Can I have my own thread?

[SleepingUgly]

Thank you, SU, I'm learning right along w/you about this aerophagia bit. I've been toying w/the idea of an inexpensive mouthguard but didn't have the slightest idea where to find one except a sporting goods speciality store and there isn't one very convenient to where we live.

I don't know if it will do anything for aerophagia, unless aerophagia is a function of mouth opening (which it could be, to some degree). I am keeping the pressure low while I work on these other issues, so I don't know yet whether it would help the aerophagia. I also don't think I could do this long term, as I really need to use my custom nightguard, plus I feel like I'm not exactly training my tongue to stay in the right place by having my tongue shoved farther back due to the space this nightguard takes up. But I am also curious whether boiling and biting with my lower jaw forward might help, and if so, maybe I should give more thought to a MAD (I've been pretty scared that it would mess up my bite, but if I felt considerably better, it would be something to at least investigate).

Anyway, every Walmart seems to have the upper teeth only mouthguard, but only some seem to have the dual channel one, and that one is near the boxing gloves, if they have it.

[SleepingUgly]

Just in case anyone else is going to try Walmart's Everlast "double mouthguard" (that's what the package calls it)... It's hard to get significant teeth imprints following the directions the way they are written. So I ended up doing it this way and got much more significant indentations, which I think helped hold my lower teeth in place better:

Boil a pot of water with enough to water to cover the mouthguard. When it's rapidly boiling, remove it from heat and let it stand 30 seconds. Place guard in hot water for 30 seconds (use second hand and make sure you don't go over). Remove guard from hot water with a spoon, and immediately shake water off guard and place in mouth, center it around the upper teeth (use a mirror if you don't have someone helping you and line up the hard plastic tab in the middle of your mouth--I did mine off-center and it's not great). When the upper teeth are centered in the channel, bite into guard and suck out the air and water by pressing tongue against the back of the upper teeth. You may also use your fingers to press the outside walls of the guard against the teeth and gums. Leave guard in mouth for 30 seconds, then remove and place under running cold water.

Disclaimer: These are the instructions for the single channel mouthguard, which I ended up having to use on the double to get enough of an imprint. It should be warm, but obviously use your judgment and don't burn yourself if it's too hot.

[SleepingUgly]

I slept with the Swift FX for Her and an itchy chinstrap last night. I am sure my jaw didn't drop, and I think my mouth was closed. Yet, on both the double mouthguard night and last night, I kept waking up with a dry mouth. I don't understand what is causing this. If the air is going through my nose and down my airway, it seems it shouldn't be circulating around my mouth! Any ideas of what I should try besides turning humidifier up and hope my nose doesn't get too muggy?

[-SWS]

If the air is going through my nose and down my airway, it seems it shouldn't be circulating around my mouth!

SU as I recall you're a bruxer. So I think it's possible to have plenty of pressurized air circulating in the mouth, despite sealed lips according to this CPAP/bruxism theory I admittedly concocted:

Even with sealed lips, your mouth alternates between being more or less cavernous. When your teeth are clenched and your tongue is pressed against the roof of your mouth, then there is little or no oral cavity available for air to occupy. But as soon as you create some oral cavity, by dropping your tongue and/or mandible, then CPAP air will instantly rush in because of pressure equalization...

So as a bruxer, you can theoretically introduce plenty of pressure-equalizing air inside your mouth, throughout the night, with your lips perfectly sealed.

[robysue]

OK this is most likely a really stupid question, but I think it needs to be asked anyway:

Are you on ANY MEDICATION that might remotely have dry mouth as a side effect?

There are literally hundreds, if not thousands of medications with dry mouth as a side effect and it's just possible that the bit of CPAP air that gets into your mouth at night is pusing the bit of dry mouth that you would ordinarily experience with the medicine out of the I can ignore or live it with it category and into the The dry mouth can't be ignored any longer category.

That seems to be happening to me with the use of Zyrtec this year. I've taken it in the past for a week or two at a time and never noticed any dry mouth. This year, I hit five days in a row and I notice that dry mouth really, really badly. Only real change is the BiPAP blowing air down my throat: and I know that some of it gets into the back of my mouth even with my tongue firmly on the roof of my mouth and against the back of my front teeth because it tickles the back of my throat and makes the back of my tongue unhappy when I'm still awake at night with the BiPAP on.

[robysue]

If the air is going through my nose and down my airway, it seems it shouldn't be circulating around my mouth!

SU as I recall you're a bruxer. So I think it's possible to have plenty of pressurized air circulating in the mouth, despite sealed lips according to this CPAP/bruxism theory I admittedly concocted:

Even with sealed lips, your mouth alternates between being more or less cavernous. When your teeth are clenched and your tongue is pressed against the roof of your mouth, then there is little or no oral cavity available for air to occupy. But as soon as you create some oral cavity, by dropping your tongue and/or mandible, then CPAP air will instantly rush in because of pressure equalization...

So as a bruxer, you can theoretically introduce plenty of pressure-equalizing air inside your mouth, throughout the night, with your lips perfectly sealed.

-SWS, you may have just concocted this theory, but it makes sense in a logical way to me as a life long sufferer from TMJ with bruxism---particularly if that rush of air doesn't require much "extra" room. As a bruxer I grind my teeth even with my night guard at night. When I'm in that half sleep/half wake stage I can feel my teeth clenching and releasing ever so slightly with the barest jaw movement. And my lips remain tightly sealed and the front of my tongue (usually) remains firmly on the roof of my mouth firmly against the back of my front top teeth. My leak lines usually are quite flat and at or below my mask's intentional leak rate in Encore Viewer's Total Leak rate graphs. So how much would the tongue or mandible need to drop to have CPAP air forced in through the back of the throat to equalize the pressure?

[-SWS]

-SWS, you may have just concocted this theory, but it makes sense in a logical way to me as a life long sufferer from TMJ with bruxism---particularly if that rush of air doesn't require much "extra" room. As a bruxer I grind my teeth even with my night guard at night. When I'm in that half sleep/half wake stage I can feel my teeth clenching and releasing ever so slightly with the barest jaw movement. And my lips remain tightly sealed and the front of my tongue (usually) remains firmly on the roof of my mouth firmly against the back of my front top teeth. My leak lines usually are quite flat and at or below my mask's intentional leak rate in Encore Viewer's Total Leak rate graphs. So how much would the tongue or mandible need to drop to have CPAP air forced in through the back of the throat to equalize the pressure?

Robysue, I'm thinking we might test that theory by simulating bruxism while lying awake and relaxed wearing CPAP. If the theory holds water we might be able to get an idea how much/little dynamic "cavity creation" is required for noticeable airflow over mucous membranes with perfectly sealed lips... I'll try the experiment tonight just for kicks.

[Slinky]

And, I don't so much grind my teeth as I do just clench my jaws. I find when driving long distances I tend to clench my teeth as well and often end up w/sore, achey jaws as a result. Other than that I have no jaw "pain" or discomfort issues despite I have almost no "padding" cartilage left between my jaw "joints" according to xrays. VERY interesting theory, especially if you accept the theory that stress can increase our OSA numbers.

[SleepingUgly]

Robysue, I am on meds that can cause dry mouth, but I was on these, and even more of them, previously and I don't remember this as an issue.

So what is the solution?

[robysue]

Robysue, I am on meds that can cause dry mouth, but I was on these, and even more of them, previously and I don't remember this as an issue.

So what is the solution?

As I said, the Zyrtec wasn't a problem for me in the past.

An incomplete solution for me seems to be:

1) Biotene Mouthwash for Dry Mouths two or three times a day.
2) Wear the TMJ nightguard at night every night. Lets my lips close completely and teeth seem to stay fairly close to it even when I relax the bite a bit, and that seems to minimize the air getting in through the back of my throat. I don't think I could do the same with the OTC boil-n-bite guards since they are much bulkier than my dentist made guard.
3) Keep yourself well hydrated---drink more water and other liquids than usual. Avoid caffeinated drinks as they can be dehydating.
4) Biotene Gel for emergency can't stand the dry mouth any more in the daytime and away from a sink. (Don't have to resort to this very often, though)
5) Biotene toothpaste if need be ($$, but worth it for me. *sigh*)
6) Sugarless gum---if it doesn't aggravate the aerophagia that you are also fighting. *sigh*
7) Considering playing with the humidity setting---counter intuitive as it sounds, my dry mouth symptoms seem to be a bit less with lower humidity settings. I'm now using passover humidity and humidity set on 1 instead of 2 or 3. All I can figure is that when the nose is happy (with the bit drier air), the bruxism is less and that causes less air rushing into my mouth from the back of my throat.

It's not a complete solution because I still feel like I've got a very dry mouth at times, but it's manageable and the lips are not too chapped. My lips always get super chapped when I have a dry mouth due to unconscious licking of them.

[robysue]

Robysue, I'm thinking we might test that theory by simulating bruxism while lying awake and relaxed wearing CPAP. If the theory holds water we might be able to get an idea how much/little dynamic "cavity creation" is required for noticeable airflow over mucous membranes with perfectly sealed lips... I'll try the experiment tonight just for kicks.

Count me in on your little experiment: I'll try to stay awake consciously enough to remember consciously do with my jaw what I know I do semi-consciously tonight before drifting off for the night.

[SleepingUgly]

Can I complain without getting wacked by a 2x4? I know this isn't the right audience, as you're all going through, or have been through, something similar.

I used to catch a bus to another city and sleep in a twin bed with another person, wake up early and catch a bus back to study all day. Now I sleep alone, with 4 noise machines/fans, my arms are splinted, my teeth are splinted, there's an itchy chin strap covering my head, and a mask shoved up my nose (and before I'm asleep I'm reading with blue-light blocking glasses over my prescription glasses! ). Hannibal Lecter doesn't have anything on me, except that he probably doesn't wake up 382 times a night like I do.

I am assuming that I'm tired because I'm waking up a million times and am not at a therapeutic pressure, so it's the worst of both worlds. But there's also a nagging fear that I'll never be able to get to a therapeutic pressure, or that even if I do, I won't be cured of my EDS.

Well, thanks for letting me vent. I'm going to gear up for the night. (I feel like I'm either starring in some S&M film with the handcuffs, gags, etc. or I'm in the ICU and restrained lest I de-intubate myself. Either way, I'm an unwilling accomplice to this high maintenance-low yield lifestyle.)

[DoriC]

I always take my Zyrtec in the morning which does cause dry mouth, I'm never without a water bottle during the day, but by bedtime dryness is gone.

[robysue]

I used to catch a bus to another city and sleep in a twin bed with another person, wake up early and catch a bus back to study all day. Now I sleep alone, with 4 noise machines/fans, my arms are splinted, my teeth are splinted, there's an itchy chin strap covering my head, and a mask shoved up my nose (and before I'm asleep I'm reading with blue-light blocking glasses over my prescription glasses! ). Hannibal Lecter doesn't have anything on me, except that he probably doesn't wake up 382 times a night like I do.

LOL. Vent away SU, vent away: You so perfectly capture the startling difference between what used to be acceptable and even fun regarding sleep and what now must be done every single night in your furtive and seemingly futile search for a decent night's sleep that's always hiding in an elusive, dark corner somewhere, hopefully not chatting with the cockroaches.

I am assuming that I'm tired because I'm waking up a million times and am not at a therapeutic pressure, so it's the worst of both worlds. But there's also a nagging fear that I'll never be able to get to a therapeutic pressure, or that even if I do, I won't be cured of my EDS.

We're here for you SU. You do you're part and hopefully with our support and cheering you on (in the good times) and support and shoulders to cry on (in the darker times), you'll get there eventually. It will take longer, no doubt, than you want it too---after all, you want it to be effective as of several months ago.

Well, thanks for letting me vent. I'm going to gear up for the night. (I feel like I'm either starring in some S&M film with the handcuffs, gags, etc. or I'm in the ICU and restrained lest I de-intubate myself. Either way, I'm an unwilling accomplice to this high maintenance-low yield lifestyle.)

Night, night
Sleep tight
Don't let the bed bugs bite

And dream good dreams
And don't dream any bad dreams
And remember that we love you SU

[Bright Choice]

My mouth did not stay shut with the Walmart boil & bite mouthguard that covered only the upper teeth. Last night I tried the Walmart boil & bite that covers both the upper and lower teeth, and I left in the hard, plastic tab that is supposed to be removed (otherwise I would be able to breathe, which would defeat the purpose). I was out of it, but I THINK that my mouth did not drop open; however, my mouth got dry anyway, probably because I couldn't close it completely.

Hi SU - just wanted to touch base with you to see how you are doing with the mouthguard. I thought mine was fine ... then I started drooling a lot... then I started swallowing more to take care of the drooling... then guess what else I swallowed? I had really bad aerophagia yesterday that would not move either up or down. Ouchee! So, last night I tried with nothing in my mouth, just the chin strap - ended up with a leak of 6 or so. I'm hoping my tongue will get "trained".

I did read your description of your "history" with OSA. Interesting and frustrating for you. I think we really have some similarities. I also posted to my thread viewtopic/t62947/Help-Clueless-about-Fl ... tions.html per your suggestion - a bit of my history, goals and a chart from Rescan. Couldn't have done it without your help with photobucket. Thanks!

I'm doing home sleep study tonight - that should be interesting.

Be well!