Mouth leaks

wading thru the muck! · Post by **wading thru the muck!** » Fri Oct 29, 2004 6:59 pm

Does anyone have any experience with how to prevent/resolve mouth leaks on CPAP?

My wife heard numerous small "puffs" from my mouth. She said she hadn't noticed any my first two nights on CPAP. Maybe she was just enjoying the lack of my snoring!

My software shows leaks, but not above the max line. Does this mean my PB 420E is compensating for any mouth leaks I might have?

Also my apneas have been decreasing to the point where I had none last night.

I guess I'm cured HA!

Seriously I mention this because I wonder if the mouth leaks cause the machine to not recognize my flow restrictions because the pressure is exiting my mouth.

Any insight is much appreciated

sleep technician · Post by **sleep technician** » Fri Oct 29, 2004 8:28 pm

you need a full face mask., or a nasal with a chin strap to keep your mouth close. try using a c hin strap that should work.

sleep technician · Post by **sleep technician** » Fri Oct 29, 2004 8:29 pm

you need a full face mask., or a nasal mask with a chin strap to keep your mouth close. try using a c hin strap that should work.

wading thru the muck! · Post by **wading thru the muck!** » Fri Oct 29, 2004 9:04 pm

I doubt a chin strap would work because I am not opening my mouth.

I also wear a mouth guard to prevent grinding my teeth so there is no slack in my jaw.

I would prefer not to use a full face mask but I may have to try one if I can determine that I am mouth breathing. I would prefer to find another solution though.

Maybe I'll try some duct tape seriously!

rested gal · Post by **rested gal** » Fri Oct 29, 2004 10:44 pm

Taping the lips shut is the way quite a few people solve the problem of air puffing out - which can indeed happen even with jaw closed and lips closed. Chin straps wouldn't prevent lip leaks.

Depending on how forcefully your pressure pushes air out from between your lips, you could first try an Ace (horizontally around your head, covering your lips.) That extra support against the outside of your lips might be enough to keep your lips shut against the air trying to puff out. It also helps keep the cheecks flat. If escaping air balloons the cheeks out, the air is even more likely to escape through the lips.

An Ace covering the lips is what I use, along with a second Ace cut to a length to go over the top of my head, the ends sewn to the sides of the "mouth Ace" to keep the mouth Ace from slipping down. Looks like the simplest horse halter imaginable. If that's not enough, and if you can find a nice thin comfy piece of silicone about 4" x 2 or 3", slap that across the front of your mouth under the mouth Ace for even more support as a dam against the lips. I bought a square of Retouch Scar reduction silicone on Ebay and cut a big rectangle off it to use for extra "damming" under the mouth ace. Very comfortable. The "Retouch" can be rinsed off in the morning and used again and again.

Against higher pressures, taping the lips shut is the surest solution. It would be a good idea to fold one end of the tape onto itself for a "pull off tab". It's been a long time since I've used tape, but...been there, done that. Not fun to remove in the morning.

Yes, your machine is compensating for leaks up until it would hit LL (large leak) on the graph. Interesting question, though, on whether it can read you accurately if some of your exhalation is escaping out your mouth. It probably is reading you accurately enough with small leaks, but dunno...hadn't thought about that.

wading thru the muck! · Post by **wading thru the muck!** » Mon Nov 29, 2004 4:53 pm

Hi Rested Gal,

I've got a perplexing one for you. I tried your silicone pad/ace bandage mouth closure last night. I used it with my Activa mask. I lasted about half the night and I took it off. I 'm sure I could get used to it over time. My leak graph for the first part of last night was practically a flat line. This system seems to work very good. The perplexing thing was my wife just told me I was snoring (through my nose) continuously for about the first ten minutes after I fell asleep. I've never had this happen before. She said once in a while I snore once or twice and then stop.

One other question - do you put the sticky side of the silicone toward your lips? (this is what I did). I tried it both ways while I was fitting thing up but it seemed if I used the smooth side I needed the ace bandage too tight.

I would greatly appreciate your input.

rested gal · Post by **rested gal** » Mon Nov 29, 2004 8:09 pm

Hi Wader,

Yes, I use the "sticky" side of the silicone against my lips.

It helps, but doesn't stop lip puff leaks completely for me, and yes, it's aggravating to wear the Ace too.

As for the perplexing part - that when you first went to sleep all rigged up, your wife heard about 10 minutes of snoring from you even with your lips shut... my guess would be it was just "one of those nights". Did she notice if you were on your back, perchance? If clusters of snores show up more than just occasionally, possibly your lower pressure needs to be upped a tad. Of course, then it becomes a trade-off ... higher "low" pressure increasing the chance of leaks. Personally, I wouldn't worry about upping the pressure unless the snoring seems to interfere with how you feel the next day. Or go by how your wife feels about the snores.

wading thru the muck! · Post by **wading thru the muck!** » Mon Nov 29, 2004 9:25 pm

R G,

Thanks for your analysis. I'm going to try it again tonight. I don't think a pressure increase is in order. I have the minimum pressure set at 6cm and I have a titrated pressure of 7cm (I'm embarassed to admit I require such a low pressure) Maybe I was just congested and that's why I had a hard time with tolerating the mouth seal. My wife thought I was nuts taping my mouth shut. I've notice that I feel better in the morning when my leak graph is flatter. That's why I tried the silicone tape. I'm hoping the illusive Activa full face is a reality soon and am looking forward to trying it.

Thanks for all the help!

Harper · Post by **Harper** » Mon Nov 29, 2004 9:34 pm

Try the Oracle ... I was recently given one by F-P, for a "Market Test" ... if you can get past some of the "startup aggravations" of the Oracle, you might find it to be a good alternative , to all the "Chin Strap Krap" ...

Maybe a thick piece of Silicone, placed INSIDE your lips against your teeth, AND a good chin strap ... find a piece about 1/8" thick, & expiriment with cutting it to a comfortable shape, to fit inside your mouth, so that it won't dig into the "base" of your gums ... but is still large enough to provide a "seal", against the inside of your lips ...

I use a "Modified" Respironics "Deluxe" Chinstrap [the Black one]. I added about an inch of material on each side of the chin cup, because it was too small, & was sliding off my beard. Now, it doesn't "cut" into my chin so much, & I can wear it a bit tighter...

Does anybody here know where to get the material [in Bulk], that most chinstraps, & CPAP headgear seem to be made out of ... not only the "rubbery, padded stuff", but also, the "Stretchy Velcro"? I am pretty good with sewing, & I think I could make my own headgear, a LOT cheper, than buying it thru a DME!

jmiller · Post by **jmiller** » Tue Nov 30, 2004 2:25 pm

I have been reading that heated humidification can have the effect of reducing mouth leaks.

Btech · Post by **Btech** » Mon Dec 06, 2004 12:04 pm

I was plagued by my lips opening up on a regular basis to let out pressurized air for the weeks before I read the above postings. I wrapped an ace bandage around my head and mouth and have stopped all mouth breathing. What a difference. I already look like some creature from a poor sci fi movie so why not add to the picture. Anyway - it works!

rested gal · Post by **rested gal** » Mon Dec 06, 2004 2:08 pm

LOL Btech !! Yeah, I've pretty much given up on worrying about how I look all decked out for the night. As a poster on another board once said (maybe not in these exact words)... "I think of it as my nightly beauty treatment." Heck, for years women went to bed with curlers in their hair. I still remember the pain of sleeping on hard plastic curlers or those bristle covered mesh cylinders during high school.

At least what we cpap users have to put on now at night can be taken off each morning, and we can go about our merry way. When I see/help my dad still being lifted from bed to chair to bed every day for the past two years following a massive stroke, I am soooooo glad I found my way to cpap therapy. I'll happily gear up all night, every night, for breathing purposes.

Thank goodness for the message boards where I was able to find out how to make it work for me. Mouth leaks and puffs from between the lips plagued me from the beginning. Still do from time to time. I can't imagine how people make it with this kind of therapy with only a local DME to turn to. Well, of course, a lot don't...big drop out rate, or so I've heard.

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