I'd been very successfully taping until recently. I've always had the blowfish effect (where air puffs your cheeks and out your mouth). I mouth tape and this seemed to contain it. However, for a while now, the air seems to get under the tape and makes a small channel or more, to escape. I can see a number of leaks now. I've tried different widths and brands of tape. These worked mostly fine before.
I'm not sure why things have changed for me. I did shift to the NA II, though the leak line was nice and calm at the beginning. I am going to try a different mask tonight, either the Bravo or the Swift to see if it's happening with them.
In general, I'd love to get rid of the blowfish, since it does sometimes wake me during the night. I partly got rid of it by learning how to cause the air to go to my lungs and suck my cheeks in, but when I relax into sleep, it seems to come back.
I can't wear a chinstrap because of tmj.
What causes this and what can be done?
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): swift
Blowfish effect and mouth taping
Blowfish effect and mouth taping
- Rose
Thread on how I overcame aerophagia
http://www.cpaptalk.com/viewtopic/t3383 ... hagia.html
Thread on my TAP III experience
http://www.cpaptalk.com/viewtopic/t3705 ... ges--.html
Thread on how I overcame aerophagia
http://www.cpaptalk.com/viewtopic/t3383 ... hagia.html
Thread on my TAP III experience
http://www.cpaptalk.com/viewtopic/t3705 ... ges--.html
You tried ALL the chinstraps? I cannot imagine how my Topaz would irritate TMJ at all. But, I'm not you.
Just checking... If it might work for you, I'll keep a note, and when I figure out how to create a natural fiber Topaz, send you a sample for testing.
Do not hold your breath. Jen will figure out how to KNIT ONE faster than I'll figure out how to SEW ONE!
GOOD LUCK!!!!!
B.
Just checking... If it might work for you, I'll keep a note, and when I figure out how to create a natural fiber Topaz, send you a sample for testing.
Do not hold your breath. Jen will figure out how to KNIT ONE faster than I'll figure out how to SEW ONE!
GOOD LUCK!!!!!
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula. 
-
Guest
Did you possibly have a tonsillectomy as a child or adult?
If so, that could be why you cannot stop mouth breathing or the blow-fish syndrome. As the air pressure comes in from the nasal passage it has to push against the soft palate and Uvula against the base of the tongue. If you cannot maintain that seal between the base of the tongue and the soft palate, any air that gets by will escape out the mouth.
In order to maintain that seal, you need to keep your tongue planted up into the hard palate. When you plant your tongue into the hard palate it brings the tongue base and soft palate closer together improving that seal.
I spent some time playing around with that, using a small hand-held mirror and a small flashlight.
I wanted to see how far I had to open my mouth before that "seal" was broken. I was laying down in bed with the mask On, machine on at my starting pressure. Once the machine turned on I realized where the seal was being made. I then let my lips part keeping my tongue planted into the base of the tongue. I continued to let my mandible drop slowly watching in the mirror and holding the flash light to see what was happening inside. I was surprised to see my soft palate touching the base of the tongue, the Uvula was in the "vee" of the tongue making that seal, it was like that anatomy was molded for that purpose.
I continued to open my mouth wider while watching in the mirror until that seal broke. I was surprised I could open and part my lips about 1" before that seal broke.
My pressure never usually gets over 10 cm, but I imagine if my pressure was higher I probably couldn't hold that seal as long or open my mouth as far.
The point to all this was it showed me where the seal was being made. I could close my mandible and put my tongue back into the palate and things would reseal.
I did it a half dozen times.
So I can understand now why they suggest a chin strap. But from my own tests I learned that he chin strap doesn't have to apply a lot of pressure to keep your mandible from dropping. In fact, you don't even need a stretchy type strap, it just needs to be a belt-like strap that doesn't apply a lot of pressure, like a velcro strap.
Next if you study how a dental device works you learn that it moves the mandible down and out. This is probably not good for you TMJ because that movement out comes from the TMJ joint. If you use a chin strap that wraps around the crown of your head at the back, it will pull your mandible back into the TMJ joint beyond your natural relaxed position, not much be even if it is 2mm, that 2mm narrows your airway at the back of the throat by that same 2mm. Look at the MMA/GA surgery from Josh and others, they are lucky if that surgery gives them 10 to 14mm, but with that surgery you understand the concept.
All a chin strap has to do is keep your mandible from dropping. When it drops it drops when you are asleep, probably including some of the same muscle control that allows your tongue to fall into the back of the throat or the beer belly muscles that allow the airway to collapse.
So all the strap should do is keep your mandible from dropping. That strap doesn't need any real tension "IF" it can be held in place. The strap needs to be VERTICAL as opposed to attaching at the back or crown of the head. If you don't use one attached to the crown of the head it shouldn't pull the mandible back into the TMJ joint, should not narrow the airway at the back of the throat.
Something you could try:
1. Right before bed after you brush your teeth, take a teaspoon of honey and put it in your mouth, allow it to coat the top of the tongue and the palate.
2. Check your machine reports and compare leak rates the next day. The concept of using the honey is to make your tongue and soft palate "sticky" so it more easily maintains that seal. But just like those snore sprays, it may not work for you (e.g. if you had your tonsils taken out). But BreatheRight strips have been clinically shown to reduce RDI. All they do is keep your nose open and reduce congestion. They also make a snore spray which also has been clinically shown to work in reducing snoring, again NOT with everyone but those it did work with, they had observations with and without on those that seen positive results and it did reduce their snoring. All that spray does is the same thing as honey, it makes the soft palate stick to the tongue and you snore less. Honey does the same thing.
3. You also have to practice keeping your tongue planted in the hard palate, again the honey may help.
I think you can stop it, I used to mouth breathe all the time, I have the reports to prove it. My 30-day avg leak rate is around 10L/m. I could use 3 rolls of duct tape and never get my leak rate down that low. Probably a lot of that lower leak rate may be due to using the A-Flex machine. It has always been in Respironics algorithm to lower pressure on Large Leak. Could it be that the relief on inhale therapy offered by A-Flex reduce my mouth leaks? I don't know, but I follow a routine that seems to work well and if I was having Large Leaks associated with mouth breathing, I think it would show up on my reports.
My routine is:
1. Address any nasal congestion, I do that by using a saline rhino rinse regularly, sometimes only once a week, sometimes 2-3 depending on allergy season/conditions.
2. I use a BlueAir true HEPA filter in my bed room. It runs 24 hrs a day. Probably doesn't do any good at night because the machine filters the air I actually breathe in via the hose. I am allergic to dust mites like many, so I do a lot of vacuuming.
3. I use a Large BreatheRight strip across my nose every night, it fits under my Soyala nasal mask. I buy 2-3 boxes every time I go to Costco.
4. I use a Large Soyala nasal mask so that I'm sure there is no outside pressure on my nose contributing to any nasal congestion.
5. I have my bed elevated, I take a PecidComplete tablet before bed, berry flavor is best.
Some how I can't help but think the A-Flex has helped with controlling that leak rate obviously better than I ever got on Cflex or my 420e, but I haven't used the 420e since getting the A-Flex, been using it over a month now.
Other causes:
-If you have recently switched mask interfaces, I would try going back to the one you used prior, if you have for example a slight deviated septum and switch masks or cinch up on pressure it can put extra pressure on the end of your miss piggy nose and cause that septum valve to completely close.
-Paradoxical vocal cord dysfunction. PVD can also be a cause, it can be exacerbated with GERD. If your airway becomes blocked due to PVD dysfunction it will block your airway both directions. So not only does your airway become blocked it becomes harder for CPAP to open the airway, if there is a lot of thick mucosa it can act like glue and keep those vocal cords closed were no air can pass.
In other words, with PVD no amount of CPAP pressure will be able to force those cords open (also RG's theory on NR's being returned by Respironic auto machines), so the pressure backs up has no place to go so it has to come out your lips making it nearly impossible to maintain that tongue-palate seal. In that case you use 5 wraps of duct tape I think. If that is the cause, I would suggest elevating the head of the bed, try a PecidComplete before bed, make sure your allergies are not leaving a lot of mucosa at the back of the throat (can also make PVD worse, in that case you need a decongestant for several days to dry things out). But using a decongestant is even controversial, some think you need to let that mucosa flush things out. Again, I find the saline rhino rinse on a regular basis eliminates that from happening.
If so, that could be why you cannot stop mouth breathing or the blow-fish syndrome. As the air pressure comes in from the nasal passage it has to push against the soft palate and Uvula against the base of the tongue. If you cannot maintain that seal between the base of the tongue and the soft palate, any air that gets by will escape out the mouth.
In order to maintain that seal, you need to keep your tongue planted up into the hard palate. When you plant your tongue into the hard palate it brings the tongue base and soft palate closer together improving that seal.
I spent some time playing around with that, using a small hand-held mirror and a small flashlight.
I wanted to see how far I had to open my mouth before that "seal" was broken. I was laying down in bed with the mask On, machine on at my starting pressure. Once the machine turned on I realized where the seal was being made. I then let my lips part keeping my tongue planted into the base of the tongue. I continued to let my mandible drop slowly watching in the mirror and holding the flash light to see what was happening inside. I was surprised to see my soft palate touching the base of the tongue, the Uvula was in the "vee" of the tongue making that seal, it was like that anatomy was molded for that purpose.
I continued to open my mouth wider while watching in the mirror until that seal broke. I was surprised I could open and part my lips about 1" before that seal broke.
My pressure never usually gets over 10 cm, but I imagine if my pressure was higher I probably couldn't hold that seal as long or open my mouth as far.
The point to all this was it showed me where the seal was being made. I could close my mandible and put my tongue back into the palate and things would reseal.
I did it a half dozen times.
So I can understand now why they suggest a chin strap. But from my own tests I learned that he chin strap doesn't have to apply a lot of pressure to keep your mandible from dropping. In fact, you don't even need a stretchy type strap, it just needs to be a belt-like strap that doesn't apply a lot of pressure, like a velcro strap.
Next if you study how a dental device works you learn that it moves the mandible down and out. This is probably not good for you TMJ because that movement out comes from the TMJ joint. If you use a chin strap that wraps around the crown of your head at the back, it will pull your mandible back into the TMJ joint beyond your natural relaxed position, not much be even if it is 2mm, that 2mm narrows your airway at the back of the throat by that same 2mm. Look at the MMA/GA surgery from Josh and others, they are lucky if that surgery gives them 10 to 14mm, but with that surgery you understand the concept.
All a chin strap has to do is keep your mandible from dropping. When it drops it drops when you are asleep, probably including some of the same muscle control that allows your tongue to fall into the back of the throat or the beer belly muscles that allow the airway to collapse.
So all the strap should do is keep your mandible from dropping. That strap doesn't need any real tension "IF" it can be held in place. The strap needs to be VERTICAL as opposed to attaching at the back or crown of the head. If you don't use one attached to the crown of the head it shouldn't pull the mandible back into the TMJ joint, should not narrow the airway at the back of the throat.
Something you could try:
1. Right before bed after you brush your teeth, take a teaspoon of honey and put it in your mouth, allow it to coat the top of the tongue and the palate.
2. Check your machine reports and compare leak rates the next day. The concept of using the honey is to make your tongue and soft palate "sticky" so it more easily maintains that seal. But just like those snore sprays, it may not work for you (e.g. if you had your tonsils taken out). But BreatheRight strips have been clinically shown to reduce RDI. All they do is keep your nose open and reduce congestion. They also make a snore spray which also has been clinically shown to work in reducing snoring, again NOT with everyone but those it did work with, they had observations with and without on those that seen positive results and it did reduce their snoring. All that spray does is the same thing as honey, it makes the soft palate stick to the tongue and you snore less. Honey does the same thing.
3. You also have to practice keeping your tongue planted in the hard palate, again the honey may help.
I think you can stop it, I used to mouth breathe all the time, I have the reports to prove it. My 30-day avg leak rate is around 10L/m. I could use 3 rolls of duct tape and never get my leak rate down that low. Probably a lot of that lower leak rate may be due to using the A-Flex machine. It has always been in Respironics algorithm to lower pressure on Large Leak. Could it be that the relief on inhale therapy offered by A-Flex reduce my mouth leaks? I don't know, but I follow a routine that seems to work well and if I was having Large Leaks associated with mouth breathing, I think it would show up on my reports.
My routine is:
1. Address any nasal congestion, I do that by using a saline rhino rinse regularly, sometimes only once a week, sometimes 2-3 depending on allergy season/conditions.
2. I use a BlueAir true HEPA filter in my bed room. It runs 24 hrs a day. Probably doesn't do any good at night because the machine filters the air I actually breathe in via the hose. I am allergic to dust mites like many, so I do a lot of vacuuming.
3. I use a Large BreatheRight strip across my nose every night, it fits under my Soyala nasal mask. I buy 2-3 boxes every time I go to Costco.
4. I use a Large Soyala nasal mask so that I'm sure there is no outside pressure on my nose contributing to any nasal congestion.
5. I have my bed elevated, I take a PecidComplete tablet before bed, berry flavor is best.
Some how I can't help but think the A-Flex has helped with controlling that leak rate obviously better than I ever got on Cflex or my 420e, but I haven't used the 420e since getting the A-Flex, been using it over a month now.
Other causes:
-If you have recently switched mask interfaces, I would try going back to the one you used prior, if you have for example a slight deviated septum and switch masks or cinch up on pressure it can put extra pressure on the end of your miss piggy nose and cause that septum valve to completely close.
-Paradoxical vocal cord dysfunction. PVD can also be a cause, it can be exacerbated with GERD. If your airway becomes blocked due to PVD dysfunction it will block your airway both directions. So not only does your airway become blocked it becomes harder for CPAP to open the airway, if there is a lot of thick mucosa it can act like glue and keep those vocal cords closed were no air can pass.
In other words, with PVD no amount of CPAP pressure will be able to force those cords open (also RG's theory on NR's being returned by Respironic auto machines), so the pressure backs up has no place to go so it has to come out your lips making it nearly impossible to maintain that tongue-palate seal. In that case you use 5 wraps of duct tape I think. If that is the cause, I would suggest elevating the head of the bed, try a PecidComplete before bed, make sure your allergies are not leaving a lot of mucosa at the back of the throat (can also make PVD worse, in that case you need a decongestant for several days to dry things out). But using a decongestant is even controversial, some think you need to let that mucosa flush things out. Again, I find the saline rhino rinse on a regular basis eliminates that from happening.
Jeff, you are SOOOOO lying!!!!!!!!!!! You're not really doing that, are you????
Who knew.... Why not use a ball gag?
http://www.extremerestraints.com/mouth-gags_22/
LOL,
B.
Who knew.... Why not use a ball gag?
http://www.extremerestraints.com/mouth-gags_22/
LOL,
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula.
LOL I can only imagine what your closet looks like, I bet you have a locker at the end of the bedBabette wrote:Jeff, you are SOOOOO lying!!!!!!!!!!! You're not really doing that, are you????
Who knew.... Why not use a ball gag?
http://www.extremerestraints.com/mouth-gags_22/
LOL,
B.
someday science will catch up to what I'm saying...
Nahhh... I was a really BAD submissive. They never even got the chance to try to gag me.Snoredog wrote:LOL I can only imagine what your closet looks like, I bet you have a locker at the end of the bedBabette wrote:Jeff, you are SOOOOO lying!!!!!!!!!!! You're not really doing that, are you????
Who knew.... Why not use a ball gag?
http://www.extremerestraints.com/mouth-gags_22/
LOL,
B.
I just have a wide variety of friends. And most of them dress funny in one way or another...
LOL,
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula.
Every night, without fail.Babette wrote:Jeff, you are SOOOOO lying!!!!!!!!!!! You're not really doing that, are you????
Who knew.... Why not use a ball gag?
http://www.extremerestraints.com/mouth-gags_22/
LOL,
B.
_________________
| Mask | ||||
 | ||||
| Additional Comments: Equipment isn't correct, S9 ASV w/H5i | ||||
DANG! What's that material? Well, if it works... Maybe I should try that instead of chinstrap....
Thanks!
B.
Thanks!
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula.
Dude, you're killing me. And it keeps your mouth shut? Okay, I gotta try that. I'll report my experience.
Rose, are you paying attention? Can't hurt to try.
Cheers,
B.
Rose, are you paying attention? Can't hurt to try.
Cheers,
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula.
No, the 2" tape keeps my mouth shut. The head band keeps the "blowfish" away. That was her original question...LOLBabette wrote:Dude, you're killing me. And it keeps your mouth shut? Okay, I gotta try that. I'll report my experience.
Rose, are you paying attention? Can't hurt to try.
Cheers,
B.
_________________
| Mask | ||||
| ||||
| Additional Comments: Equipment isn't correct, S9 ASV w/H5i | ||||
Oh duh.... Jeff, okay, I get it now.
Daddysaur, no I just googled "ball gag". The things I've seen in that vein are very much nightmare inducing...
BTW - before ya'll PM me, I'm NOT INTO BDSM and I'm most definitely not going to join you in those games!!!!
I'm a midwest girl with a genetic baptist streak. Open minded - possibly. Open bodied, most definitely NOT.
LOL,
B.
Daddysaur, no I just googled "ball gag". The things I've seen in that vein are very much nightmare inducing...
BTW - before ya'll PM me, I'm NOT INTO BDSM and I'm most definitely not going to join you in those games!!!!
I'm a midwest girl with a genetic baptist streak. Open minded - possibly. Open bodied, most definitely NOT.
LOL,
B.
_________________
| Machine: PR System One REMStar 60 Series Auto CPAP Machine |
| Additional Comments: Started XPAP 04/20/07. APAP currently wide open 10-20. Consistent AHI 2.1. No flex. HH 3. Deluxe Chinstrap. |
I currently have a stash of Nasal Aire II cannulas in Small or Extra Small. Please PM me if you would like them. I'm interested in bartering for something strange and wonderful that I don't currently own. Or a Large size NAII cannula.
Whoa, Jeff, that was a scarey pic, but it does seem clear how it could help with the blowfish and with the mouth taped under it. I stopped at a store today but they didn't have a headband. I'll get one and try it. If it doesn't work, I can use it for some other mask fix later, I'm sure.
Babette, it was the topaz I was wearing (with the NA II) when I got the TMJ flare up. It hasn't been that painful in years. I'm going to go to the dentist and get a biteguard, not the kind talked about here but one called the NTI TSS that's not so expensiive as the others. It works great for me, but I'll have to wear it in the day now because it props your mouth open . I can't see wearing it under a FF mask, though. My life gets more complicated by the day, I swear!
Babette, it was the topaz I was wearing (with the NA II) when I got the TMJ flare up. It hasn't been that painful in years. I'm going to go to the dentist and get a biteguard, not the kind talked about here but one called the NTI TSS that's not so expensiive as the others. It works great for me, but I'll have to wear it in the day now because it props your mouth open . I can't see wearing it under a FF mask, though. My life gets more complicated by the day, I swear!
- Rose
Thread on how I overcame aerophagia
http://www.cpaptalk.com/viewtopic/t3383 ... hagia.html
Thread on my TAP III experience
http://www.cpaptalk.com/viewtopic/t3705 ... ges--.html
Thread on how I overcame aerophagia
http://www.cpaptalk.com/viewtopic/t3383 ... hagia.html
Thread on my TAP III experience
http://www.cpaptalk.com/viewtopic/t3705 ... ges--.html