Mouth puffing

I finally got a new CPAP to replace my AirSense 10, which had too many hours on it. Aetna made me jump through hoops, first requiring a home study, and when that didn't produce quality data, I had to have another lab study.

I've had occasional mouth puffing issues, but it seems worse with the new machine. Last night, it woke me up 4x, and since I have an enlarged prostate, I had to get up and pee 4x too.

It seems worse when I'm on my side, but last night I stayed on my back, and it still happened. I use the P10 nasal pillows with a chin strap (Pap Cap), so now I'm considering mouth taping.

Any insights into why this gets worse? I'd post OSCAR data, but I just realized I didn't put a card into the new machine.

Can't speak to why your mouth puffing is more problematic on the new machine. In general with the mouth puffing, I spent my early years on CPAP struggling with this. Done it from straps to taping. After seeing it suggested on here, I began a mission to train my tongue to stay suction sealed forward to the roof of my mouth - not just for sleep but 24/7 until it became 2nd nature. Best thing I ever did for myself in regards to CPAP use. Additionally, I started using a firm flat pillow to prevent gravity from working against me. If the jaw cannot hang down there is less chance of the jaw dropping when relaxed and breaking the seal. The best way to keep the air from puffing up the mouth is to not allow it to enter. Good luck with things. Just for the record, I've got maybe 15 years in with no puffy mouth issues.

Thanks for the reply. My tongue is trained pretty well too, I think.

I have mouth-taped for the last several days. The first few days it worked perfectly. Then last night, I actually had my cheeks blowing up like a balloon a couple of times. I'm going to float out the window if I'm not careful.

Can you explain a little bit about your pillow strategy? I have two pillows, one that is extremely firm (filled with buckwheat hulls), the other is a memory foam one when I sleep on my side. Generally speaking, I'm noticing the mouth puffing more on my side on that pillow.

What I don't really understand is the biomechanics of why the air is going out my mouth instead of out my nose or down to my lungs, depending on the direction. I suspect it's because I have a deviated septum (years ago my first ENT asked me if I had been a boxer) or because of nasal congestion.

Don't have an educated thought on why the air comes out the mouth instead of other directions, but just thinking it through, maybe it takes the path of least resistance. In the case of an apnea compromising the airway, rather than go against constant incoming air from the CPAP, any crack in a tongue seal would be easy passage. Sounds like you are using pillows that keep the head flat so there is no gravitational pull on the jaw. Maybe it would help to position your face slightly off the edge of the pillow to allow your face to tilt toward the mattress. This would make the tongue fall forward and help maintain the seal. I have read on here that people with a high arch in their mouth could have more trouble maintaining a tongue seal. Are you using tongue placement or tongue suctioning? I spent months practicing with strong suction because placement alone wasn't working for me. Just don't get over zealous like I did and get a hickey on the roof of your mouth. My poor mouth felt tender and bruised so I had to lighten up on the suction.