Why is this Now happening? New CPAP problems

[herbertk1]

Hi,
I have been using a CPAP machine since 1999 with no problems. In that time I have had new machines, masks, and repeat sleep studies, all with no problems. All of a sudden (well, quickly at least), I started having a bunch of problems for the past 6 months.
After 12 years on CPAP with a pressure of 10, & ultra mirage nasal mask, I started to experience mouth breathing (flow of air from nose out mouth to be more specific). My mouth began to become super dry, and disturb my sleep and my wifes due to the noise. I was also exhaused in the AM. So I tried a chin strap, which had no effect, and was uncomefortable. The doc gave me a full face mask (Redmed), which would not seal at all and caused a high pitch leak noise from the mouth area. Then I went to another brand of ff-mask (comfort cushion) which seals better only if I make it so tight I get a head ache, and bruising on the bridge of my nose.
Then I had a CT scan of my neck (no issues detected), and a camera put down my throat thru my nose (no issues detected).
- I had another sleep study 3 nights ago where the tech said he thought I was having air break through my mouth because at 10cm of air I was gagging upon exhale, but at 15cm I was fine, and did not mouth breath, and had no significant apneas. Great....so I adjusted the pressure to 15, and went back to the ultra mirage. Major air escape from my mouth occured as soon as I fell asleep. I tried the Micropore tape, which held strong (no leaks at all), and helped me feel more awake, but my mouth was still super dry and I was woken up by "chipmonk cheaks" multiple times.

- Why is this happening after so many years of no problems with Cpap? D
- Does anyone have any suggestions I can try? (APAP?, Dental appliance of some kind?)
- I am getting kinda desperate.

Thank you all in advance for your help.

Here are some specs:
Machine - Resmed S9 CPAP with humidifier set to 3
Mask - I'd like to use the ultra mirage 2
EPR - None
Pressure - was 10, now 15....tonight 14 I guess?
Ramp - 15 min. Starts on 7
I have gained some weight in those 12 years, but it was not rapid, or significant.

[nychuck]

I too after 3 three years am waking with very dry mouth. Tried chin strap, no effect.

I am using the new comfortgel mask for which 3 for 3 have leaked. Has anyone else experienced a problem with the new mask?

[Pugsy]

I tried the Micropore tape, which held strong (no leaks at all), and helped me feel more awake, but my mouth was still super dry and I was woken up by "chipmonk cheaks" multiple times.

As you have experienced, dry mouth can come from just the air going up the nose and trying to exit through the mouth even with the lips taped and this gives us chipmunk cheeks. Normally the placement of the tongue acts like a barrier to prevent the air from entering the mouth cavity. For some reason your tongue has decided it doesn't want to do that job any more. It goes on strike when you are asleep and can't make it do its job.

It doesn't take much air entering the mouth (either entering or exiting through the lips or sneaking past the tongue from the upper airway) to cause dry mouth.

Retraining the tongue to do its job is easier said than done sometimes. Tongue will work fine for you while awake but once you go to sleep and can't force him to do his job...he will get lazy. Consciously keeping the tongue in the roof of the mouth, so that it acts like a door during the day, is one way to try to get the tongue to learn to stay in the position needed to block the air from entering the mouth while asleep. I don't know if sleeping position will make the training easier to manage. Like is the tongue more lazy when supine?

Why has the tongue decided to go on strike now after all this time? Who knows..but if you can put him back to work like he used to work, air won't try to exit the upper airway via the mouth and dry mouth and chipmunk cheeks will cease.

[Sheriff Buford]

Who knows why... maybe over time your habits and conditions can change. I wouldn't expect my cpap equipment or conditions to be the same after being on therapy as long as you have... my body will change. You may want to go to a full face mask, if breathing thru your mouth continues. Check out all the full face masks at your DME. Look at the Resmed Mirage liberty mask. Its a hybrid (one of these days I will learn how to spell that word! ) mask. It offers the nasal pillows but covers the mouth for mouth breathers.

Sheriff

[harry33]

sounds like you now need a full face mask
all masks need careful adjustment, the elastic usually stretches on new headgear, final adjustments are best made when lying in bed, pull mask up on face

[jazzer4]

To nychuck
Yes, I have noticed a change in the SoftGel replacement cushions.
My last replacement cushion was different than all the ones before it.
Much harder.
I don't know if it leaked more that the older cushion because I barely made it a night with it on.