Chin Strap Troubles

[Rob K]

I just realized my Resmed Sulivan chin strap is causing my breathing to be more restricted by pulling my lower jaw back too far and causing the soft tissues to in my throat to block my nasal passage. I have it just snug enough to keep from falling off.

Because of the shape of my head I have to hook the strap on the end of my chin and then around the top back of my head just like in the photo to keep the strap from coming off. I'm using it as shown. This pulls my jaw back and causes more restriction in my breathing. I've tried having the strap just under my jaw to pull it more upward and the other side of the strap more toward the top of my head, but it seems to always come off this way.

Laying on my back I did some experimenting with head and jaw position to find what causes the least restriction while breathing through my nose. I seem to have a lot of flappy soft tissue in my throat so airway restriction is pretty obvious when making positional changes.

First by adjusting head position and tucking my chin to my chest I have a hard time breathing through my nose, this also makes my jaw move back and my overbite worse. If I lay perfectly flat on the floor with my head on the floor this also makes it hard to breath through my nose. With my head in an elevated position my nasal passage is least restricted. So it looks like I'm a candidate to use a pillow when I lay down. lol

Secondly I have an overbite and the strap makes the overbite worse by pulling the jaw back. This causes nasal restriction to be worse in any position. If I move my jaw forward so that I have just a slight under bite then there is far less restriction in all positions.

Thought about a cervical collar, but I sleep hot and that sounds horrible. Even the bigger chin straps make my head sweaty, keep my temp up and I don't sleep well. If my room temp is much above 70 I don't sleep very well. Maybe tape is the way to go or a chin strap that I have not seen. Guess I'll try sleeping without the chin strap again and see what happens.

A dental device would help with my bruxism.

I'm not a doc so I could use some advise from the more experienced while I study up on anatomy and wrap my head around what this all means.

[Gryphon]

I would try one of the less expensive boil and bite mouth guards you get for sports like boxing etc... some of them can be quite cheap but the better ones are around 5 to 10 dollars. Shouldn't need to spend more then that.

It sounds like you already did your home work on some of the other options and found reasons why they might not be right for you.

If your using the chin strap to avoid mouth breathing. One option you could try is taping. I used to use a small piece of quality paper medical tape placed vertically in the middle of my mouth. Leaving me still able to breath from the sides of my mouth if needed but this kept my mouth closed during the night.

Hope your able to find something that works for you.

Goodluck

Gryphon

[snuzyQ]

Hi Rob k:

With your overbite and troubles with bringing your lower jaw forward, a dental device is likely in your future.

The type of dental devices that move your lower jaw forward and then back in a 24 hour period may not be appropriate for you because they can substantially strain your TMJs. Going to a maxillofacial TMJ specialist dentist would most likely protect your TMJs and offer you a device(s) that would bring your lower jaw into proper alignment 24/7. Such a device(s) would also address your OSA, though, alone, it will probably not bring your AHIs to normal (less than five).

I use such a device at night, along with my CPAP and my AHIs are in the 0.2 to 0.8 each night. This is down from an AHI of 36. A 2nd sleep study, done with my dental device alone, reduced my AHI to 24.

My dentist's title is (craniofacial TMJ specialist), DDS. I was first put into "crozats" (upper and lower removeable dental devices) to wear during the daytime, even while eating. At the same time he fashioned a twinblock type of appliance to keep my jaw in the same alignment as the daytime devices, only at night. He permanently changed my bite - for the better (especially my appearance). The devices took a bit of adjusting to (for the teeth - just like braces would have done) and learning how to eat and talk with the daytime devices in took awhile. But I adjusted just fine. From the very first day of wearing the devices, my TMJ troubles were over - pain all gone. My TMJ Syndrome had been brought on from the pressures of CPAP which threatened to upend my CPAP treatment.

Because my treatment was for TMJ Syndrome, I was totally responsible for the cost, even though my CPAP treatment had brought on the disorder. The cost was close to $5,000. It's possible that your medical insurance would pay for your treatment because it would be for OSA instead. I don't know if your health insurance would pay for only one treatment and not the other, but there are lots of folks who use both CPAP and a dental device to treat their OSA each night. I would think the insurance would cover both.

There is a strong association between OSA and TMJ Syndrome. In fact, one of the tip-off questions on my dentist's registration form was: "Have you ever been diagnosed with obstructive sleep apnea".

If you go to see such a specialist, pay special attention to his/her mode of treatment because these TMJ specialists have different ideas on best-treatment technique. You don't want to wind up harmed in the process.

Hope this helps you some.

[palerider]

I just realized my Resmed Sulivan chin strap is causing my breathing to be more restricted by pulling my lower jaw back too far and causing the soft tissues to in my throat to block my nasal passage. I have it just snug enough to keep from falling off.

That's the problem with chin straps, they don't keep you from mouth breathing, since teeth aren't air tight, and they can restrict the airway more.

Taping may be the easiest thing, or you can try wearing a soft headband over your lips. This works for some.


viewtopic.php?f=1&t=112758&p=1085906#p1086296

[klm49]

I just realized my Resmed Sulivan chin strap is causing my breathing to be more restricted by pulling my lower jaw back too far and causing the soft tissues to in my throat to block my nasal passage. I have it just snug enough to keep from falling off.

Because of the shape of my head I have to hook the strap on the end of my chin and then around the top back of my head just like in the photo to keep the strap from coming off. I'm using it as shown. This pulls my jaw back and causes more restriction in my breathing. I've tried having the strap just under my jaw to pull it more upward and the other side of the strap more toward the top of my head, but it seems to always come off this way.

Laying on my back I did some experimenting with head and jaw position to find what causes the least restriction while breathing through my nose. I seem to have a lot of flappy soft tissue in my throat so airway restriction is pretty obvious when making positional changes.

First by adjusting head position and tucking my chin to my chest I have a hard time breathing through my nose, this also makes my jaw move back and my overbite worse. If I lay perfectly flat on the floor with my head on the floor this also makes it hard to breath through my nose. With my head in an elevated position my nasal passage is least restricted. So it looks like I'm a candidate to use a pillow when I lay down. lol

Secondly I have an overbite and the strap makes the overbite worse by pulling the jaw back. This causes nasal restriction to be worse in any position. If I move my jaw forward so that I have just a slight under bite then there is far less restriction in all positions.

Thought about a cervical collar, but I sleep hot and that sounds horrible. Even the bigger chin straps make my head sweaty, keep my temp up and I don't sleep well. If my room temp is much above 70 I don't sleep very well. Maybe tape is the way to go or a chin strap that I have not seen. Guess I'll try sleeping without the chin strap again and see what happens.

A dental device would help with my bruxism.

I'm not a doc so I could use some advise from the more experienced while I study up on anatomy and wrap my head around what this all means.

I find using one of these:
https://www.walmart.com/ip/Wilson-Mouth-Guard/11968966
trimmed down to just my front teeth and worn on the bottom teeth + taping + cervical collar works great for my bruxism and mouth breathing. At first the Cervical collar made mt neck sore so I spun it around and wear it backwards.

[zonker]

I just realized my Resmed Sulivan chin strap is causing my breathing to be more restricted by pulling my lower jaw back too far and causing the soft tissues to in my throat to block my nasal passage. I have it just snug enough to keep from falling off.

That's the problem with chin straps, they don't keep you from mouth breathing, since teeth aren't air tight, and they can restrict the airway more.

Taping may be the easiest thing, or you can try wearing a soft headband over your lips. This works for some.


viewtopic.php?f=1&t=112758&p=1085906#p1086296

hi, palerider. <waves>

to the OP, this is the method i use and it worked wonders for me! however, i use it in conjunction with the cervical collar, which you say you don't want to use.

i can't verify it's efficacy without the cervical collar.....

[Rob K]

Wow, talk about things new to me and making my head swim. I have a lot of studying to do. I'll get some tape and a mouth guard for experimenting. Skipping the collar for now. I tried going without the chin strap a number of times a couple years past and always had problems. Air out the mouth and real dry in the morning. Last night was great without it. Didn't have any problems at all. 90% pressure was about the same as always and had .9 AHI. Would be amazing if that continues.

My first sleep study came up with 9AHI and near 40 when in REM. Recommended pressure was 8CM.
My second sleep study came up with 4AHI and 24 during REM. Recommend pressure was 5CM, sleep on side or go without.

None of that stuff worked for me. The forum members helped me get set to 10-14cm auto range. 90% pressure is around 11-12 most nights. AHI is around 1 typically. Started feeling much better.

I'm extremely excited to have a good night without the chin strap. Sure would be amazing if I could go without the machine though. It's still quite annoying after 4.5 years. I know, one step at a time. Not sure if I'm a candidate for a dental device, but will study up.

[Holden4th]

The soft cervical collar is nowhere as sweaty as people make out and I should know as I live in a tropical climate. What this thread has done has made me look at mouth taping but with a difference.

PRs suggestion about a soft headband over the lips reminded me that I bought some Scunsi headbands for this purpose but I've never tried them. Tonight's the night! It won't get in the way of my DW nasal pillows or the soft cervical collar.

[palerider]

PRs suggestion

Credit where credit is due, Jay Aitchsee's suggestion of the scunsi...

[Rob K]

I'll keep the head band in mind for future testing. AHI was .2 last night without the chin strap. That has to be the lowest ever. 90% pressure was 11. No problems to report again. AHI is trending downward. This is so awesome. lol