Mouth Breathing - Is It Really So Bad?

[blownaway]

I'm a mouth breather as a result of a deviated septum (fancy word for a bad nose). ResMed keeps sending me emails that I have a serious leak problem. Goes over 24L/min. for periods of 30 mins or more. I've heard that mouth breathing is often the source of leads with some types of masks but I've not been able to prove that. Supposedly, air escapes by going in the mouth and out the nose. Have tried to make that happen but can't. My mask leaks whenever the pressure ramps up unless I pull the straps uncomfortably tight. Sometimes the mask "flutters" with high pressure and wakes me up. What is "high"? Anything over about 8-9. Set range is 4-20 but it doesn't often go over ten (that I know of). My AHI is pretty low, but the few are doozeys and cause the problem which is based on the fact that I only sleep 4-5 hours/night which is enough for me.

Thus, a high 30 minute leak is a big deal, a big part of my sleep time.

I'm only 7 weeks on CPAP and the good news is that today I have noticed marked improvement in my alertness and my problem of falling asleep whenever I sit down and not seriously engaged in something. All my life I wake up feeling rotten for so long that rotten became normal. Now I don't feel the need for that first cup of coffee to get me going.

In summary, my therapy is producing results BUT, how much more effective would it be if I could stop the leaks. Is mouth breathing definitely a problem or do I need to look into other masks. I can't accept the tightness needed for this one to eliminate the leaks.

I should add that my so-called "full" face mask has the nose outside the mask but fitted up to the nostrils so that if I exhale thru the nose, it seems to go back into the mask cup.

[PoolQ]

Is your mask the Amara View? I think it is by your description, there are other Amara masks.

Mouth breathing ONLY matters if you do not have a FFM. If you are a mouth breather, as I am, then you have a FFM to stop the mouth breathing from being a leak.

Yes you exhale into the mask "cup" and your exhale exits through the mask bents, along with a continuous flow of background air.

Consider that you may be overtightening the mask in an effort to stop the leaking. I use the Amara View to 15 pressure almost every night and do not have a leak problem.

I used to overtighten it and then I did have leaks.

[Goofproof]

It's only a problem if you care about your treatment, if you want to play De-Nile, don't worry about it, I've never seen a dead person with Sleep Apnea, I guess you could say there is a cure after all, and you'll never need a sleep test to verify it.

Small mouth leaks might not be a big deal, but if you still have events it is. Why would anyone use XPAP and not make sure it's working, is beyond me, but it takes all kinds, the Reaper gets to sort them out! Jim

[Lucyhere]

It's only a problem if you care about your treatment, if you want to play De-Nile, don't worry about it, I've never seen a dead person with Sleep Apnea, I guess you could say there is a cure after all, and you'll never need a sleep test to verify it.

Small mouth leaks might not be a big deal, but if you still have events it is. Why would anyone use XPAP and not make sure it's working, is beyond me, but it takes all kinds, the Reaper gets to sort them out! Jim

Gee -- such a kind and helpful response.

[Goofproof]

It's only a problem if you care about your treatment, if you want to play De-Nile, don't worry about it, I've never seen a dead person with Sleep Apnea, I guess you could say there is a cure after all, and you'll never need a sleep test to verify it.

Small mouth leaks might not be a big deal, but if you still have events it is. Why would anyone use XPAP and not make sure it's working, is beyond me, but it takes all kinds, the Reaper gets to sort them out! Jim

Gee -- such a kind and helpful response.

Careful, you will step on your udders again. Jim

[cancun]

It's only a problem if you care about your treatment, if you want to play De-Nile, don't worry about it, I've never seen a dead person with Sleep Apnea, I guess you could say there is a cure after all, and you'll never need a sleep test to verify it.

Small mouth leaks might not be a big deal, but if you still have events it is. Why would anyone use XPAP and not make sure it's working, is beyond me, but it takes all kinds, the Reaper gets to sort them out! Jim

Isn't the purpose of a FFM for mouth breathers? I understand you need to find the reason for the leaks but do not need to stop breathing thru your mouth when using a FFM.

[Lucyhere]

In summary, my therapy is producing results BUT, how much more effective would it be if I could stop the leaks. Is mouth breathing definitely a problem or do I need to look into other masks. I can't accept the tightness needed for this one to eliminate the leaks.

One thing you might try is keeping the tip of your tongue at the roof of your mouth. That will help prevent the air from leaking out of your mouth. Some people have tried tape but I wasn't comfortable doing that. It took me a few weeks to get the hang of it, but it can be done. Eliminating leaks is important so trying other masks is also a good idea.

[Heart Jumping]

If you haven't seen it, this link might be useful.

wiki/index.php/Mask_Leaks

[Goofproof]

It's only a problem if you care about your treatment, if you want to play De-Nile, don't worry about it, I've never seen a dead person with Sleep Apnea, I guess you could say there is a cure after all, and you'll never need a sleep test to verify it.

Small mouth leaks might not be a big deal, but if you still have events it is. Why would anyone use XPAP and not make sure it's working, is beyond me, but it takes all kinds, the Reaper gets to sort them out! Jim

Isn't the purpose of a FFM for mouth breathers? I understand you need to find the reason for the leaks but do not need to stop breathing thru your mouth when using a FFM.

Yes, a FF MASK, is a solution that allows the airway to be pressurized if you are a mouthbreather, BUT, the narural and preferred way of breathing is thru the nose. The nose acts as a filter for debris in the air stream, it also adds needed moisture for the lungs. Mouth breathing dries the mouth out, causing increased tooth and gum damage. Many people can train themselves not to mouthbreath or lesson it, by practicing parking the tongue to the roof of the mouth against the top teeth, and applying a suckling action, forming a light vacuum. Do this as much as you can, you may be able to beat mouthbreathing.

It's important to use the software to monitor your total leak rate and compare it to your mask vent rate, at your treatment pressure, I set my goal at under 10% over the normal vent rate at my pressure, usually 38 LPM, for me! If I am under that, I'm good to go. Spikes in the leak rate from mask leaks need to be controlled too. Jim

[blownaway]

It does indeed take all kinds, including those who don't or can't read carefully like Goofproof I made it clear in the very first sentence that I mouth breathe because of a defect in my nose. Short of surgery, I'm not going to "beat" it. I also mentioned data obtained from analytical software so the comment about Sleephead was unnecessary. That's where I got it.

Yes, I have the Amara View and my conclusion was that mouth breathing was not the cause of my major leaks and was looking for confirmation. Experimenting with the mask, I could not make air escape thru my nose but was not sure that this could not happen in sleep. After all, for 40 years I did not know that I was suffocating in my sleep every night.

Glad to hear someone mention over tightening as I was leaning toward that conclusion but when I tried looser I had trouble with that too. The headgear has a lot of adjustments, so I guess I need to give it more time to play around with it to see if I can't get a better fit, some kind of happy medium. And if I do, I'll take a marker and mark the positions on the straps so that when I clean it I can put it back in the right positions as that appears to be a big part of the problem.

Thank you all for your responses.

[Julie]

How many masks have you tried? Most of us go through a number of them til we find the right one...

[49er]

blownaway,

The reason why it was suggested to use sleepyhead software was that it does a much better job of showing you if the leaks that Resmed is referring to occur just a few times or throughout the night. I wasn't clear from your post if you felt your sleep was impacted or you were worried there was a problem because Redmed said there was. That is why I am suggesting that viewing the leak data in Sleepyhead might be a better choice in case you were considering making a mask change that possibly might not be necessary.

48er

[blownaway]

How many masks have you tried? Most of us go through a number of them til we find the right one...

Just one mask. Doesn't that get a little expensive?

[blownaway]

blownaway,

The reason why it was suggested to use sleepyhead software was that it does a much better job of showing you if the leaks that Resmed is referring to occur just a few times or throughout the night. I wasn't clear from your post if you felt your sleep was impacted or you were worried there was a problem because Redmed said there was. That is why I am suggesting that viewing the leak data in Sleepyhead might be a better choice in case you were considering making a mask change that possibly might not be necessary.

48er

SH tells me that I have leaks, how big they are and how long they last, but it does not tell me how to stop them as I do, indeed, have and use that software. The leaks often result in high pressures and me tearing the mask off in my sleep. I wake up to find it on the floor. That is impacting my therapy about as much as anything could. But even if I don't tear it off, it still skews the results. As with last night, most nights there are only two major events that cause ramping up to high pressure that cause the leaks that result from that. Otherwise the graph remains well below the 24L/min base line. As I said, the duration is usually around 30 mins. so that is very significant.

[49er]

blownaway,

The reason why it was suggested to use sleepyhead software was that it does a much better job of showing you if the leaks that Resmed is referring to occur just a few times or throughout the night. I wasn't clear from your post if you felt your sleep was impacted or you were worried there was a problem because Redmed said there was. That is why I am suggesting that viewing the leak data in Sleepyhead might be a better choice in case you were considering making a mask change that possibly might not be necessary.

48er

SH tells me that I have leaks, how big they are and how long they last, but it does not tell me how to stop them as I do, indeed, have and use that software. The leaks often result in high pressures and me tearing the mask off in my sleep. I wake up to find it on the floor. That is impacting my therapy about as much as anything could. But even if I don't tear it off, it still skews the results. As with last night, most nights there are only two major events that cause ramping up to high pressure that cause the leaks that result from that. Otherwise the graph remains well below the 24L/min base line. As I said, the duration is usually around 30 mins. so that is very significant.

Thanks for clarifying blownaway and my apologies for not understanding your situation initially. Yup, as one who used to unintentionally take off my mask, I definitely agree you have a problem. Good luck in resolving it.