Mouth breathing?

[steveko23]

How can I tell if I am or are not mouth breathing? I have a nasal mask, and I do wear a mouth piece because my dentist recommended it years ago for night time teeth grinding (which I'm hoping is all related to my sleep apnea) but I don't know how to tell for sure if I am breathing through my mouth over the course the the evening. Would OSCAR should massive leaks? Or if I just open my month for a moment would OSCAR show a leak and I really couldn't tell if the leak was due to my mouth being open or due to my mask coming off for a moment? Or maybe OSCAR doesn't show anything when my mouth opens?

Thanks!

[Pugsy]

Would OSCAR should massive leaks?

Maybe....maybe not.

Not all mouth breathing equals massive leaking.

You need to tape your mouth shut and make sure the tape doesn't come loose and then see what the leak line looks like to get an idea if you are mouth breathing or not.

A while back I woke up and I was mouth breathing and since I wasn't quite ready to get up out of bed I decided to just lay there and continue mouth breathing so that I could see exactly what showed up on the leak graph with known mouth breathing.

Below is the report....and I circled the known mouth breathing at the end of the night in red.
As you can tell the leak was actually very minimal and certainly far from massive....and certainly not enough to impact therapy either.

[steveko23]

Thanks, I guess I will get some mouth tape to at least rule out if that is or isn't a problem. Though OSCAR should very very little leaking when I've looked at it. I'm just trying to figure out what's going wrong. I've had 19.9 and 15.6 events per hour over the past 2 nights. But the night before that I was 2.3. Last night at least I did change from a min pressure of 6 to 6.8, though I would have guessed that increasing that would have resulted in less events per hour rather than more. But I had no change from the 2.3 to the 15.6 and am still waking up pretty much all night. Apple watch has me waking up a min of 9 times every night and past 2 nights reports me as awake for 2 hours. So I need to be in bed a min of 10 hours to get a reasonable total hours of sleep (though no matter how many total hours I get waking up every 45 min sucks) and being in bed 10+ hours a night isn't really a great option either since I'm not at all tired at 8pm, which is also a bit early to go to bed.

[ChicagoGranny]

I've had 19.9 and 15.6 events per hour over the past 2 nights.

Post a screenshot on imgur.com and put the link in this thread. Instructions in my signature.

[steveko23]

Here are the past 3 days of my OSCAR data:
https://imgur.com/a/E3hLs1x

Thanks for any help interpreting this and what I can do. Interestingly/sadly these past 3 days are some of the worst sleep I've had in the 1.5 months I've been using the CPAP machine. No idea what changed and why my sleep is seemingly getting worse.

[steveko23]

And my not so epic sleep as my apple watch sees it:
https://imgur.com/a/WyP52rO

[Pugsy]

When you say

some of the worst sleep I've had in the 1.5 months

We assume you mean lots of wake ups?????? If so, any idea why?

I don't think you can blame mouth breathing causing failure of therapy as the culprit. Your actual leak line is well within the machine's ability to compensate for.

Something else is going on. IMHO.

[steveko23]

When you say

some of the worst sleep I've had in the 1.5 months

We assume you mean lots of wake ups?????? If so, any idea why?

I don't think you can blame mouth breathing causing failure of therapy as the culprit. Your actual leak line is well within the machine's ability to compensate for.

Something else is going on. IMHO.

No, I don't really mean lots of wake ups because honestly this is about the avg number of wake ups for me. What is more abnormal is the length of time awake during those wake ups. So I was awake while in bed for ~2 hours each of the past 3 nights and I'm usually closer to ~1 hour awake over the course of the night. But no, I have no idea why 1. I wake up so much in general or 2. why over the past 3 days I couldn't fall back to sleep as quickly as I'd like.

And I agree looking at my graphs and your graph on mouth breathing it does appear that isn't the culprit. Maybe I'll try sleeping a night without my mouth guard? Really open to any possible suggestions here.

Thanks!!!

[Pugsy]

Okay....not so many wake ups but a problem with going back to sleep after the whatever wake up.
It's called sleep maintenance insomnia....which is where we either have trouble with the number of wake ups or the problem going back to sleep which lends also to a sleep onset insomnia problem.

Now teasing out the cause of the problem is critical to fixing the problem....but that's not always so easy to do.
Plus even when we do know the cause of the problem....fixing it isn't always so easy either.
Been there and done that and have the TShirt myself.

Begs the question...what changed to cause the poor sleep quality?

Do you take any medications of any kind (even OTC) and if so, what? Any change in dosage of any current meds?

Any other physical or mental health issues going on that could mess with your sleep quality?

Stress????

Bed comfort??? Mask comfort? Any comfort issue???

What could have changed to cause this problem with your sleep quality???

I fully sympathize and empathize with your situation....going through that right now myself and while I know the reason I find it impossible to just turn off the switch and fix the problem.

I suspect that the bulk of the elevated AHI you are seeing is most likely related to false positive flagging of the irregular breathing that comes with being awake or semi awake. You could use SleepHQ and let us zoom in on the flow rate to confirm that possibility but it still doesn't tell us what is causing the poor sleep quality much less fix it.

I don't see it being related to the therapy itself though.
Which means I don't think you have a therapy problem but instead you have a sleep quality problem for some reason or other. Unless leaks are waking you up....they aren't bad enough to impact therapy itself so I don't think leaks of any sort are the problem.

Read this thread please. Prime examples of false positive flagging here.
viewtopic.php?f=1&t=187556&p=1449368&hi ... e#p1449368

[steveko23]

Begs the question...what changed to cause the poor sleep quality?

Do you take any medications of any kind (even OTC) and if so, what? Any change in dosage of any current meds?

Any other physical or mental health issues going on that could mess with your sleep quality?

Stress????

Bed comfort??? Mask comfort? Any comfort issue???

What could have changed to cause this problem with your sleep quality???

I can't really pinpoint anything that would have changed, though to be fair I haven't really had great sleep in 15 years, but I would have said more often than not over the past year I wouldn't have had 3 consecutive nights this abysmal. Though I can't say it hasn't happened previously either.

No meds. And no change in supplements which include taking fish oil and resveratrol.

I did start back at work this past Monday after being off for 1.5 weeks for the holidays. Work is a desk job, I wouldn't say I have stress.

Bed is probably not the best bed in the world, but hasn't changed in 15 years. I think the mask is comfortable, it's the only mask I've ever used so I can't really say I have anything to compare it against, but I wouldn't say I have a comfort issue.

I did start my new years diet and exercise. I'm a typical yo-yo dieter who generally eats well and exercises and loses weight over the first couple months of the years and then gains it all back over the rest of the year. So I did start eating right and exercising again after pretty much just eating sugar over Christmas.

I'd love to get to the root of the insomnia issue, but the searching I found on it doesn't really help. I have 1 caffeinated coffee before 8am and 1 decaf shortly there after. Then drink water. I've tried to stop tech in bed, though tech in bed would hamper my falling asleep not staying asleep right? Thoughts?

Thanks again!!

[steveko23]

I'm glad you mentioned SleepHQ, I'd never heard of it. Here's some data:
Last night: https://sleephq.com/public/25c798fd-454 ... 7612941d34
2 nights ago: https://sleephq.com/public/3c8b4283-695 ... 65391813d7
4 nights ago (better sleep) https://sleephq.com/public/4cf45cce-88e ... 47aed59252
7 night ago (also decent sleep): https://sleephq.com/public/78de9a58-fbf ... 6485874ab7

And some trend data: https://sleephq.com/public/bcfda537-b21 ... d3ad10e525

[steveko23]

Based on this: https://sleephq.com/public/f22d7d52-9a0 ... 67bc56e111
if you zoom in to 10:40 - 11:00 ish. and looking at the breathing compared to the sleep stage, would you say my breathing is waking me up? And thus my apneas are the cause of my constant waking up throughout the night?

[Pugsy]

would you say my breathing is waking me up? And thus my apneas are the cause of my constant waking up throughout the night?

No....your breathing isn't causing the wake ups.
You are waking up FIRST and then you are getting false positive flagging of events.
The flagged events (false positives) are symptoms of the poor sleep but not necessarily the cause of the poor sleep.
Something else is causing the wake ups and it is not related to airway issues.
IMHO anyway.

[steveko23]

So are you saying that nearly all my apnea events are false positives since the vast majority of them seem to occur when my sleep stage is listed as awake? Also, what made you conclude that I'm waking up first and then getting the false positives rather than the event causing the wake up? I was guessing the opposite, but I really have no idea. I really wish there was a conclusive way to know when I was awake vs asleep. I do suspect my watch is doing a decent job, but if magically I could get something that was 100% accurate I think that'd be insightful, because I'm guessing at least some of my wake ups are not really wake ups at all, just a movement that my watch interprets as awake.

[Dog Slobber]

Try mouth tping and see if the leaks and events go away.

I posted this in another topic but it is equally applicable here.

When I first started CPAP and then adjusted to it, I used a nasal mask and never had any mouth-breathing or leak problems.

Then about a year and a half ago, my leaks started creeping up, got bad and I learned I had started mouth breathing. No idea why, and no idea how to stop mouth breathing.

So I ordered some Cover-roll Stretch, but with a beard, there simply wasn't enough surface area for the tape to stick.

So off came the beard. Luckily for me, I am extremely handsome both with a beard and without.

But,... every morning my leaks were back, and the Cover-roll Stretch was barely hanging on. I soon learned that using the xylimelts/drool was leaking and reducing the efficiency of the tape.

I stop using the xyliments and the Cover-roll sticks well every night.

This past Movember was the first one I stayed relatively clean shaven.

I'm lazy about shaving, rarely wet-shave, and use an electric every few days, but now if I let the stubble accumulate for a few days, I'll get some leaks.