the ramp button as much as you like", but that requires being awake. Oh, and my ramp is set at 4 cm and takes 45 minutes to reach my regular setting.

Please let me know if you have a Resprironics M series and I can tell you how to set the peak flow, but you need to promise that you will work towards your prescribed number. If it is set too low, you will continue to have sleep apnea.

Mark T.

rested gal · Post by **rested gal** » Sat Nov 25, 2006 1:55 pm

I didn't see this topic until after I'd already answered a PM Laurie sent me. So, still being lazy after Thanksgiving, I'll just post my reply here.

Hi Laurie,

It was good to hear from you. The tape I've used for several years is Johnson & Johnson waterproof adhesive tape -- the one inch width size. I have to slightly overlap two strips of that to completely cover well above and below my lips.

However, recently I've started using 3M micropore tape, in the two-inch width size. One strip of that covers completely. It holds better than the J&J tape I'd been using. Of course, that means it's a little "ouchier" to get off in the morning than the J&J. So far (3 nights) the micropore tape hasn't caused any irritation or rash around my mouth, the way two other tapes (Nexcare and Tegaderm) I had tried do.

I guess each person's skin is going to react differently to different tapes' adhesives.

As for a taped mouth filling up with air -- cheeks ballooning out, or "blowfish" effect as some call it -- the kind of tape you use is not going to stop that. You'd have to put a strap of some kind around your head, over your cheeks, to keep them flat if the ballooned cheeks bother you. I've had that happen sometimes while I'm drifting off to sleep. To get rid of it, you can suck your cheeks inward and use your tongue to work the excess air backwards until you get the air moved back far enough that it gets caught by the air you're continuing to breathe and is whisked on down. Just don't swallow the air. If my cheeks puff out while I'm asleep, I don't notice it.

There's no leak in the tape when you notice your cheeks filling out with air. In fact, that's a sign that the tape is holding well and you're NOT leaking air out your mouth. That air that puffed your cheeks out was cpap air detouring into your mouth from behind..from back at the throat area. If you weren't using tape, that air that puffed your cheeks out would have been gushing out your mouth.

Gosh, the things we do to get "good treatment". LOL!!!

Good luck,

Laura

I'll add this... for some of us it doesn't matter where we park the tongue, or what the pressure setting, or how long our bodies have become accustomed to breathing cpap pressurized air.

For some of us there's always going to be a seeping (or gushing!) of cpap air into the mouth from the back of the throat IF some part of the tongue relaxes enough to allow that. For me, that tongue relaxation happens at the back -- in the area around the back molars.

That cpap air detouring into the mouth from the back can balloon the cheeks out if tape is keeping the lips securely closed and there's nothing keeping the cheeks flattened.

If there's nothing at the lips to hold it back, and relaxation of sleep causes the tongue to not maintain an airtight seal INSIDE the mouth, cpap air detouring into the mouth is simply going to escape as a mouth air leak. Wrecking good treatment because air blowing out into the bedroom is not helping keep the inside of the throat open.

It all depends on the geometry of the inside of the mouth and the tongue of each individual as to whether the tongue is going to hold an airtight sealing position inside the mouth all night during the complete relaxation of sleep.

For some, their mouth/tongue geometry is such that just a simple chinstrap to keep the jaw from dropping will keep the tongue in a sealing position. But for many of us, it doesn't matter how "closed" the jaw is, even to the point of clenching our teeth. For many of us, even with a chin strap keeping the jaw tightly closed, the tongue just can't keep an airtight seal inside the mouth. We just will get mouth air leaks.

Lucky, lucky, lucky are the people whose mouth and tongue geometry naturally lets them maintain an airtight seal inside the mouth during the total relaxation of sleep!!! They don't need a FF mask, or tape, or polident strips, or a NoseBreathe device, or a DIY boil'n'bite mouthguard. The lucky people just put on a mask and switch the machine on. No leaks. It's ok to hate them.

viewtopic.php?t=8011
Links to: Mouth leaks - Air Leaks - Tape - DIY Guard

ozij · Post by **ozij** » Sat Nov 25, 2006 3:38 pm

The lucky people just put on a mask and switch the machine on. No leaks. It's ok to hate them.

You are a riot!

O.

laurie2025 · Post by **laurie2025** » Sat Nov 25, 2006 3:50 pm

Any other animal we can relate this to?
I think that I am going to try setting the CFlex on my machine. I was told how to add that as one of the settings, and I will try it on 1 and work my way up if necessary. I am also going to try the micropore tape in lieu of what I was using and if that doesn't work I will try a chin strap, but I sure would like to avoid that. I am also going to pay attention to any perceived changes in my tongue/cheek position when I get the 'blowfish' problem.
I was told not to swallow the air that it can be painful??? I'm not sure I understand that but I'll try not to do it.
Thanks,
Laurie

Guest · Post by **Guest** » Sat Nov 25, 2006 3:54 pm

LOL Rested gal you can hate us. But some of us close so tightly that we then develop jaw problems.

Thanks for the description of what happens in our mouths.

rested gal wrote:
Lucky, lucky, lucky are the people whose mouth and tongue geometry naturally lets them maintain an airtight seal inside the mouth during the total relaxation of sleep!!! They don't need a FF mask, or tape, or polident strips, or a NoseBreathe device, or a DIY boil'n'bite mouthguard. The lucky people just put on a mask and switch the machine on. No leaks. It's ok to hate them.

SelfSeeker · Post by **SelfSeeker** » Sat Nov 25, 2006 3:58 pm

that was me

First night -- need help with a problem

First night -- need help with a problem

Cflex

Re: Cflex

chipmunk cheeks - blowfish

Mask