Nasal mask use and mouth leak

[gregoriomunita]

Hi, this is my first post in cpaptalk.com. My native language is Spanish so I´ll try my best.
My issue is that I am new to CPAP therapy, about 2 months, and I have been researching for my best mask. I found one after 3 tryouts the one that feels comfortable and I can sleep with it most of the night. My problem is that after 5 o 6 hours of continuous use at some point of the early morning I start leaking air through the mouth. I can definitely wake up or consider sleeping without the mask. I was prescribed with an antiallergic (that I am not using for now) and Nasonex spray (mometasona furodato) 2 puffs before going to sleep. My theory is that at some point my nose gets insufficient air and I start breathing through my mouth and leaking air through it since the positive air is still coming through my nose. I have read that maybe a chin strap could help, but since my nose flow is less effective maybe won't be a good idea. And also saw a hybrid mask for nose and mouth could help. Any experience with this issue and recommendation please ?

[Pugsy]

Welcome to the forum.

When you have time could you please add your equipment to your profile like I have mine (see below my comments here).
wiki/index.php/Registering_Equipment_in_User_Profile

Yes, too much mouth breathing can impact the effectiveness of the therapy pressure. How much of an impact depends on how much you are mouth breathing. I do a little mouth breathing sometimes...most of the time it doesn't even amount to enough to register as a large leak. Sometimes it may reach large leak status but only lasts 5 minutes. I choose to not worry about it because to try to use a chin strap or tap my mouth or use a full face mask would cause more problems with my sleep quality than 5 minutes in large leak would cause.

Let's see if your equipment allows for data collection so that you can see just how bad (or not) your mouth breathing is and then you can decide on what you want to do to try to fix it.
If we know exactly which machine you are using then we can figure out if we can get you some software so you can see what the leaks really are.

Lots of forum members use the Hybrid mask type or some other full face mask. It works well for a good many people.
Mask preferences are highly individual....one man's treasure is another man's trash.

[gregoriomunita]

First of all thanks Pugsy. I have updated my equipment as you suggested in your earlier post. Please tell me how to proceed in orfer to give you more information. Best Regards. GM.

[mgaggie]

welcome to the forums GM.

I can't help you with your problem (I am new to cpap as well), but Pugsy and many others on here are excellent sources of information.

[gregoriomunita]

thanks mgaggie lets see what is their opinion. regards, GM

[Suzannaor]

I am very interested in the responses to your post, as I also have mouth leak! Usually when I first go to bed. Not sure how long it lasts. But it is a large amount of air coming out of my mouth. I have only been on the C-PAP for a month.

[avi123]

All nasal masks allow for mouth leaks which interfere with treatment and cause dry mouth. If you use a chin strap as I do, it needs to be tight enough to keep the mouth closed. Jaw against jaw and lip against lip. If you get a dry mouth in the morning and it's not from Medication that you take or your senior age it's then an indication that you're a mouth leak-er.

[caffeinatedcfo]

Welcome! CPAP therapy has helped my nasal breathing. Sometimes one nostril is clogged and a couple sprays of generic saline spray takes care of it.

I use a nasal pillow mask and occasionally mouth-breath, but rarely and only briefly when I do. It usually occurs because of a dream that I start talking in my sleep with.

I simply place my tongue against the roof of my mouth just behind my front teeth and that keeps my mouth shut.

[Stormynights]

There is a difference in mouth breathing and mouth leaks. Mouth leaks is when the air comes out of your mouth. I have no problem with mouth leaks until the pressure goes up high on my apap.

[Pugsy]

You have the S9 AutoSet...so a full data machine and I see you show that you have ResScan software now.
Have you figured out how to use it so that you can get the detailed graphs...looking specifically for the leak graph.
Not worried so much about the 95% leak number because sometimes that makes things look worse than it is.

Here's a video on how to manage ResScan and get that detailed data.
First make sure that the AutoSet is set to record all the detailed data. The default from the factory is for only the summary usage.
Go to the Clinical Menu
Here's how if you don't know how
http://www.apneaboard.com/resmed-s9-cpap-setup
And make sure that Sleep Quality is set to "On" and not "Usage"
Here's the video
http://montfordhouse.com/cpap/resscan_tutorial/
Pay special attention for the download directions to change it to show "all detailed data" as the default is for summary usage.
Then you should have leak line graphs available in the detail report section.

Your S9 machine reports excess leak only and your leak number you want to avoid is 24 L/min.
There's a red line that makes it easy to see on the graphs.
ResMed is the only machine that removes the mask's intentional vent/leak rate prior to leak reporting. That's just the way they do things.

I have an explanation about how the 95% leak (just means the leak was at OR below that number for 95% of the night) can sometimes look ugly when maybe it was only briefly ugly. Look at my number 4 post as it shows examples of one of my leak reports that the overall 95% number looked bad but I really didn't spend all that much time above 24 L/min. I am 99.9% certain that my leaks are from mouth breathing. I use nasal pillow mask and they never move...the mouth is the only other possible culprit. So see if you go above 24 L/min and if you do how much time do you go up there and how far above it. Then we decide just how much of a negative impact your possible mouth breathing/leaking is having on therapy.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html

[gregoriomunita]

Welcome! CPAP therapy has helped my nasal breathing. Sometimes one nostril is clogged and a couple sprays of generic saline spray takes care of it.

I use a nasal pillow mask and occasionally mouth-breath, but rarely and only briefly when I do. It usually occurs because of a dream that I start talking in my sleep with.

I simply place my tongue against the roof of my mouth just behind my front teeth and that keeps my mouth shut.

Thanks caffeinatedcfo, regards.

[gregoriomunita]

Hi Pugsy, amazed with your dedication and answer, thanks!!!. I will answer you with red between your suggestions.

You have the S9 AutoSet...so a full data machine and I see you show that you have ResScan software now.
Have you figured out how to use it so that you can get the detailed graphs...looking specifically for the leak graph.
Not worried so much about the 95% leak number because sometimes that makes things look worse than it is.

Here's a video on how to manage ResScan and get that detailed data.
First make sure that the AutoSet is set to record all the detailed data. The default from the factory is for only the summary usage.

It was set to "usage" and changed to "on"

Go to the Clinical Menu
Here's how if you don't know how
http://www.apneaboard.com/resmed-s9-cpap-setup
And make sure that Sleep Quality is set to "On" and not "Usage"
Here's the video
http://montfordhouse.com/cpap/resscan_tutorial/
Pay special attention for the download directions to change it to show "all detailed data" as the default is for summary usage.
Then you should have leak line graphs available in the detail report section.

Saw the video, tonight I will record with the new settings for tomorrow analize it and share the results

Your S9 machine reports excess leak only and your leak number you want to avoid is 24 L/min.
There's a red line that makes it easy to see on the graphs.
ResMed is the only machine that removes the mask's intentional vent/leak rate prior to leak reporting. That's just the way they do things.

I have an explanation about how the 95% leak (just means the leak was at OR below that number for 95% of the night) can sometimes look ugly when maybe it was only briefly ugly. Look at my number 4 post as it shows examples of one of my leak reports that the overall 95% number looked bad but I really didn't spend all that much time above 24 L/min. I am 99.9% certain that my leaks are from mouth breathing. I use nasal pillow mask and they never move...the mouth is the only other possible culprit. So see if you go above 24 L/min and if you do how much time do you go up there and how far above it. Then we decide just how much of a negative impact your possible mouth breathing/leaking is having on therapy.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html

Well, really appreciated your advice. Will share the analysis with you. Thanks again. G.M.

[DaveL]

You have the S9 AutoSet...so a full data machine and I see you show that you have ResScan software now.
Have you figured out how to use it so that you can get the detailed graphs...looking specifically for the leak graph.
Not worried so much about the 95% leak number because sometimes that makes things look worse than it is.

Here's a video on how to manage ResScan and get that detailed data.
First make sure that the AutoSet is set to record all the detailed data. The default from the factory is for only the summary usage.
Go to the Clinical Menu
Here's how if you don't know how
http://www.apneaboard.com/resmed-s9-cpap-setup
And make sure that Sleep Quality is set to "On" and not "Usage"
Here's the video
http://montfordhouse.com/cpap/resscan_tutorial/
Pay special attention for the download directions to change it to show "all detailed data" as the default is for summary usage.
Then you should have leak line graphs available in the detail report section.
ur S9 machine reports excess leak only and your leak number you want to avoid is 24 L/min.
There's a red line that makes it easy to see on the graphs.
ResMed is the only machine that removes the mask's intentional vent/leak rate prior to leak reporting. That's just the way they do things.

I have an explanation about how the 95% leak (just means the leak was at OR below that number for 95% of the night) can sometimes look ugly when maybe it was only briefly ugly. Look at my number 4 post as it shows examples of one of my leak reports that the overall 95% number looked bad but I really didn't spend all that much time above 24 L/min. I am 99.9% certain that my leaks are from mouth breathing. I use nasal pillow mask and they never move...the mouth is the only other possible culprit. So see if you go above 24 L/min and if you do how much time do you go up there and how far above it. Then we decide just how much of a negative impact your possible mouth breathing/leaking is having on therapy.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html

Pugsy!
this is so helpful for me.

A friend at work (non-compliant) has sold me her machine. It is an S9, a c pap machine. (I worked with her for months trying to assist her to become compliant. To no avail. She feels with weight loss she is cured. Sad.) I waited several months from her first offer....well I even feel bad taking her machine. I'll use it well.


So I have replaced my S8.

Thanks for this information.
It will help me as I start this path to learning more about treatment.

DaveL

[DaveL]

Like others I have tried chinstraps. Probably bought 5...
I've used a cpap cap successfully for a couple of years..It's a beanie with a chinstrap fastened to it with velcro. Worked much better for me, most nights. However, I'd just as soon not wer it.

Found a pad at Mountain Equipment Co-op intended to be used on baby carriers.

Here it is.
_DSC0626 by blacktan92, on Flickr


Here's an even worse photo of the back side.

_DSC0625 by blacktan92, on Flickr

I put a strap around it and draw it tight under my jaw. Works perfectly for me. My mouth doesn't fall open. It's really quite comfortable.

Hope this helps someone.

edit: here's a link to where I bought it.... Mountain Equipment Coop. It's a Canadian firm.
http://www.mec.ca/product/5024-410/litt ... y%2Bcarier

I followed through and found the gear that it is used with You may have a better chance of finding it if you know what it is used on!

http://www.mec.ca/product/5027-581/litt ... d-carrier/
It cost me $11 and tax.

This idea came from another poster who uses something under his chin like a large pool noodle....Bless him for sharing. My sleep quality has improved since I found this pad. My DME downloaded data from my S8 proving it resolved my leakage/mouth breathing problem.

I am very thankful to pariticipants here. It would be much more difficult to be compliant if I was doing it on my own!

[NateS]

Like others I have tried chinstraps. Probably bought 5...
I've used a cpap cap successfully for a couple of years..It's a beanie with a chinstrap fastened to it with velcro. Worked much better for me, most nights. However, I'd just as soon not wer it.

Found a pad at Mountain Equipment Co-op intended to be used on baby carriers.
I put a strap around it and draw it tight under my jaw. Works perfectly for me. My mouth doesn't fall open. It's really quite comfortable.

Hope this helps someone.

This idea came from another poster who uses something under his chin like a large pool noodle....Bless him for sharing. My sleep quality has improved since I found this pad. My DME downloaded data from my S8 proving it resolved my leakage/mouth breathing problem.

I am very thankful to pariticipants here. It would be much more difficult to be compliant if I was doing it on my own!

Thanks for the suggestion. What is it filled with?

Regards, Nate