Dry Mouth

[rested gal]

LINKS to: Mouth leaks - Air Leaks - Tape - DIY Guard
viewtopic.php?t=8011

[Squilla]

Thanks, RG, for the links. (And I'm installing a plant hanger today..what a great idea!)

Taped last night with a J&J brand first aid tape; it kept my lips sealed, alright. I had to pull one out from under for a sip of water, but all was sealed still when I awoke (and dry).

What I don't understand is how the dryness happens from mouth breathing. I can't breathe in through my mouth under cpap, and air entering from nasal passages and throat is humid. My nasal passages have long since adjusted to the windshear factor, and my throat is never dry in the morning. Since it's a recent development, I thought the aging process might be in play, but that's ruled out right away on the sites I visited.

'Net searches for physiological causes turns up a cadre of syndromes that are unlikely to be affecting me. I'd not be terribly concerned if not for the associated increased risk of dental problems.

Well, off to the Doc with me!

[momzus]

I am new on the site, but have the terrible dry mouth using a full face mask and humidifier. I have only had the CPAP for 2 months and it does leak when I am sleeping. (My hubby notices the "flatulance" noises. I will be trying a "Chin-Up" strip that tapes in a sort of squared U shape under your lower lip and up on the cheeks on either side. I will let you know when I have a determination about if they work for me. Anyone out there use them? mz

[john_dozer]

I am new on the site, but have the terrible dry mouth using a full face mask and humidifier. I have only had the CPAP for 2 months and it does leak when I am sleeping. (My hubby notices the "flatulance" noises. I will be trying a "Chin-Up" strip that tapes in a sort of squared U shape under your lower lip and up on the cheeks on either side. I will let you know when I have a determination about if they work for me. Anyone out there use them? mz

A major leak would cause air to pass faster over your humidifier causing a given volume of air to pick up less moisture and being more dry. So there may be a connection.

But I use a FFM and found leaks on a FFM aren't required to get to dryness.

I had some dryness before using CPAP because of my mouth breathing tendencies. The same ones that require me to get a FFM. So I'm sort of borderline to begin with.

The surface area of my cheeks are bigger than the surface area covered by my mask, so my mouth inflates somewhat drawing the lips apart at least slightly at all times. This effect is especially bad with the reduced footprint of the Liberty mask that I use.

Add in a mask that uses fast flowing air to generate an elevated pressure. More air flows in and out of the mask than you usually inhale. So there's a lot of air flow in the mask that is in addition what would be happening with normal breathing. Just that air passing over your lips would be bad enough in helping to dry out my mouth, but most masks are designed pointing straight at your lips. The majority of air you inhale down to your lungs plus that extra flow is jetted right on your lips and mouth. Air that doesn't make it in your lungs is going in and out of your mouth swirling around and pulling out moisture.

[Ottarod]

I think my experience is very relevant to the above thread because it shows that the dry throat condition is not a consequence of what type of CPAP or mask one has, or how it is adjusted. The dry throat condition is purely a result of mouth breathing, period.

A few months ago I started to find that particularly in the dry indoor conditions in Winter, I would wake up in the morning with a dry throat and headache. My condition worsened such that I would wake up several times a night with a dry throat and airways.

I was prescribed a CPAP machine just so I could use the mask and humidifer to alleviate the condition even though I do not suffer from sleep apnea. It did not help much because I only had a nose mask and tend to breath through my mouth at night. I tried obtaining a full mask covering both my nose and mouth. That improved matters but in the depth of Winter (-10, -20 or -30 deg C outdoors) when the indoor humidity cannot exceed say 35%, the CPAP is not able to provide enough additional humidity, and the reservoir empties half way through the night anyway.

In desperation I tried instead a Respironics Premium chip strap (ie without a CPAP machine). It worked well but tended to slip out of place too easily. Now I tie the soft belt from my dressing gown under my chin and over my head. If I am lucky and it stays in place I get a good period of sleep without suffering a dry throat.

[Ottarod]

Perhaps I should add to my previous post that I think a solution for CPAP users with dry throat problems is to use a CPAP machine with a built in humidifier and a full mask covering both mouth and nose. A chin strap should be worn (but in no circumstances should anyone be tempted to tape their mouths completely shut. That is just too dangerous). If that solution does not work then the next step is to somehow arrange a pre-humidifer for the the air going in to the CPAP machine. Not easy to do, but I am at a loss to think of viable alternatives. The air going in could be raised to at least 70 or 80% RH without risking damage to the CPAP. The CPAP humidifier would then raise the humidity futher so that evaporation from throat and bronchi would be reduced. Thermal insulation (foam?) around the CPAP delivery tube would help as well by preventing condensation in the tube.

Of course the CPAP manufacturers could help by increasing the capacity of the humidifiers in their CPAP machines in order for them to be able to better handle dry indoor Winter conditions.

[Wulfman]

Perhaps I should add to my previous post that I think a solution for CPAP users with dry throat problems is to use a CPAP machine with a built in humidifier and a full mask covering both mouth and nose. A chin strap should be worn (but in no circumstances should anyone be tempted to tape their mouths completely shut. That is just too dangerous). If that solution does not work then the next step is to somehow arrange a pre-humidifer for the the air going in to the CPAP machine. Not easy to do, but I am at a loss to think of viable alternatives. The air going in could be raised to at least 70 or 80% RH without risking damage to the CPAP. The CPAP humidifier would then raise the humidity futher so that evaporation from throat and bronchi would be reduced. Thermal insulation (foam?) around the CPAP delivery tube would help as well by preventing condensation in the tube.

Of course the CPAP manufacturers could help by increasing the capacity of the humidifiers in their CPAP machines in order for them to be able to better handle dry indoor Winter conditions.

And, your opinion is based on.......what?
Do you realize that increased humidity has a tendency to increase nasal congestion and can actually have the opposite effect? When you close off the nasal breathing, guess what happens then.

Den

[Treesap]

No leaks; my husband hasn't seen me breathing through my mouth. I asked him to keep an eye out (he's awake a lot, poor dear). No medications.

You usually can't see it. It's not like you have to have your mouth open wide to have the air escape. I've recently developed a few nights of mouth breathing. It seems to find a small path through my lips, and I can only feel it. It's not like my mouth was actually open. It happens when I sleep on my back and my neck is in a different position. I think whatever that funky neck position is, it doesn't allow the air to go back, so it goes out the mouth. If I turn on my side and stay there, I don't have a problem. I notice EXTREMELY dry mouth when this happens, and my leak rate is much higher when I wake up knowing I had air escaping my mouth.

[Ottarod]

Den asked:
And, your opinion is based on.......what?
Do you realize that increased humidity has a tendency to increase nasal congestion and can actually have the opposite effect? When you close off the nasal breathing, guess what happens then.

*****************************************************************************************

Why do I think increased humidity using a humidifier and mask covering mouth and nose will solve a dry mouth condition and throat condition?
Well I would have thought that it was obvious that evaporation of moisture from the mouth throat and bronchi is caused by breathing through the mouth, and so the solution has to be to keep the mouth closed or to reduce the rate of evaporation somehow. In my case even if I wash my nasal passages with an isotonic salt solution (sea salt not table salt to avoid extra iodine) my nose is clear when I go to bed but gets partially blocked during the night. I have tried nasal strips to keep my lower nostrils open and they help but not by much. So if I cant breath adequately through my nose I have to breath through my mouth. Hence the solution has to be increased humidity. I only get this dry throat problem or rather it is only a serious concern during the dry indoor conditions of the winter month's, and this validates this conclusion. Either I need to increase the humidity in the room (which I am reluctant to do because it can potentially cause problems in the structure of the house, or I need to incerease the humidity just in the air I breath.

I have noticed that Fischer Paykel sell a stand alone humidifier to go with their CPAP machines. I might try putting one of those in tandem with the output of my FP CPAP to increase the humidity. Will keep this list posted on how I get on.

Den your point about humidity causing nasal congestion surprises me but I guess you might be right because the water would tend to swell the tissues and constrict the nasal passages. On the other hand when one has congestion due to a respiratory infection "steam" breathing is a very effective and proven way of reducing blockage and helping one breath again. I guess its a case of "suck it and see"!

Either way it wouldnt matter with my suggestion because even if the nasal passages do get constricted one could still breath comfortably by breathing through the mouth.

What would you advocate instead I wonder?

Rod

[Wulfman]

Den asked:
And, your opinion is based on.......what?
Do you realize that increased humidity has a tendency to increase nasal congestion and can actually have the opposite effect? When you close off the nasal breathing, guess what happens then.

*****************************************************************************************

Why do I think increased humidity using a humidifier and mask covering mouth and nose will solve a dry mouth condition and throat condition?
Well I would have thought that it was obvious that evaporation of moisture from the mouth throat and bronchi is caused by breathing through the mouth, and so the solution has to be to keep the mouth closed or to reduce the rate of evaporation somehow. In my case even if I wash my nasal passages with an isotonic salt solution (sea salt not table salt to avoid extra iodine) my nose is clear when I go to bed but gets partially blocked during the night. I have tried nasal strips to keep my lower nostrils open and they help but not by much. So if I cant breath adequately through my nose I have to breath through my mouth. Hence the solution has to be increased humidity. I only get this dry throat problem or rather it is only a serious concern during the dry indoor conditions of the winter month's, and this validates this conclusion. Either I need to increase the humidity in the room (which I am reluctant to do because it can potentially cause problems in the structure of the house, or I need to incerease the humidity just in the air I breath.

I have noticed that Fischer Paykel sell a stand alone humidifier to go with their CPAP machines. I might try putting one of those in tandem with the output of my FP CPAP to increase the humidity. Will keep this list posted on how I get on.

Den your point about humidity causing nasal congestion surprises me but I guess you might be right because the water would tend to swell the tissues and constrict the nasal passages. On the other hand when one has congestion due to a respiratory infection "steam" breathing is a very effective and proven way of reducing blockage and helping one breath again. I guess its a case of "suck it and see"!

Either way it wouldnt matter with my suggestion because even if the nasal passages do get constricted one could still breath comfortably by breathing through the mouth.

What would you advocate instead I wonder?

Rod

This whole discussion about humidity (which comes up frequently) is one that is dependent on the individual and the environment that they live in. It seems logical to me that users need to experiment with different options and settings if they're having problems with the ones they're using. Most people are told to INCREASE their humidifier settings if certain conditions exist. However, sometimes the opposite is the case and they need to DECREASE their humidifier settings or go without any heat at all. Sometimes it's counter-intuitive, but if one doesn't try it, they won't know. This is why when someone posts that they can't breathe through their nose and they have their humidifier cranked all the way up, or if they have dry mouth with a full face mask and they have their humidifier turned all the way up, I suggest to them that they try going the other direction (turned down or off) and see how that works. Lots of users have found that sometimes "Less is better".....with regard to humidity.

All most of us can do is to relate from our own experiences and to mention what others have discovered and posted on the forum.

Den

[Guest]

Den said:

This whole discussion about humidity (which comes up frequently) is one that is dependent on the individual and the environment that they live in. It seems logical to me that users need to experiment with different options and settings if they're having problems with the ones they're using. Most people are told to INCREASE their humidifier settings if certain conditions exist. However, sometimes the opposite is the case and they need to DECREASE their humidifier settings or go without any heat at all. Sometimes it's counter-intuitive, but if one doesn't try it, they won't know. This is why when someone posts that they can't breathe through their nose and they have their humidifier cranked all the way up, or if they have dry mouth with a full face mask and they have their humidifier turned all the way up, I suggest to them that they try going the other direction (turned down or off) and see how that works. Lots of users have found that sometimes "Less is better".....with regard to humidity.

*************************************************************************************************************

My latest experiments suggest that rinsing my nose with sea salt water (isotonic so it matches the tissues) before sleeping is not good and does tend to cause blockage of nasal passages later in the night. My doctor gave me some Nasonex sprays to try (a corticosteroid spray) and that seems to help a lot my keeping my nose clear at night. This suggest I have a minor allergy problem that is not helping at night.

I can try less humidity very easily by just not using the CPAP (as I do not have sleep Apnea). It is about 30% RH here indoors in January and February. I have yet to solve the problem of increasing the humidity in the air I breath at night, but when I use a room humidifier and raise the level as high as I dare without risking problems with my house it does cause some improvement.


Ottarod

[roster]

..............

My latest experiments suggest that rinsing my nose with sea salt water (isotonic so it matches the tissues) before sleeping is not good and does tend to cause blockage of nasal passages later in the night. ..........

Ottarod

My ENT works closely with the sleep lab in the same practice. He also told me that the salt water rinses are great but use them in the morning and not in the evening. Your comment and my ENT's comments are contrary to many discussions on this forum. However, since the words from my ENT, I have avoided using my neti pot after 4:00 p.m.

[Fire Man]

Hey guys,

I have the same problem with air blowing through my lips, even with a chin strap. I think I get less sleep with the CPAP than I did before. I'm wondering about some kind of mouth piece similar to what boxers wear.....obviously less bulky and thinner. I can't use a full face mask because of several brain surgeries through my forehead that is painful with the head piece of the mask. Anyway, has anyone heard of some sort of, maybe Latex, mouth piece that might seal agains the inside of the lips? Oh, I have a bushy moustache so no tape here and the moustache is NOT leaving.

[Wulfman]

Hey guys,

I have the same problem with air blowing through my lips, even with a chin strap. I think I get less sleep with the CPAP than I did before. I'm wondering about some kind of mouth piece similar to what boxers wear.....obviously less bulky and thinner. I can't use a full face mask because of several brain surgeries through my forehead that is painful with the head piece of the mask. Anyway, has anyone heard of some sort of, maybe Latex, mouth piece that might seal agains the inside of the lips? Oh, I have a bushy moustache so no tape here and the moustache is NOT leaving.

What mask (specifically) are you using? I use a full face mask and the way I have it adjusted, the forehead support doesn't even touch my forehead. All tension is on the bottom straps. I also have a mustache (about 35 yrs.).
You could also try Polident adhesive denture strips between the lips to seal them. They're used by a number of folks on this forum.

Den

[SharkBait]

Hey guys,

I have the same problem with air blowing through my lips, even with a chin strap. I think I get less sleep with the CPAP than I did before. I'm wondering about some kind of mouth piece similar to what boxers wear.....obviously less bulky and thinner. I can't use a full face mask because of several brain surgeries through my forehead that is painful with the head piece of the mask. Anyway, has anyone heard of some sort of, maybe Latex, mouth piece that might seal agains the inside of the lips? Oh, I have a bushy moustache so no tape here and the moustache is NOT leaving.

I've got the Hybrid and I don't think it has forehead supports...

https://www.cpap.com/viewImage.php?PNum ... adgear.JPG

LOL at the whole mustache thing...