Air Being Forced Out of My Mouth

[bcab17]

I've been using a CPAP for close to 15 years, and have had no major problems. For the past few years I have been using nasal pillows, again, with no problems. Then, about a month ago, I started noticing at night the feeling that an air bubble had worked it's way through my mouth, parted my lips, and with a soft "puff"...out it went.

This has been happening on a regular basis every night since...and often...maybe every few minutes or so. I'm often woken by different sounds that are made as the air pushes out through my lips (sometimes in short bursts, and sometimes it's a sustained rush of air). It's so wierd. I sleep with my mouth closed, so that's never been a problem. I have no idea why this started happening all of a sudden.

The only change that I can think of at the time this started was that I had started a fairly intense exercise program (intense for a 57 year old, that is) a few months earlier, and had lost 15 lbs...but I can't see how that would have anything to do with it.

Has anyone experienced anything like this or have any ideas what might be the cause?

Oh yeah, for the 15 years I've been using a CPAP, I have never needed the humidifier (even during the dry winters...NEVER). At almost the same time as this "air pushing out of my mouth" thing started happening, I have been having horrible cotton-mouth.

[Pugsy]

Sounds like you are mouth breathing or at least allowing some of the air to exit out your mouth instead of making its way down the airway.
Air goes up the nose...starts down the airway and is entering the mouth and attempting a premature exit.
Normally the tongue acts like a good barrier and for some reason it seems to be not doing its prior good job.
Obviously annoying because it wakes you up but more importantly if you are doing it very much you know you are losing precious therapy pressure.
Need to figure out how to make the tongue stay in place..stop the exit...or you may need a full face mask.

[user from Singapore]

bcab17,

If nothing else has changed then it must be you who has changed
You mention about losing weight. I heard many stories of people who stop snoring after a diet. Maybe these changes you observed are also related to you being fitter. Anyway, follow Pugsy's advices. You are in good hands

[Pugsy]

Forgot....it would be helpful if we knew what machine is being used. Depending on machine there may be some software data available to help evaluate any possible mouth opening/leaks to make sure if it is bad enough to harm therapy.

Please add your equipment to your profile's equipment page in text please. The images are tiny and we can't tell one model from another and models are important.

[LSAT]

Meanwhile...add a chinstrap and see if that helps. Otherwise you may need a Full Face Mask.

[kaiasgram]

Well I'm still a noob to be sure, but I would wonder if the significant weight loss and getting fit (or fitter) could result in subtle anatomical (loss of fat?) and/or functional (overall muscle tone?) changes that might call for an adjustment in max settings? Just a thought...

[bcab17]

Forgot....it would be helpful if we knew what machine is being used. Depending on machine there may be some software data available to help evaluate any possible mouth opening/leaks to make sure if it is bad enough to harm therapy.

Please add your equipment to your profile's equipment page in text please. The images are tiny and we can't tell one model from another and models are important.

I'm using a Resmed S8, but I'm not sure what buttons to press to get to the data.

[mkostelec]

I'm a little late to the dance here but I am having the same issue.

I use:
ResMed S9
Nasal pillows
I also use the humidifier and slimline tubing.

I have used this for years now and have had no issues. In fact, I loved this machine and the rest it brought me (and anyone else around me).

Since September I have lost 58 lbs and over the last month or so I started to notice "air bubbles" popping through my lips as I start to drift off into sleep. Once asleep I would wake up with air gushing out of my mouth while still breathing through my nose.

I am wondering if since the weight loss the pressure is too high and my body is using my mouth as a sort of release valve. It sounds a bit corny to think that way but I have a hard time believing I've become a mouth breather over the last month.

Any thoughts?

[jwerley]

This is just my two cents, but if I had lost such a significant amount of weight I would try to get another sleep study done....and be re-titrated....there could be changes you are not aware of.

Janice

[rjg202]

I have lost 15 lbs on an excercise routine and my Doc would like another test when I hit 25 lbs. Just my 2 cents.

[StuUnderPressure]

I have lost 15 lbs on an excercise routine and my Doc would like another test when I hit 25 lbs. Just my 2 cents.

Great example of why everyone should have an automatic CPAP (aka APAP).

Your pressure would be automatically adjusted (probably down) as you lose the weight.
No additional expensive Sleep Study would be needed. Nor would "I" ever agree to one.

[slwiser1]

I have had a Resprionics Apap with c-flex since 2005. About 12 months ago this started happening to me so I started using a chin strap. Just this week I have replaced this unit with a resmed s9 Autoset. I have not had to have the chin strap since. Hence, I suspect the c-flex function had failed. It does seem that something in the Resprionics machine change on me instead of something with me changing given this experience. Just one persons opinion.

[mkostelec]

Thanks for all your responses.

I decided to skip the expensive retest and simply lower the pressure little by little until I found that happy zone where:
A) My wife doesn't hear me snore
B) I'm not awakened by air pouring out of my mouth.

It seems I went from 10 to 7.4. Now I will gauge my rest for a while and when I see my primary again in May I will see what he would like me to do.

[iguanid]

At 67-yeras-old, I have been using a ResMet S9 with nasal pillows, no humidifier, very successfully for two years. Following a very brief sleep test, I was diagnosed with severe sleep apnea. About a week ago, while going to sleep with the machine as I always do, I experienced irregular puffs of air building up behind my tongue, running along my teeth and escaping through my mouth, which is what is being discussed here. The effect is seriously disruptive. It is still ruining my sleep and making me highly anxious, knowing the thing will happen and my cheeks will suddenly flap like a horse snorting before the air goes out my mouth. I even taped my mouth shut in an effort to stop it, but the air just came to the front and then backed up down my throat. I knew it couldn't be the machine, though an alteration in the air speed might help (it's Christmas Day and no one is around to help). I have always had it set to top speed by the providers. Three weeks ago, I had open abdominal surgery to correct a failed Nissen fundoplication (rebuilding of the stomach/esophagus junction at the diaphragm, with entry up through the abdomen below the breastbone - preventing reflux) and from what I have read here, it would seem that procedure is the direct cause of the CPAP problem. The doctors had to place a large breathing tube down my mouth and probably my nose, during open surgery over three hours long. As of today, I suspect that part of the procedure has altered my soft palate to a possibly great degree. I thank the writers who mentioned possibly altering the air flow - and I hope this will work for me. Otherwise, I am condemned to a full face mask, which I began with and disliked, intensely. I actually can't see how that would avoid the problem. Anyhow, I will try to report back on how things go. My thanks again for the important information.

[bdug]

A year after the last post on this thread (Christmas to Christmas!), I wanted to jump in and say I am having the same problem with air being pushed out of my mouth. I am using a resmed s10 with nose pillows, and I am in my first week of using the machine. It happens at pressures as low as 4, though I have also experienced at 7 or higher. The technician said she has never heard of this happening, so I was glad to find others wrestling with this, though I remain unsure about what to do about it, and welcome any and all advice.