New CPAP user (~1 week) and only one issue so far

[cake321]

The only issue I've noticed so far is that when I wake up, my front two top teeth, as well as my bottom front 4 or so teeth feel kind of "sore". I am thinking this is because I now grind my teeth when I sleep. Is that a possibility? I am concerned about the long-term effect of this... or is this something that you eventually stop doing? I am using nasal pillows, if that matters. Never had this kind of problem before and never grinded teeth.

Thanks!

[NightMonkey]

Is it possible you are mouthbreathing? Were you told that mouthbreathing allows the pressure to release and the therapy is then not effective?

[TalonNYC]

Welcome - to both the forum and CPAP therapy! Please fill out your profile when you get a chance. The problems might be due to how your mask is fitted, and we therefore need to know what kind of mask you use =)

I know that for me, the first mask I got (nasal-type) was too tight, and pressing on my teeth. Your profile can list your equipment if you fill in that section, and also lets us know a little about you.

[apneawho]

I have experienced this. I use nasal pillow which I think does add some additional pressure or adjustment to upper lip and jaw. I also grind my teeth. My teeth were loose and sore for the first couple months. It has lessened with time. Keep a check on it for yourself. In my case, a small piece of my bottom front tooth chipped off. I did not need a crown, but the dentist filed the sharp edge down. This is my opinion, but I think the cpap mask, use of chin straps or tape, any of these things do change the way you hold your upper and lower jaw and may affect your teeth. I asked the dentist but he didn't really give me a yes or no.

[cake321]

I've updated my profile to list my equipment. I am using a Swift FX Nasal Pillow (male version). The weird thing is when I fall asleep or wake up, I have not noticed myself grinding... if that is what I am doing, it's only happening while I am asleep. Prior to getting CPAP, I did breathe through my mouth 99% of the time, but since starting, I've been able to easily fall asleep with my mouth closed when using CPAP. When I received my equipment from my doctor last week, he showed me how to put on the mask and fitted it for me. I have not changed anything since then. I was so excited to be able to use CPAP with no major problems, so this is kind of a disappointment. I look forward to any help you all can provide - thanks in advance!

[jamiswolf]

Hi Cake321,
You're doing well if that's your only issue. You do want to confirm that you aren't leaking from your mouth since, as Nightmonkey already stated...it negates treatment. The best way is to look at the machine data and see if your large leaks numbers are off the top.

Just wanted to point out that some cpap users will also use an oral appliance along with cpap. There are inexpensive ones (anti-snoring) and then the custom ones made by your Dentist. I've got a cheapo one on order to try it out. It certainly would solve your bruxism issue...but resolve the mouth leak question as your first priority.
Good luck,
Jamis

[Pugsy]

http://www.fphcare.com/osa/cpap-solutio ... e-200.html

The SleepStyle 234 does not offer full data. It offers how many hours it has been used (compliance data). It doesn't even offer leak compensation.

Basic bare bones machine. No way to tell if leak is bad enough to impact therapy. No way to tell if therapy is optimal or not. All it tells is how many hours you use the machine to satisfy insurance requirements so the DME will get paid.

I don't know if data is important to you or not but it would be to me.
You might want to read this "help I have a brick"...scroll down a bit to see it.
http://maskarrayed.wordpress.com/

[xenablue]

When I first started CPAP therapy, my front upper and lower teeth would be a bit sore, but once I loosened up my mask a bit, and started wearing a chinstrap to stop my mouth from falling open, don't seem to have that issue so much any more.

Initially I used a FFM, but exchanged it for a Resmed Mirage Liberty (mouth piece and nasal pillows) and I believe with both the straps were too tight keeping my teeth pressed against each other.

I don't believe you'll have any long term issues with this as I think you'll find a way to lessen that pressure on your teeth with mask adjustments and/or a chinstrap if your mouth drops open (some use tape on their mouth - can't quite get my head around that).

Cheers,
xena

[jamiswolf]

Pugsy wrote: Basic bare bones machine. No way to tell if leak is bad enough to impact therapy.

Hi Pugsy, thanks for pointing that out. Bummer. When I get a mouth leak (at higher pressures) it makes enough noise to wake me up!

How can a data-less person tell then? Dry mouth, poor therapy response? Other ideas?
Jamis

[Pugsy]

How can a data-less person tell then? Dry mouth, poor therapy response? Other ideas?

Magic eight ball? Ouja board?

There is no way to tell with any degree of certainty. Heck maybe a person feels crappy because the pressure is not quite right and they are still having enough events to impact how they feel. It happened to me. My titration prescribed pressure still allowed an AHI of 8 to 10. Sometimes the titration study is spot on and sometimes not.

It doesn't take much mouth breathing to give a person dry mouth. So they may or may not be mouth breathing to the point of impacting therapy. They may or may not be having leaks bad enough to impact therapy. Without data they are just flying blind and guessing. Still feel like crap....maybe therapy is optimal and other issues need to be investigated but how would they know? Give it time? No amount of time will help inadequate therapy pressure or huge leaks that no one knows about.

I think all patients should be given machines that offer full data. If the person doesn't want to follow their own data that is fine but we wouldn't give a diabetic a prescribed amount of insulin and not follow up with some sort of checking to make sure it works....why do they do it for cpap therapy? They don't advise making insulin changes based on "how we feel" yet we are expected to go by "how we feel" with cpap therapy. The cost for a full data machine is just a tiny bit more than the basic compliance only machine. P... poor way of doing things IMHO. My health is much more important to me and I refuse to fly blind.

[cake321]

Sorry, I'm a bit confused. Are you all suggesting that I may have sore teeth as a result of mouthbreathing? How does would that cause soreness? Just curious.

I have not been told by my wife that she's noticed my mouth open (not that she really looks, obviously), and I certainly feel better than I did before CPAP. I also record (audio only) myself nightly and do not hear any loud leaks (although I'm not sure if I would be able to really tell anyway).

Should I look into getting a chin strap like this? http://www.amazon.com/SP-Medical-Purita ... 664&sr=1-6

What about this for help with the teeth grinding? http://www.amazon.com/gp/product/B000EL ... I88ANT6NRU

Thanks a lot, guys!

[jamiswolf]

Hi Cake321,

Cake321 wrote: Sorry, I'm a bit confused. Are you all suggesting that I may have sore teeth as a result of mouthbreathing? How does would that cause soreness? Just curious.

Much dental pain can come from gum problems. CPAP could cause pressure to gums and mouth breathing could cause gum irritation from drying.

Keep in mind that sometimes, in problem solving threads like this, that there's a certain amount of brainstorming...ideas thrown out not because of their likelihood but because of their possibility.

Keep an eye on your teeth to be sure you're not grinding and causing damage.

A chin strap isn't a bad idea. On the mouth guard, I'd go for one that at least claims to help with snoring. Assuming no TMJ.
Cheers,
Jamis

[Pugsy]

Sorry, I'm a bit confused. Are you all suggesting that I may have sore teeth as a result of mouthbreathing? How does would that cause soreness? Just curious

It wouldn't normally. Just got side tracked a bit. You will find that happens often here.

I have used a nasal pillow mask for well over 2 years now and I haven't had any tooth or gum pain. Nor have I developed any teeth grinding issues. I suppose it might be possible to have the back strap too tight and thus putting tension on the front teeth.

Recording for sounds for leaks won't help. A person can have leaks that don't make any sounds. It might pick up snores though which could indicate possible flow limitations which may or may not be associated with some obstructive events.
With your machine not offering any data you are pretty much just guessing.

If your main problems seem to be teeth pain and possibly teeth grinding a small inexpensive boil n bite mouth guard might give you some relief and then perhaps you could investigate a more refined mouth guard.
Might also try loosening the back strap just a bit to see if it is the tension on the front teeth that is the problem.

I have wondered if the subconscious brain, in an effort to keep mouth closed, will cause clinching of the teeth and perhaps then have some grinding. I have no proof...just an idea that is plausible.

[NightMonkey]

I think at least one study can be found that shows the cause of bruxism is sometimes obstructive sleep apnea. When a person is having apneas, his body struggles to breathe and he may reflexively clench his teeth.

I operate on a paradigm that many nasal interface users unknowlingly mouthbreathe and still have apneas. I see you use a nasal interface and complain about sore teeth. It is just automatic that I apply my paradigm and warn about mouthbreathing.

Ultimately you (and maybe your spouse and medical professional) will have to figure out what exactly is working right and what is working improperly.

I have another paradigm that says every CPAPer with an IQ of 85 or higher should have a data-capable machine with software. Sorry your medical professionals kept these capabilities hidden from you. I hope you can get a new machine in the near future.

[chunkyfrog]

Similar experience here; except it was a mirage micro--and it was mask tightness--not grinding.
If loosening the straps is an option, that would be the easiest thing to try.
Remember, the active cushion masks need to inflate in order to fit.
If fit is too poor for that to work, a gel mask may be in order.
I wonder when a gel pillow will be possible. . .