What is it? Is it "chipmunk cheeks"?

Hello, my friends. First of all, sorry for my poor english, I’m not a native speaker.

I’ve been struggling with a moderate sleepness (all day long) and a lightly headache. My cognitive performance and focus went to space and my days are really lost.

I was given the referral to polysomnography, but all the clinics in a range of 5-hours-drive aren’t oferring the exam, due to covid. (I live in the countryside).

Like I said, I’m having true lousy days and I had to do something about that. I read about cpap in internet and decided to give it a shot. So I rent from a physiotherapy clinic a equipment (philips respironics DreamStation). I also bought a nasal pillow mask (Philips Respironics DreamWear). They taught me how to use.

In the first two days I was able to use almost three hours each one and I take it out at some point at the night, don’t know why. I felt like kinda better during the days, don’t know if placebo’s effect. In the past two days, unfortunately, I failed to sleep in my last 4 attempts (two naps and two nightsleeps), all of them because of the same “phenomenon”:

When I’m JUST about to sleep (to get on the first stage of NREM) and become unconscious, I awake over the involuntary oppening of my mouth and some air getting out of. And it happens more 4 ou 5 times, until the anxiety take me over and I take out the cpap to calm down and try to sleep in the “normal way”. I feel like this happens after some seconds of no-breathing. I don’t know if it’s normal these seconds without breathing, but that’s what happens.


Any tip on that?

Two questions as well:

1. It seems to me what I described is the complete opposite of “mouth breathing”. Here is air from out to inside, and I described a movement from inside to outside. So, what is it? Is it the “chipmunk cheeks” that I read in this forum moments ago? Is it a matter of mask, maybe?

2. Is it posible that the no-breathing period has to do with central apnea, and not obstructive apnea? If so, the cpap is innocuous and I have to give it a try on BIPAP?


Thanks you all in advance!!

Oh, another information: my AHI from the last two days are 29.3 and 32.4. Almost 100 ‘total obstructive apneas’ in three hours usage. I was totally awake in these two days while using the cpap, so I don’t know if is useful information.

Awake reported AHI is pretty much useless data. If we aren't asleep it simply doesn't count.
The machine is just flagging awake breathing irregularities as some sort of apnea event. Remember the machine only measures air flow and has no way to know if we are asleep or not. Awake breathing is very irregular when compared to asleep breathing and it's quite common for the machine to flag those awake irregularities by mistake.

Chipmunk cheeks is when air goes up the nose and then tries to exit out the mouth but the lips are closed so the cheeks puff up like little balloons...hence chipmunk cheeks which get poofy from food stretching out the cheeks.

No, that is not chipmunk cheeks. It's just normal mouthbreathing or mouth leaks.

There are some solutions:

1. Full face mask - your mouth can open but the therapeutic CPAP pressure is maintained.

2. Chinstrap - these may keep your jaw from dropping.

3. Foam cervical collar - same idea as chinstrap plus keeps the neck in an ideal position for airway patency.

4. Mouth-closed training - practice placing the tip of the tongue on the roof of the mouth to keep it closed.

philips respironics DreamStation

There is more than one model of DreamStation. What is the exact model you have?

ChicagoGranny wrote: ↑

Sat May 23, 2020 4:52 pm

No, that is not chipmunk cheeks. It's just normal mouthbreathing or mouth leaks.

There are some solutions:

1. Full face mask - your mouth can open but the therapeutic CPAP pressure is maintained.

2. Chinstrap - these may keep your jaw from dropping.

3. Foam cervical collar - same idea as chinstrap plus keeps the neck in an ideal position for airway patency.

4. Mouth-closed training - practice placing the tip of the tongue on the roof of the mouth to keep it closed.

philips respironics DreamStation

There is more than one model of DreamStation. What is the exact model you have?

It's DreamStation Auto.

But the thing is that: I really dont know if my jaw moves that much (to the point that need a chinstrap). It seems more like a subtle movement of the lips.

Pugsy wrote: ↑

Sat May 23, 2020 4:50 pm

Awake reported AHI is pretty much useless data. If we aren't asleep it simply doesn't count.
The machine is just flagging awake breathing irregularities as some sort of apnea event. Remember the machine only measures air flow and has no way to know if we are asleep or not. Awake breathing is very irregular when compared to asleep breathing and it's quite common for the machine to flag those awake irregularities by mistake.

Chipmunk cheeks is when air goes up the nose and then tries to exit out the mouth but the lips are closed so the cheeks puff up like little balloons...hence chipmunk cheeks which get poofy from food stretching out the cheeks.

"so the cheeks puff up like little balloons"

It seems a lot like that.

What happens is that the air getting out of the mouth is the responsible for keeping me awake. I have to stop that.

Full face mask would be the quickest.
You can always work on other solutions later.

JPB

wannadream wrote: ↑

Sat May 23, 2020 5:13 pm

What happens is that the air getting out of the mouth is the responsible for keeping me awake. I have to stop that.

welcome to the zoo!

may i recommend-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

it works a treat for me and may work for you as well. i use it with a foam cervical collar.

i've modified it slightly, but it's still the same basic rig that jay came up with.

good luck!

jimbud wrote: ↑

Sat May 23, 2020 5:29 pm

Full face mask would be the quickest.
You can always work on other solutions later.

JPB

Thanks..

So, the no breathing time apparently has nothing to do with central apnea?

zonker wrote: ↑

Sat May 23, 2020 5:40 pm

wannadream wrote: ↑

Sat May 23, 2020 5:13 pm

What happens is that the air getting out of the mouth is the responsible for keeping me awake. I have to stop that.

welcome to the zoo!

may i recommend-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

it works a treat for me and may work for you as well. i use it with a foam cervical collar.

i've modified it slightly, but it's still the same basic rig that jay came up with.

good luck!

Thanks for the advice, Zonker. I'll read all the topic, seems interesting.

One other option for the mouth leaks: tape. I use Somnifix strips, which are gentle on the skin but keep my lips from opening.

You would also need to position your tongue so your mouth didn't balloon up with air (chipmunk cheeks). That is something you can probably learn fairly quickly.

In case there are no chipmunks in you part of the world:

Miss Emerita wrote: ↑

Sat May 23, 2020 5:54 pm

One other option for the mouth leaks: tape. I use Somnifix strips, which are gentle on the skin but keep my lips from opening.

You would also need to position your tongue so your mouth didn't balloon up with air (chipmunk cheeks). That is something you can probably learn fairly quickly.

In case there are no chipmunks in you part of the world:

Chipmunk-2-e1454797459730.jpg

hahahahahah...

Surely I will have a look on these tapes as well.

And thanks for the technical and cultural inputs.

wannadream wrote: ↑

Sat May 23, 2020 5:47 pm

Thanks for the advice, Zonker. I'll read all the topic, seems interesting.

you are most welcome!