Mouth Breathing (mouth leaks) with Nasal Mask- Waveforms

[palerider]

There is a mistake in my last post. What I meant to say is that I have tried CHINSTRAPS with no luck. I did not mean headbands.

look at your post with the mistake, look for the EDIT button on the top... fix mistake

[PEF]

Thanks, CG!

[PEF]

Thanks, Palerider - I did not see the EDIT button at first.

[PEF]

After importing my data for today, I reread Pugsy's tutorial on "LEAK" for probably the tenth time just to be sure I was reading it right. Last night, I used my P10 without the tape. My leak numbers were 20.1 for 95% and 30 for Max leak. When I looked the data, I had 3 episodes in large leak territory. The total time in LL territory was just under 5 minutes, out of a little over 6 hours of sleep. And I slept well - the leaks did not wake me up. However, if I sleep lightly, sometimes they do wake me up which is more of a problem.

So, comparing the 2 nights, the night before last when I used tape, my leaks were 13 for 95% and 21 for Max. Last night when I did not use the tape, my leak rate was 20.1 for 95% and 30 for Max. This is pretty much what I would expect the comparison to be.

Also, last night I did not take an antihistamine. I only had slight nasal congestion, not enough to take off the nasal mask. I did not experience dry mouth. The dry mouth the night before was obviously caused by the medicine, not mouth breathing.

Am I reading this right?

Maybe I am worrying too much about leaks. That could be causing minor leaks to wake me up more. Last night I just did not care and they did not wake me up. Maybe I should give up the tape and not worry unless I begin to see more time in LL territory. It is not only mouth breathing that is probably causing some leaks. Sometimes I still roll over on the hose pulling on the mask and vaguely remember adjusting the mask, other times I awake slightly and pull on the mask just to be sure air is still flowing since I am a little paranoid about electrical outages. I would be happy to hear what others think.

Sorry Jay, I did not mean to hijack your thread. I still cannot get a lot of the Sleepyhead functions to work, I could not get the cursor up or get the 100% zoom to work, but now I am thinking this may be not necessary. It is just that I am so interested in this and think it is just so cool. I don't know if the problem is my computer or maybe the version of Sleepyhead I downloaded. It is V1.0.0 Beta 1

[sleepychar]

I tried the Scunci... for me, it wasn't comfortable. When I woke up, my lips felt a bit swollen from my teeth being pressed into my lips from the pressure of the Scunci. I may try it again in the future but, for now, I am so new at this (4 nights on CPAP), I don't want to add one more source of discomfort. Plus, my machine still showed a 10L leak so not sure it was helping. I know I'm not normally a mouth breather but I was occasionally exhaling through my mouth... so problem not really resolved but put on hold for now...

[Pugsy]

I had 3 episodes in large leak territory. The total time in LL territory was just under 5 minutes, out of a little over 6 hours of sleep. And I slept well - the leaks did not wake me up.

5 minutes in LL territory and the farthest you went into large leak territory was 30 L/min...I wouldn't give those numbers a second glance as long as you can say "the leaks did not wake me up".
It may or may not have been mouth breathing...we can't always tell for sure but 5 minutes in 3 segments...not enough to worry about even if it was all mouth breathing and I am betting it wasn't all mouth breathing.

I have had leaks bad enough to wake me up. Usually when I am trying a new mask and having the first night issues getting the straps adjusted. Those I expect and just deal with as part of the "new mask" adjustment process.

Sometimes the cure is worse than the disease though...mouth taping isn't without its own annoyances and if someone already has fragile sleep (like your sometimes insomnia issues) I just don't see adding more chances for the annoyances to make the fragile sleep worse unless there is a real and urgent need....and 5 minutes in large leak territory for maybe some minutes of mouth breathing...doesn't warrant the annoyance of taping in my book. I have done the taping thing and while not horribly annoying...it's still annoying and caused some unwanted wake ups from either discomfort or the tap coming loose or simply the brain telling me that I have tape on my lips.
I feel the same way about using chin straps.

Now I know that for some people there is a real need for extraordinary measures but 5 minutes doesn't qualify for me. It would take a lot more before I would add another potential annoyance into the mix.

Those 95% numbers...often they make out things to be worse than they are and that's why I don't put a whole lot of stock in just the number itself without looking at the real evidence seen on the graphs.
95% number of anything are simply too easily skewed by very brief times at a higher number.

For people with insomnia issues...I think that worrying about things that really aren't that bad does nothing but make the insomnia worse...the brain just won't turn off and relax and that old insomnia monster gets fed really well so it's real big and real ugly.

[Pugsy]

my machine still showed a 10L leak so not sure it was helping.

The leak number on a ResMed machine is a 95% number and all that means is that you were AT OR BELOW that number for 95% of the night. People often forget or don't understand the "or below" part of the definition.

If my 95% leak number was 10 L/min I would be doing a happy dance all over the place...that's a really, really good leak control number.
ResMed won't even have Mr Frowny show up until you hit over 24 L/min for more than 30% of the night.

For a 10 L/min 95% number...I wouldn't be doing a chin strap or taping or anything for my mouth...even if it was all mouth breathing...it isn't enough to make the therapy compromised. The machine can and will handle leaks up to 24 L/min quite well. It just starts getting iffy once you go past 30 L/min.
Besides...I bet it wasn't all mouth breathing...I bet there was some mask movement leak in there as well.

Now if you have a lot of little leaks and they wake you up...yeah, work on them but work on them because they are harming sleep quality and not because they are making therapy ineffective.

You are new to this therapy and you are going to have some initial adjustment issues with mask fit and comfort and the brain in general wanting to alert you to the alien stuck on your face...don't add worrying about 10 L/min leaks into things unless they are waking you up because 10 L/min is far from bad and not worth worrying about.

[Jay Aitchsee]

PEF, Sorry I can't help you with your version of SH. I have an older one. I do see there is another newer than yours - beta 2

SleepyChar, As Pugsy says, don't try to fix something that isn't broke. As a new cpap user, your first task should be just to get comfortable with the machine, mask, and treatment. Don't let one night's results, influence you too much. We all have good and bad nights. Learn what's normal for you before trying to fix it. Usually the biggest hurdle is just to sleep through the night without taking off the mask. It sounds as if you've already mastered that. Great start!

[sleepychar]

Thank you for the encouraging words about not worrying about 10L leak... I am very happy to have found this group. So far I think things have been going pretty well. Biggest problem sore nostril which I posted about separately and got some good suggestions which I will follow. But I am not struggling with feeling like I can't breathe or anything like that and I have been able to keep the mask on for the whole night for the most part. I will stop worrying about 10L leak right this minute - problem gone as of now!

[palerider]

Thanks, Palerider - I did not see the EDIT button at first.

lots of people miss it, and many miss the quote button... my guess is they're looking for something at the bottom of the post, which is where most other forums put those kind of things.

[PEF]

Thanks so much, Pugsy, for clarifying again about the leak issues. I am really relieved.

[ArmenDDS]

Ok - something really interesting that shows how what I often perceive as happening in my sleep is NOT what really happened.

Last night, I forgot to disconnect my humidifier (which I intend to do tonight) until right before I went to bed and realized I needed to change out the hose, so put it off. So the humidifier was still working.

I was so tired that I decided to get a good night's sleep by going to bed the way I was most comfortable - using my P10 and mouth tape. I sleep best this way UNLESS my insomnia is bad. Knowing how bad my allergies can get at night, I took a Clartin to hopefully prevent a stuffed up nose from waking me up. But last night I got to sleep almost right away. 2 hours later (I know that from Sleepyhead this morning, but did not know what time it was when I awoke), I woke up aware that my mouth was extremely dry. I vaguely remember trying to wet my mouth by moving my tongue around and then going back to sleep, which usually works, but this night it did not work and I began to choke and cough. I pulled the mask and mouth tape off. My nose was a little stuffed up, but not bad enough to abandon the mask. I THOUGHT that the dry mouth was because of large mouth leaks, so I did not put the mask back on and went back to sleep without it. I slept pretty well, but awoke with a dull headache and lots of nasal congestion and phlegm, which always happens when I don't wear my mask.

I EXPECTED to find massive large leaks when I imported my data this morning, but was I ever in for a surprise. I was looking a almost perfect data for those 2 hours I slept with the mask. NO large leaks at all and the leak numbers weren't bad for me - very short periods of leaks of 13L to 21L. So obviously, I could have reapplied the tape and put the mask back on and had a very good night's sleep. I chose not to in the middle of the night because of my fear of my nose getting stuffed up and choking because of that. This just goes to show how often what I perceive happening while I sleep is not what is really happening. I am glad to have Sleepyhead to show me that.

This is not the first time I have shot myself in the foot by using antihistamines. So many doctors tell me to take them when using CPAP in allergy season. The first night or 2 they work fine. Then they start to make my mouth and throat so dry that I often choke in the middle of the night, which is probably what caused my extreme dry mouth last night, NOT excessive mouth breathing. the other thing that happens to me when using antihistamines is a very unpleasant rebound effect when I stop using them.

Jay - I have done comparisons of nights using tape and not using it. My masks are relatively leak free unless my nose gets stuffed up. So when I don't have nasal congestion, the only difference is that, nights I use tape, I do not see any large leaks at all and when I don't use tape, I see some large leaks. However, the actual large leak time tends to be no more than 20 to 30 minutes out of 7 or 8 hours.

Thanks so much for your "head band" suggestion. I am going to order one and try it. I have tried both cervical collars and headbands without much success. I usually can't get to sleep at all with a cervical collar and the headbands hurt my jaw.

Sylvia - Thanks for your suggestion about tongue position. I keep practicing.

For some reason, I can't get a lot of the Sleepyhead functions to work. I don't know if it is my computer or the software. I was not able to get the cursor when I selected "View and toggle cursor". Nothing happened. I also was not able to get the 100% zoom to work - nothing happened. My husband, who is better with computers than I was not able to make it work either.

Hi.
A few things caught my attention. I just wanted to have a few things clarified. For one, many medications can cause dry mouth by reducing the saliva flow. Also, naturally, when we go to sleep our saliva production dramatically reduces. that is why we have to brush and floss and get all the bacteria off of our teeth before going to bed. With "drymouth" from lack of saliva, you are much more prone to getting cavities as saliva acts as a buffer against the cavities. Have you ever tried using a hypertonic saline solution to irrigate your nose, instead of the anti-histamines? Please let me know, as that may make a difference for you

[tlohse]

Lol a guy uses a girls headband now thats funny.

[Julie]

Oh, grow up!

[Jay Aitchsee]

Lol a guy uses a girls headband now thats funny.

Yah, I should have included a picture of the Scunci for Men headbands, too.