Keep reading if you fall into this category:
- You experience unpleasant dry mouth when using a CPAP, and have yet to find a comfortable solution
- The dry mouth is caused by air leaking out from your lips, even though your jaw is still shut
I believe that my problem is that pressure builds up in my mouth which forces just my lips open, so a prolonged, minor slow outgoing leak develops. I don't think it's that my chin drops, though I can't be positive. My unsuccessful solutions included:
- Heated tubing and humidifier, which I still use, and are helpful but don't address the problem
- Trying a full face mask for a short time, but the leakage problems were annoying, and I still ended up with dry mouth on top if it all
- Taping my mouth closed. It made me anxious. In spite of the CPAP, I still wake up gasping for air a few times a year, and the thought of being unable to instantly open my mouth was unnerving. Taping only part of my mouth didn't help, since the location of the leak changes depending on my sleeping position. Plus there were the issues of cost, skin irritation, and the inability to talk without removing the tape.
- Chinstraps helped but were an incomplete solution. They only produced a minor benefit in preventing my lips from being forced open by internal air pressure.
Then I stretch a band over my head such that in the front, it covers from beneath my chin to just above my upper lip (so it encompasses my entire mouth and the underside of my chin), and located in the back such that it provides the necessary stability (more or less directly opposite the chin area). I put the mask on after putting on this band.
These bands put mild pressure on my lips directly, but it's enough to make my lips much more resistant to internal air pressure in my mouth. They also offer the advantages that they're easy to make, can be re-used and are therefore fairly inexpensive, and can be purchased all over the place. And I can breathe, and kinda talk if necessary without removing the band. And there's no velcro to adjust.
The results for my first week are encouraging (see images via imgur link below). My average leak rate is half of what it was prior to the modification. All the other leak statistics have also improved substantially. And I've noticed zero instances of severe dry mouth.
There are several issues with this workaround:
- The machine is reporting somewhat higher AHI and greater time in Obstructive apnea, yet fewer Clear Airway events. I have to believe this is due to improved accuracy as a result of lower leakage rates, since it's hard to imagine that this change could affect the behavior of the underlying apnea, or that making the CPAP less leaky would worsen my symptoms. But if anyone has any theories, I'm ready to hear them.
- The tights can temporarily lose their effectiveness when I reposition myself during the night unless I make minor adjustments, such as tightening them a bit. So when I roll over, I give them a quick test and (if necessary) a tweak before falling back asleep.
- It looks weird, although perhaps not as weird since the pandemic has normalized mask wearing. And certainly I look less reminiscent of Hannibal Lecter, as I did with the chinstrap ("It puts the distilled water in the reservoir!").
- It leaves visible panty lines on my face, somewhat like the chinstrap, but exacerbated by the fabric curling at the edges.
You can quickly test to see whether this might help you. Close your mouth and try to exhale though your mouth without actively opening your mouth or lips, and observe how much (i.e., little) pressure it takes for the pressure to open your lips to let air escape. Now take two fingers (such as index and middle) and place them gently against your closed lips such that they apply light pressure against the full surface area of your lips, and try the exhalation again. If you're like me, the pressure has to build up substantially before air starts escaping.
It could be that this would work with fabrics other than tights.
Three images: https://imgur.com/a/NfrbX9w