Chin strap with FFM - recommendations

[CPAPSteve]

This topic has been touched on in the past but I wanted to get peoples opinions on what chin strap would work best to achieve what I need. I have recently started developing intense dry mouth again (not sure what changed) but using biotene, drinking more water throughout the day and even bumping up the humidity hasn’t helped.

I would rather not tape because I want the flexibility to breathe out of my mouth as needed because I get a wicked bad plugged nose once I lie down and things don’t open up until I am nearly asleep. My mouth tends to drop open when I am extremely tired.

I mostly use a resmed f20 ffm and occasionally a p10 nasal pillow when I nap.

The goal for using a chin strap is to keep my mouth closed to reduce dry mouth while having the flexibility to mouth breathe as needed. I can’t have a strap that applies any inward pressure to my jaw as I have suffer from TMJ issues.

Looking at a video that CPAP.com posted on YouTube years ago seems to gloss over the various straps styles and the very last one (appears to be a Philips Respironics deluxe chin strap) sounded like it was the most comfortable and effective. Seems it could serve double duty to prevent me from being able to easily remove my mask in my sleep.

Thoughts on the Philips deluxe chin strap ? Is there a big difference between the Philips original deluxe chin strap vs the Philips premium strap? The premium strap here in Canada seems to cost considerably less than the deluxe one.

Many thanks,

[Julie]

Can't recommend one over the other, but will say that people have been less happy with straps than they have with soft cervical collars that keep your head up, airway more open and jaws, but not lips closed.

[CPAPSteve]

I did consider a collar but one thing comes to mind - heat. I sleep quite hot and my wife is already complaining the house is too cold at night as it is so I thought to try something not quite as warm first.

[Sheriff Buford]

Steve: though you didn't come out and say it, and the whole point to the thread is about fixing the dry mouth issue, but can I assume that the dry mouth is completely unbearable?

I sleep probably all night with my mouth open due to nasal issues. Like everything cpap-related, I've gotten used to the dry mouth. Is that possible?

Sheriff

[CPAPSteve]

Hey Sheriff, it is pretty annoying (borderline unbearable) and it is so bad that I almost wake once or twice a night like clockwork and my mouth is like the Sahara dessert. Painful to say the least and the only option I haven’t tried is xylimelts but I would prefer to treat the root cause of the issue which is the fact that my mouth tends to drop open when I am in deep sleep. I love using the P10 but I only use it for short naps because I can’t keep my jaw closed for more than maybe an hour or so before I find it starts to leak out of my mouth. This is why I mostly use the F20 because at least when I use a FFM I know my therapy is at least working.

The funny thing about the cervical collar is that I did have one years ago that I finally got rid of because I couldn’t see myself ever needing it after my neck injury from 15+ years back.

[Julie]

The collar you wear with Cpap has no relation to the whiplash type... it's small, soft and may not be a heat issue at all... a forum search (or Google) would show you some.

[Snoregone Conclusion]

Hey CPAPSteve,

I have used a ResMed chin strap (ref 16015) for 2 nights with good success. While I wouldn't claim to have had TMJ issues, I did have lower jaw advancement surgery about half a lifetime ago, and muscles don't quite fit like they used to. I've found that it doesn't cause any problems with it jacking the jaw around. I believe this is the only chin strap ResMed sells: it's what my DME shipped me when I asked for one, for some weird reason, they don't list them at all on their website and didn't have any in stock, and yet, they have nasal masks.... As much due to the jaw surgery as anything, it's more natural for my jaw to come open than not, no matter what: it takes at least a small amount of effort while awake to keep it closed, and while asleep, things balance out at least slightly open by default, even without being a mouth-breather (except when exercising hard enough: I can't possibly breathe in all through my nose when above aerobic limits).

I'm running at a 20-20 pressure with 3 EPR and without it, I'm not just dealing with a dry mouth, I'm dealing with dry lungs, which takes a lot of rehydration to make feel back to normal.

[Jas_williams]

I did consider a collar but one thing comes to mind - heat. I sleep quite hot and my wife is already complaining the house is too cold at night as it is so I thought to try something not quite as warm first.

I have had good success with a Dr Dakota collar as this is just a block under your chin and a strap at the rear which is cooler

[CPAPSteve]

The collar you wear with Cpap has no relation to the whiplash type... it's small, soft and may not be a heat issue at all... a forum search (or Google) would show you some.

Julie, very aware of the ones used for whiplash... I actually had a minor ski accident and I remember the collar I purchased was indeed a soft collar as others have suggested to use in this forum. Shame that I tossed it just a year or so ago when I was cleaning out my closet.

Can you imagine wearing a hard aspen collar to sleep to keep mouth closed?? LOL

[CPAPSteve]

I did consider a collar but one thing comes to mind - heat. I sleep quite hot and my wife is already complaining the house is too cold at night as it is so I thought to try something not quite as warm first.

I have had good success with a Dr Dakota collar as this is just a block under your chin and a strap at the rear which is cooler

I do recall folks in the past mentioning the Dr. Dakota collar as well. I will check that out to see where in Canada I can look/buy it.

Still wanting to know if anyone has actually tried using the Philips deluxe strap. Looks comfy but somewhat big b/c of how wide the band is.

[CPAPSteve]

Hey CPAPSteve,

I have used a ResMed chin strap (ref 16015) for 2 nights with good success. While I wouldn't claim to have had TMJ issues, I did have lower jaw advancement surgery about half a lifetime ago, and muscles don't quite fit like they used to. I've found that it doesn't cause any problems with it jacking the jaw around. I believe this is the only chin strap ResMed sells: it's what my DME shipped me when I asked for one, for some weird reason, they don't list them at all on their website and didn't have any in stock, and yet, they have nasal masks.... As much due to the jaw surgery as anything, it's more natural for my jaw to come open than not, no matter what: it takes at least a small amount of effort while awake to keep it closed, and while asleep, things balance out at least slightly open by default, even without being a mouth-breather (except when exercising hard enough: I can't possibly breathe in all through my nose when above aerobic limits).

I'm running at a 20-20 pressure with 3 EPR and without it, I'm not just dealing with a dry mouth, I'm dealing with dry lungs, which takes a lot of rehydration to make feel back to normal.

I looked at the Resmed strap at my DME last month and I wasn't overly gung ho over it's narrowness. I move around a lot in my sleep and I would be concerned of it falling off my face/head. That is not to say I won't reconsider it but I had some reservations about it when I last looked at it. Fortunately for me, my TMJ issues never required surgery but did need me to wear braces as an adult no less than 3 times to keep my jaw properly aligned. I really should've done jaw surgery to fix it in my early 20's but I didn't bother because of the inherent risks that surgery had.

[Snoregone Conclusion]

Hey CPAPSteve,

I have used a ResMed chin strap (ref 16015) for 2 nights with good success. While I wouldn't claim to have had TMJ issues, I did have lower jaw advancement surgery about half a lifetime ago, and muscles don't quite fit like they used to. I've found that it doesn't cause any problems with it jacking the jaw around. I believe this is the only chin strap ResMed sells: it's what my DME shipped me when I asked for one, for some weird reason, they don't list them at all on their website and didn't have any in stock, and yet, they have nasal masks.... As much due to the jaw surgery as anything, it's more natural for my jaw to come open than not, no matter what: it takes at least a small amount of effort while awake to keep it closed, and while asleep, things balance out at least slightly open by default, even without being a mouth-breather (except when exercising hard enough: I can't possibly breathe in all through my nose when above aerobic limits).

I'm running at a 20-20 pressure with 3 EPR and without it, I'm not just dealing with a dry mouth, I'm dealing with dry lungs, which takes a lot of rehydration to make feel back to normal.

I looked at the Resmed strap at my DME last month and I wasn't overly gung ho over it's narrowness. I move around a lot in my sleep and I would be concerned of it falling off my face/head. That is not to say I won't reconsider it but I had some reservations about it when I last looked at it. Fortunately for me, my TMJ issues never required surgery but did need me to wear braces as an adult no less than 3 times to keep my jaw properly aligned. I really should've done jaw surgery to fix it in my early 20's but I didn't bother because of the inherent risks that surgery had.

So, here's to address your concerns with it sliding off: if you have it on tight enough (I didn't even adjust it from the default package setting, it worked well, but it is adjustable) it won't be a problem when you use as directed. If you're looking at it sliding around just because it's a single narrow band around your head, you aren't looking at it from the correct perspective: if you only wear it by itself, I'd fully expect rolling around would have it come off. If you start looking at things from a systems view, also keep in context that if you had it go around the headgear of whatever mask you use, it likely also would slide off as you roll around. But now we get to the magical systems view where you use it as directed: it works far far better.

How much better? In my 2 days of experience, where I wear it as directed (put it on first, then put on mask with headgear over it) it has a synergistic value where the whole is greater than the sum of the parts: the headgear keeps the (apparently) unstable chin strap stable, because it has it bound down by pressure in other ways, and the chin strap itself (both the strap part as well as the chin part) helps keep the headgear and mask on better, in my case, the bottom of the mask rests partly on the chin part: even without it resolving my issue of my mouth opening to burp out air while sleeping (which got messy with humidity built-up and bottom lip getting past the bottom of the mask, resulting in certain wake up) I could relax my face a bit, and the pressure of the mask against the chin part causes it to move around less, improving the average seal and reducing the leak rate. It's once I had the chin strap that I deciphered what was causing the weird mask issues: once the mouth was kept sufficiently closed (not with so much force as to hurt jaw or teeth, a little open when relaxing the jaw, but lips keep sealed) that when I woke up and found I had a lot of air to pass out the backside! The headgear and mask fully stabilized the chin strap, and the chin strap greatly stabilized the headgear and mask, when used as directed/described. Wearing a more involved chin strap "solution" with comparable headgear would likely result in less stability, not more, I'm guessing, in much the same way you run a high risk of a wobbly table with 4 legs in imperfect conditions (leg length not perfectly matched, or uneven floor) but if you have exactly 3 legs, it won't wobble: it'll either be perfectly stable or if 1 leg is way too short, it'd never stand, due to a severe weight imbalance.

From what I see, it's a cheap experiment: worst-case scenario is you have a helmet strap to add to a helmet

[wardmiller]

I use a home-made chin strap I saw here about 6 years ago. Take a velco strap about 8" or 9" long, loop it over one of the FFM lower straps, feed it across under the bottom of your chin and over the other lower strap, then join the ends of the strap. It does not need to be drum tight, just snug so it presses up under the chin. You can still open your lips, but the strap tends to keep your mouth closed and lips as well.

There was an excellent picture of it here, but I don't know how to find it now. Much better than any of the commercial chin straps I've seen.

[CPAPSteve]

I use a home-made chin strap I saw here about 6 years ago. Take a velco strap about 8" or 9" long, loop it over one of the FFM lower straps, feed it across under the bottom of your chin and over the other lower strap, then join the ends of the strap. It does not need to be drum tight, just snug so it presses up under the chin. You can still open your lips, but the strap tends to keep your mouth closed and lips as well.

There was an excellent picture of it here, but I don't know how to find it now. Much better than any of the commercial chin straps I've seen.

Yes I saw that. It was actually someone’s bike strap ofnsome sorts I believe. I’ll see if I can get my hands on some Velcro this week.

[wardmiller]

If you have an old mask & head straps you can use the old straps. Takes two. Sew then end-to-end, or use the Velcro to connect two together