mouth breather mask suggestions needed

[groovetta]

I wanted to get some suggestions regarding mask selection. I am now eligible for new supplies. I meet with the DME RT on Monday. I've been on CPAP/APAP for about 11 months and at times have noticed that I sometimes wake up with my mouth open. I don't think this is the case every night though. I was originally Rx'd for 8cm H20 and after a little while, the DME RT noticed that I was maxing out most nights on the pressure and suggested I talk to the MD to see if my pressure needed to be raised. The MD seemed to humor me by raising my pressure to 9cmH20, although she thought my AHI was within acceptable limits. I was still getting headaches on 8cmH20 too.
On my own, I set the machine to APAP to 4-10cm H20. From what I can tell, my 95th percentile is generally in the range of 9.2-9.8.

Anyway, I am a stomach sleeper and so far the Opus 360 has worked well with my stomach sleeping preference. I have never felt as rested as I had hoped after starting PAP therapy. Of course, I also have a previous diagnosis of idiopathic hypersomnia syndrome which is treated with medication. I haven't felt rested for about twenty years now. I'm hoping to maximize my PAP therapy Monday after meeting with the DME RT.

I would welcome suggestions regarding a new mask to cover my mouth and nose. If anyone wants to comment on chin straps or other solutions, I'd welcome that as well. I mainly want to make the best possible choice in a mask on Monday.

Thanks so much,
groovetta


ResMed S9 autoset (Rx for 9cmH20, but using APAP 4-10cmH20)
ResScan
Opus 360 nasal pillows mask
heated humidifier
climate line tubing

[STL Mark]

Welcome to the forum. I noticed this was your first post. I am not a stomach sleeper so would not be aware of what would work well for you. If you can use full face masks, you may want to try the ResMed Quattro Air and see if it is a good fit. Good luck with your search for the right mask.

[Julie]

If your pressure is consistently in the 9 range, it might be a better idea to set your low pressure at e.g. 7-8 rather than 4, and your higher one at e.g. 12, which would allow the machine to quickly 'put out' events in your range, rather than have to climb from 4 to 9, which takes time.

[avi123]

You need to decide if you actually are a Mouth Breather. If yes, then there is only one mask for such persons:

Oracle 452 Oral CPAP Mask FitPack with Headgear costing $79.50.



Notice that when using this mask you need to block your nares with the provided nose inserts.

Also, you better stop sleeping in the prone position b/c it interferes with the usage of the Oracle mask.

I would start in CPAP mode set at 10 cm.

You must rely on the Humidifier to avoid dry mouth.

If you do it then it will be a complete new experience for you.

[sleepy_learner]

The question is why you are mouth breather. Why is your nose always blocked. May be you should get that fixed first. See and ear nose and throat doc I think

[avi123]

The question is why you are mouth breather. Why is your nose always blocked. May be you should get that fixed first. See and ear nose and throat doc I think

From: http://doctorstevenpark.com/index.php?s=mouth+breather



Attention All Mouth Breathers – 5 Important Reasons Why You Must Breathe Through Your Nose


December 1, 2009

If you’re a chronic mouth breather because of a stuffy nose, you’re not alone. As the weather chills and allergies and colds abound, and nasal congestion becomes a common trend, mouth breathing inevitably follows-especially when you’re sleeping. I’m sure you’ve seen many passengers asleep on the subways and trains, head and pitched back, mouth wide open, and snoring louder than a diesel engine. Mouth breathing can surely ruin your social image, but that’s nothing compared to the havoc it can wreak on your health.



5 Potent Benefits of Breathing through Your nose

One of the most important reasons to breathe through your nose is because of a gas called nitric oxide that’s made by your nose and sinus mucous membranes. This gas is produced in small amounts, but when inhaled into the lungs, it significantly enhances your lung’s capacity to absorb oxygen, increasing oxygen absorption in your lungs by 10-25%. Nitric oxide also can kill bacteria, viruses and other germs. This is why you often hear fitness and yoga instructors emphasize inhaling and exhaling through your nose during workouts.

Also, if you can’t breathe well through your nose, your sense of smell will suffer and therefore your sense of taste, since your smell and taste buds are connected. This can lead to disturbances in your appetite and satiation levels, wreaking havoc on those struggling with weight issues.

Your nose also has vital nervous system connections to your lungs and heart. Not breathing well through your nose can alter your heart rate and blood pressure, as well as increase your stress responses.

Your nose makes about 2 pints of mucous every day. If your nose isn’t working properly and mucous isn’t cleared, the stagnant mucous can lead to infections such as sinusitis or ear infections, not to mention bad breath.

Lastly, not breathing well through your nose can aggravate snoring or obstructive sleep apnea. Nasal congestion alone doesn’t cause obstructive sleep apnea, but it can definitely aggravate it. If your palate and tongue structures are predisposed to falling back easily due to sleeping on your back and muscle relaxation in deep sleep, then having a stuffy nose can aggravate further collapse downstream. Untreated obstructive sleep apnea can lead to chronic fatigue, depression, anxiety, weight gain, high blood pressure, heart disease, heart attack and stroke.

Knowing all these benefits of breathing through your nose, however, doesn’t help much if you don’t know why you’re not able to do so. To stop mouth breathing, the first thing you must do is to figure out what’s blocking up your nose.

What Can Stop Up Your Nose

Nasal congestion is something everyone experiences now and again. Yet, if you’re trying to prevent this from happening it’s important to explore the various reasons behind why and when this occurs.

Here are five of the most common reasons for a stuffy nose:

"I Have a Deviated Septum"

By definition everyone has a slightly crooked (deviated) nasal septum. There are various reasons for having a deviated septum, including trauma, but the most common reason is no reason at all. It’s just the way your nose developed. What’s more important than how deviated your septum is is what’s happening in front of an around your septum.

Wings in Your Nose

Turbinates are wing-like structures that attach to the sidewalls of the nasal cavity, opposite the midline nasal septum. They normally smooth, warm, humidify, and filter the air that you breathe, but they also become enlarged and produce mucous when inflamed. Turbinates also swell and shrink alternating from side to side, which is a normal neurologic process called the nasal cycle.

Is It An Infection or Allergies?

If you have allergies, a cold or any kind of infection, then your turbinates will swell up, clogging your nose with lots of mucous production. Contrary to popular belief, the color of the mucous has no relation to bacterial vs. viral infections.

Flimsy Nostrils

Once you have inflammation and swelling inside your nose, for some people, depending on the configuration of your nose, your nostrils can literally cave in as you inhale. Different noses have differently shaped nostrils with various nostril thicknesses. The more narrow your nose, the more likely your nostrils can cave in. People who undergo cosmetic rhinoplasty are more at risk years later, since narrowing the nose can weaken the support structures of the nose.

A Nervous Nose?

Some people’s noses are extra sensitive, especially to weather changes, like temperature, humidity, and pressure changes. Certain chemicals, scents and odors can set off a reaction as well. Many people mistakenly think this reaction is an allergy, but it’s really your nasal nervous system over-reacting to the weather or to odors. One of the most common reasons is from poor quality sleep, which causes a low-grade stress response, which can heighten your senses.

It’s All Under Your Nose

A chronically stuffy nose doesn’t happen by itself. Usually it’s part of a bigger picture, where the entire upper and lower jaws are more narrow and constricted, in addition to more narrow nasal cavities. I’ve described this process in my book, Sleep Interrupted, where due to modern human’s eating soft, mushy, processed foods, our jaws are much more narrow than normal, with dental crowding. Bottle-feeding, which is another modern, Western phenomenon, is also thought to aggravate this problem.

If you have a stuffy nose, it can also aggravate soft palate and tongue collapse when in deep sleep, due to muscle relaxation. With more obstruction, more stomach juices are suctioned up into the throat and nose, causing more swelling and more nasal congestion. All this from smaller and more narrow jaws.


Written by admin · Filed Under Articles, obstructive sleep apnea, Sleep Health | 16 Comments

SURGERIES GALORE!

[mellabella]

I am an obligate stomach sleeper because of my blockage (choking on tongue and saliva in side or prone position). Believe it or not, I have still been able to get the Quattro full face to work, and even the FitLife Total Face (which I don't necessarily recommend). You don't have to go straight to trying the (very love-it-or-hate-it--I haven't tried it yet but have had to consider it) Oracle oral mask yet. The Hybrid is a less dramatic step in that direction.

Honestly, though, just because you wake up with your mouth open doesn't necessarily make you a mouth breather. If I am getting sufficient pressure support through my nares, I don't mouth breathe--and even though my mouth will fall open a bit during the night, I don't actually leak air out of it due to the position of my tongue and jaw. So I've found I can actually use nasal prong and nasal pillow masks. The Nasal Aire prong system was comfortable for stomach sleeping but I'm now more comfortable (especially at my high pressures) with the Mirage Swift FX I just received. I can barely tell I have it on--no hard plastic to dig in my face--which was a problem I had even when I was on the Opus.

[chunkyfrog]

Wear the mask you find most tolerable, and monitor your leak rates and mouth dryness on awakening.
I've tried chin straps, tape, (including home made chin-ups) and Poli-grip strips; and somewhere along the way,
I noticed my mouth was opening less and less--by itself, or habit, possibly due to tape.
This was most welcome, as very few full face masks fit my odd little mug.

[groovetta]

Thanks for everyone's reply. I think I'm just an occasional mouth breather-- not sure why-- rarely ever have nasal congestion. I got a chin strap today just to experiment with over the weekend to see if I feel refreshed over the next three nights and I will probably adjust my min. and max. pressures as suggested starting tonight. Honestly, I don't see my using a chin strap long term, but we will see.

I tried on some full face masks today. There in one place in our area with a fairly good selection (in stock). I'm not terribly wild about this store because when I was shopping for my machine, I had pretty much set my mind on a ResMed autoset. This is just my opinion, but... the DME store tried to pressure me , it seemed, toward a less expensive machine (I won't mention the brand here) and I suspect this was because their profit margin would have been greater if I chose the machine they were pushing me to purchase. As far as selection goes, this store rocks though.

It would be cool if they let you check out a sample mask to try overnight. Like the public library of masks. From what I tried on today, the Quattro FX for her seemed to fit me the best.

As an aside, I was also told at this same store, that F&P would be introducing a full face mask version of the eson nasal mask some time in the future.

[avi123]

Thanks for everyone's reply. I think I'm just an occasional mouth breather-- not sure why-- rarely ever have nasal congestion. I got a chin strap today just to experiment with over the weekend to see if I feel refreshed over the next three nights and I will probably adjust my min. and max. pressures as suggested starting tonight. Honestly, I don't see my using a chin strap long term, but we will see.

I tried on some full face masks today. There in one place in our area with a fairly good selection (in stock). I'm not terribly wild about this store because when I was shopping for my machine, I had pretty much set my mind on a ResMed autoset. This is just my opinion, but... the DME store tried to pressure me , it seemed, toward a less expensive machine (I won't mention the brand here) and I suspect this was because their profit margin would have been greater if I chose the machine they were pushing me to purchase. As far as selection goes, this store rocks though.

It would be cool if they let you check out a sample mask to try overnight. Like the public library of masks. From what I tried on today, the Quattro FX for her seemed to fit me the best.

As an aside, I was also told at this same store, that F&P would be introducing a full face mask version of the eson nasal mask some time in the future.

Comment,

Actually, most reputable DMEs are allowed by certain mask makers to let customers borrow masks for a certain period FREE.
But most DMEs don't do it as being unfriendly (lousy). I pay about $30 to Internet providers to let my try most masks for 30 days trial. So I pay the regular mask price plus the $30 and shipping to me is free if the total dollars are above about $90. If and when I return the mask I then pay the shipping. It's below $10 thru USPS and above it thru UPS.

Here is one Internet provider that I like to deal with:

http://www.directhomemedical.com/