refractory chipmunk (5+ types of straps tried)

[Beat OSA]

Hi. I'm curious when and how do chipmunk form when sleeping. The anatomy of our upper respiratory tract seems to make it more likely to form during EXPIRATION instead of INSPIRATION(am I wrong?) So theoretically if I tune down the pressure during expiration (by setting EPR to 3), is it less likely for chipmunk to form? I'm currently on CPAP 12mmHg and EPR =0.

[chunkyfrog]

EPR does help.
When the mouth fills with exhaled air, the chipmunk cheeks form.
The secret is to train the REAR of your mouth to CLOSE and direct air out the nose.
This means that your soft palate, uvula, and the back of your tongue seal together.
This is normal when we breathe only through the nose.
If you can breathe through your nose while awake, it's the same way
when we breathe through the nose while asleep.
Practice helps, and soon it will be easy. Use EPR.

[Beat OSA]

EPR does help.
When the mouth fills with exhaled air, the chipmunk cheeks form.
The secret is to train the REAR of your mouth to CLOSE and direct air out the nose.
This means that your soft palate, uvula, and the back of your tongue seal together.
This is normal when we breathe only through the nose.
If you can breathe through your nose while awake, it's the same way
when we breathe through the nose while asleep.
Practice helps, and soon it will be easy. Use EPR.

Thank you frog. I think I'm a nose breather during the day. It's just my jaw will helplessly fall open when I'm asleep, especially when I'm in the supine position. And I'm a naturally supine sleeper -- I always found side sleep is less comfortable for me. I'll try setting my EPR to 3 tonight.

[palerider]

Hi. I'm curious when and how do chipmunk form when sleeping. The anatomy of our upper respiratory tract seems to make it more likely to form during EXPIRATION instead of INSPIRATION(am I wrong?) So theoretically if I tune down the pressure during expiration (by setting EPR to 3), is it less likely for chipmunk to form? I'm currently on CPAP 12mmHg and EPR =0.

The EPAP (lowest pressure, pressure while not inhaling, etc) is what holds your airway open so that you can inhale again.

If you drop the EPAP too far, then you'll have more breathing issues, (snoring, flow limitations, hypopneas and apneas).

[Miss Emerita]

You can try supporting your jaw from below by using a soft cervical collar.

[zonker]

this post is to tag on to what miss e said right above this.

i use a firm foam cervical collar rather than a chin strap as i could never get the chin strap to work. in the u.s., these can be found at a local pharmacy. not sure if that's the case in "asia". if not, search for it on amazon. they help keep your jaw from dropping, but do not keep your mouth from opening.

i use it in conjunction with scunci brand hair bands. forum friend jay ahsee talks about it in this thread-
https://www.cpaptalk.com/viewtopic.php? ... s#p1086296

i use a modified version of the method he describes, but his method is where i started. and this keeps me from getting that dreaded "chipmunk cheeks".

if interested in the modifications, let me know.

good luck!

[Janknitz]

To add just a bit to what Chunky said, try this experiment:
Put your tongue on the roof of your mouth, on that ridge just behind the front teeth.
Plug your nose.
Can you breathe in or out? If you can, it may be that you cannot seal the back of the oropharynx well (something that may bear a discussion with your dentist or a speech therapist).
But if you cannot breathe in and out with your tongue in place and nose plugged, it means you CAN seal off the back of the throat.

The key is to practice all day, every day. If you are not eating or talking, your tongue should be in that spot. It will take a few days until it's a habit that will carry over all night.

Theoretically, even if your mouth falls open, this seal should still hold. (I think someone else recommends that you sort of suck in after you place your tongue so that it sticks to the spot better). Try it--open your mouth with tongue in that position and plug your nose again. This seal is not dependent on whether your mouth is open or closed.

Using an aid like a cervical collar, some tape (I don't even think you need to seal your mouth, just a vertical strip to hold your jaw up) or a chin strap may certainly help, so I'm not against that. Anything to help.

[Beat OSA]

this post is to tag on to what miss e said right above this.

i use a firm foam cervical collar rather than a chin strap as i could never get the chin strap to work. in the u.s., these can be found at a local pharmacy. not sure if that's the case in "asia". if not, search for it on amazon. they help keep your jaw from dropping, but do not keep your mouth from opening.

i use it in conjunction with scunci brand hair bands. forum friend jay ahsee talks about it in this thread-
https://www.cpaptalk.com/viewtopic.php? ... s#p1086296

i use a modified version of the method he describes, but his method is where i started. and this keeps me from getting that dreaded "chipmunk cheeks".

if interested in the modifications, let me know.

good luck!

Hi guys. Thanks for all your kind advice. A quick update

I bought a foam cervical collar and tried several combinations with a cervical collar, chin strap, hair band and tape.
sadly, It seems to me that the cervical collar did a just-so-so job of preventing my mandible from falling.
And more importantly, I surmise that theoretically the chin strap and cervical collar maybe can't help much with the chipmunk problem bc I could easily do a chipmunk chin with my jaw closed (tried it yourself). The hairband when applied against my chin would theoretically help by preventing the bubble from forming. But I failed to find one with ideal tension and comfort.

So I come up with a theory: what if I do not completely seal my mouth and only tape the middle part of my lips and leave the corner of my lips open, so the air could not build up in my mouth to an extent to cause chipmunk. And you may ask what about the mouth leak? Well, I think the mouth leak is troublesome bc 1st it's lower the therapeutic pressure and 2nd it would wake you up. By partially taping my mouth and using some sort of a jaw appliance (strap, collar) I could not open my mouth so wide-open to cause big mouth leak and hopefully the occasional small leak would not wake me up in the middle of night.

furthermore, I keep searching for a better way to keep my jaw closed and I found this youtube video
https://youtu.be/KCchQiwWt0U

So I made one and it seems better than the chinstrap. (And you would not blv how I explained to the confused tailor)

So I used the new combination (incomplete taping + cap-strap) with my P10 for a couple of days and it seems I felt better (the most important goal)

A screenshot of last Saturday (best night). Last night is somewhat awful maybe bc I stay up late and the tape went off during the night. I've not look into the data yet.

Conclusion: if anyone suffered from the same chipmunk problem as me using P10, plz try this method.

Screenshot 2022-04-18 at 12.14.54.png (461.33 KiB) Viewed 2028 times

[Miss Emerita]

What a great solution! It’s a bit like the Knightsbridge dual strap:

https://dualbandchinstrap.com/https://d ... strap.com/

But the DIY sounds like an even better homegrown fix. Thanks so much for sharing the tip!

[Beat OSA]

What a great solution! It’s a bit like the Knightsbridge dual strap:

https://dualbandchinstrap.com/https://d ... strap.com/

But the DIY sounds like an even better homegrown fix. Thanks so much for sharing the tip!

You are welcome. And another advantage of using a cap-converted-strap is that the cap will prevent the awkward strap mark on your scalp in the morning. I don't know if it works as well for long hair, but If you are a buzz-cut guy like me, the improvement is quite huge.

[zonker]

So I used the new combination (incomplete taping + cap-strap) with my P10 for a couple of days and it seems I felt better (the most important goal)

well done, you! you've found a solution to your problem and it helped improve your sleep. thanks for coming back and letting us know.

and to those of you lurking, remember, this is YOUR therapy. while we might make suggestions, sometimes you may have search and find your own way of doing things.