Six months and still struggling

jimbud wrote: ↑

Mon Jan 19, 2026 5:35 pm

...the mouth, bringing with it the high-resistance, low-pressure, and unstable mechanics of that blocked system.

Also this is incorrect, too.

Specifically, the resistance to breathing of the nose is about twice that of the mouth and nearly half the total resistance of the airways.

jimbud wrote: ↑

Mon Jan 19, 2026 5:35 pm

The act of opening your mouth often causes the tongue and soft palate to shift backward toward the throat, further narrowing the airway.

Only if you're swallowing.

Nocibur wrote: ↑

Thu Jan 22, 2026 4:14 am

jimbud wrote: ↑

Mon Jan 19, 2026 5:35 pm

The act of opening your mouth often causes the tongue and soft palate to shift backward toward the throat, further narrowing the airway.

Only if you're swallowing.

Swallowing what? Air?

I do wake up with flatulence. Mostly in the morning. It gets better after a while, as the day goes along.

jimbud wrote: ↑

Thu Jan 22, 2026 5:35 pm

I do wake up with flatulence. Mostly in the morning. It gets better after a while, as the day goes along.

I can't tell you how fucking helpful your posts are.

Really, I can't.

Nocibur wrote: ↑

Fri Jan 23, 2026 3:12 am

I can't tell you how fucking helpful your posts are.

Really, I can't.

Having noticed your penchant for nitpicking, here is a timely reminder for fellow Oklahoman's (among others) for you to nitpick.

Prepare for a snowstorm by
staying indoors, keeping warm with layered clothing, and having emergency supplies ready (food, water, radio, flashlights). Avoid overexertion while shoveling to prevent heart attacks. If you must travel, do so slowly, keep your gas tank full, and carry a vehicle survival kit.
Before the Storm (Preparation)

Stock Supplies: Ensure you have non-perishable food, water, flashlights, batteries, and a battery-powered radio.
Prepare Your Home: Have extra heating fuel, such as wood for a fireplace, and, if necessary, ensure you have safe, approved indoor heating equipment.
Vehicle Readiness: Keep your gas tank near full to prevent fuel line freeze-ups. Pack a winter survival kit: blankets, food, first-aid kit, and a small shove.

Hoping you are safe and warm.

JPB

jimbud wrote: ↑

Fri Jan 23, 2026 9:07 am

Having noticed your penchant for nitpicking, here is a timely reminder for fellow Oklahoman's (among others) for you to nitpick.

Sure!! No prob!!

That would have been a great post...

yesterday!!

Nocibur wrote: ↑

Fri Jan 23, 2026 9:48 am

jimbud wrote: ↑

Fri Jan 23, 2026 9:07 am

Having noticed your penchant for nitpicking, here is a timely reminder for fellow Oklahoman's (among others) for you to nitpick.

Sure!! No prob!!

That would have been a great post...

yesterday!!

Well I'm out. After reading about Pugsy's situation with her husband's and her health I do not want to add to her aggravation on here.

At least I was able to get you to admit NOT knowing something!

Anyway, you can PM me with any questions and I will try to walk you through them.

It has been fun. Seriously.

JPB

jimbud wrote: ↑

Fri Jan 23, 2026 11:38 am

Well I'm out.

Hey, you're the one who decided he wanted to be clever.

Not so funny now, little man.

Hey there, sorry to hijack your argument, but I was wondering if anyone could help me interpret what's going on with the wave form in these screenshots.

For context, I've switched back to my X30i mask in an attempt to stop the mouth leaking/puffing that's happening when I go into REM in the mornings. I have taken the advice of people here to try to focus again on nasal breathing, and not just breathe through my mouth when I'm wearing the mask. I'm trying to breathe through my nose but I know I probably will to some extent mouth breathe.

I think what is happening is that at some point in my sleep, I am opening my mouth more and more, and that my breathing turns into mouth breathing, which precipitates an arousal. I've highlighted two screenshots from last night here that I think demonstrate that, based on my understanding of mouth exhales on a flow rate curve. But please correct me if I'm misunderstanding it.

I feel like I am sleeping better. I think it's partially because I'm using a more aggressive advancement on the mandibular advancement device and partially because I'm finding a decent pressure that has enough IPAP to stop my flow limitations while not overwhelming my system with a high EPAP. Please note that in this screenshot it says my pressure was 8/6, but it was actually 10/6 up until when I restarted sleeping with the mask around 5:22. I changed it to 8/6 at that point because it felt like the pressure was overinflating my nose and making it hard for me to breathe through my nose, and you can see that my flow limitations shot up.

I still feel like crap in the mornings but I'm hopeful that a couple of nights with uninterrupted sleep will eventually get me back to a baseline of feeling okay. And yes I know that I'm not getting a lot of sleep VOLUME; we have a one-month old at home so there's not much I can do about that, but I do try to grab a catch-up nap during the day if I can.

Also, I am considering taping with the full-face mask. Is that a good idea? Maybe only tape part of my mouth so I can still let air out if I start to mouth breathe? I guess my thought is that if I tape my mouth I'll mouth breathe less, but then I still have the mouth part of the mask to catch my breathing when my mouth does inevitably open, usually toward the morning.

P.S. Thank you for all the nasal info/suggestions ejbpesca. I have done a lot of these things with not much help. I think I just have anatomical restriction that I'm going to eventually have to solve surgically if I want to sleep better. But for now, I'm focusing on nasal rinsing and flonase, along with trying to get the humidity as high as I can without it getting too hot int he mask. I know that some, especially on the UARS subreddit, advocate higher IPAP to deal with nasal obstruction, but I think it's too much for me to handle. I end up getting bad aerophagia and it just feels uncomfortable to breathe when the pressure support is so high.

futoncouchsofa wrote: ↑

Fri Jan 23, 2026 2:24 pm

Also, I am considering taping with the full-face mask. Is that a good idea?

NO NO NO. BAD idea.

Given your anatomical restrictions, you need to breathe through you mouth if your nose becomes obstructed. Taping will just make your struggle from more oxygen and wake you.
I am not a "mouth breather" but a bad "mouth leaker". I can handle taping just fine, but sometime I need an FFM - and have experience using one. I am also a light sleeper, and if I had leaks like yours my sleep would be dreadful.

When fitting your full face mask, make sure you can open your mouth without making it leak. If you use a MAD, fit you mask on after you've set the MAD. If you make changes to your MAD, you'll have to make changes to your mask fit. Use Resmed's mask fit option. Try letting your mouth drop making sure the seal is kept even when you let your mouth open.. Do all that when you're wide awake, not when all you want is just to sleep now.

Focus only on fitting to stop leaks. If the mask slips into your mouth, it may be the worng size for you. Or the wrong shape.

Then go to sleep and stop thinking about your breathing. As a matter of fact, I suggest that when you've fit the mask, just before you try to sleep, you tell yourself the following: My brain is doing its best to make sure I get the necessary oxygen. It wakes me up from sleep to make sure I get enough oxygen. I am now using two devices to keep my airway unobstructed. I will now trust my brain to handle my oxygen needs, no matter if I breathe through nosr or mouth.
Do not, repeat, not think of how you're breathing. If your brain needs more oxygen and makes you open your mouth during inhale, its doing its job - trust it. Stop struggling to control your breathing - that keeps you from sleeping.

My attempt at taping with a full face mask failed because I needed to mouth breathe during sleep. A collar and chin strap also failed. I have come to accept that mouthbreathing is how I must breathe when in the supine position. I only mouth breathe in the supine position. I cannot avoid rolling from side to supine and the gadetry to prevent it failed. I will have clusters of apneas in the supine position, even though my pressure has hit 18. If pressure were at 8, I could have 70 events in an hour. 12-18 cm keeps AHI at a dozen per sleep session = AHI <5.

I do not think my situation is uncommon. Some manage to train themselves not to back sleep, resulting in not needing PAP therapy. It is supine sleeping that is the source of my apnea. Nightly, it is roll to back > REM sleep > jaw lowers > mouth opens > tongue falls back = Severe Apnea unless a FF mask and up to 20cm pressure keeps AHI <5.