Nose breathing with nasal pillows

[gregnga]

Maybe I am missing the obvious, but I have the ComfortLite 2 Nasal Interface mask and was wondering how you are supposed to exhale thru your nose when you have air blowing in. Since I've gotten this mask, I have been exhaling through my mouth.

[oldgearhead]

NO, you should not exhale through your mouth. Many, like myself,
tape their mouth closed, so that, all of the benefits of xPAP can be realized.

Your expelled air should be vented out the tiny holes located in front of the CL2's elbow.

Since we do not know which machine you have, and what pressure you are
using, there is little more I can say. Please fill out your profile to get the best advice (help).

[Guest]

Exhale only through your nose. It feels hard at first but you will get used to it. If your machine has a ramp feature this can let you get to sleep before the pressure builds up. On a typical night, when I first turn on the machine I really feel the pressure against my exhaling. If I awake in the night I really don't really even notice the pressure. It just takes a little time to get used to. Hopefully you can teach yourself not to mouth breathe and avoid having to tape your mouth as some do.

[roster]

................. how you are supposed to exhale thru your nose when you have air blowing in. ...............

Once you have your mouth closed and are only breathing through your nose you can think of the cpap as "applying pressure" not "blowing air in".

Without cpap you are breathing out against a pressure of about 1033 cm H20 (one standard atmospheric pressure). A typical cpap setting is 10 cm H20.

So with cpap you will be breathing out against a pressure of 1043 instead of the pressure of 1033 that you are accustomed to. This is usually not a big deal for most people. Bigger problems are finding a mask you can tolerate, preventing mask leaks, and preventing mouth leaks.

[rested gal]

I agree absolutely with everything oldgearhead wrote in his reply to you, gregnga.

One of the most important reasons (imho, and I'm not a doctor or anything in the health care field) to NOT exhale through your mouth when using a CPAP machine with a nasal mask (covers the nose) OR nasal pillows interface is this:

While you are awake, you can control which way you exhale -- through nose or mouth. But when you drift off to sleep after several minutes of exhaling through your mouth, you will be likely to begin also INHALING through your mouth. Mouth breathing will defeat the purpose of using CPAP.

Furthermore, if you happen to be using an autopap instead of a straight cpap machine, the autopap needs to sense what's happening with the airflow when you are inhaling AND exhaling.

With either type of machine, straight CPAP or Autopap, exhaling through your mouth is going to be regarded by the machine as a massive leak.

As oldgearhead said, your ComfortLite 2 nasal pillows mask has exhaust vent holes that whisk away your exhaled air when you breathe out through your nose. Do breathe through your nose for both inhaling and exhaling.

If the pressure you've been prescribed is bothering you when you try to exhale through your nose, what the Guest said may eventually happen for you, as it does for most people:

"On a typical night, when I first turn on the machine I really feel the pressure against my exhaling. If I awake in the night I really don't really even notice the pressure. It just takes a little time to get used to. "

However, if exhaling against pressure continues to bother a person, there are CPAP machines that offer exhalation relief, like the C-Flex feature in most Respironics models.

Difficulty in exhaling against the incoming pressure doesn't mean you need to exhale through your mouth. But it could mean you might need a different machine or different settings if you can't get used to breathing out comfortably against the pressure.

[ltd123]

Gregnga - I think everyone has that reaction at first; hopefully you will get used to exhaling against the flow - most people seem to. I never could. Give it a try but if things don't improve, start bugging the people who sold you the machine for help. My experience has been that even the professionals...nicest, most sincere seeming people would give me wrong information at times. I had to keep asking and seeking answers. One tech would say the settings on my machine could not be changed... she even contacted the company and was told the settings could not be changed to help. I would read this forum and see that people here knew more than my tech. Armed with info I read here, I contacted the doctor's office and found someone who could reset my machine. There were many things they could try that adjusted the air current when I tried to exhale. I tried various possibilities for 2 months til the doctor's office staff suggested changing to a bi-pap machine which has been the solution for me.
The point of that long story is that you are going to have to keep asking for/demanding information and help from the professionals til you resolve whatever problems you have with adjusting to the treatment. Good luck and don't give up.
Laura