Dry Mouth and Throat

I've been using a CPAP for about a year. For the last several weeks, I've been waking up during the night with a very dry throat and mouth. As indicated in my profile, I use a CPAP equipped with a heated humidifier set to level 5 (max) and wear a FF mask, and a 6-foot hose. Perhaps I'm not understanding properly, but I thought the humidifier was supposed to prevent dry mouth and throat.

zenful6219 wrote:I've been using a CPAP for about a year. For the last several weeks, I've been waking up during the night with a very dry throat and mouth. As indicated in my profile, I use a CPAP equipped with a heated humidifier set to level 5 (max) and wear a FF mask, and a 6-foot hose. Perhaps I'm not understanding properly, but I thought the humidifier was supposed to prevent dry mouth and throat.

If you're mouth is dry, chances are you're large-leaking and not getting therapy, regardless of what your numbers say. It's worth fixing this. The mask you're using is typical for leaking around either the edges of your mouth or around the eyes. (At least it has been that way for me.) You may want to look into using a papcap from pursleep.com and/or a leak strap from padacheek.com. Or both! Then compare your large leak line on your medium-resolution data with your previous leak lines and see if there is improvement.

DreamDiver wrote:If you're mouth is dry, chances are you're large-leaking and not getting therapy, regardless of what your numbers say. It's worth fixing this. The mask you're using is typical for leaking around either the edges of your mouth or around the eyes. (At least it has been that way for me.) You may want to look into using a papcap from pursleep.com and/or a leak strap from padacheek.com. Or both! Then compare your large leak line on your medium-resolution data with your previous leak lines and see if there is improvement.

Even though I don't snore with the mask on (at least that's what I'm told), I've been wondering whether or not the mask is leaking, causing dry mouth/throat. I downloaded the Sleepyhead software, imported my data, and have the following summary:


cpap by zenful6219, on Flickr

My ability to read or interpret most of the summary is limited. For example what does the "90%" label signify? However, it does seem to show what I think is a large number of leaks. Whether they are "large leaks" or not, I don't know how to tell. Anyway, does this summary indicate a leak problem?

zenful6219 wrote:...Even though I don't snore with the mask on (at least that's what I'm told), I've been wondering whether or not the mask is leaking, causing dry mouth/throat. I downloaded the Sleepyhead software, imported my data, and have the following summary:


cpap by zenful6219, on Flickr

My ability to read or interpret most of the summary is limited. For example what does the "90%" label signify? However, it does seem to show what I think is a large number of leaks. Whether they are "large leaks" or not, I don't know how to tell. Anyway, does this summary indicate a leak problem?

I have that mask. If I'm not mistaken you should be seeing total leaks with 90% range of 40-somthing or below, depending on your pressure settings. You're averaging 67 liters/min, with your 90% reading at 85.40 liters/min. I could be wrong, but I think that means you're large leaking most of the night. That's probably why your mouth is dry. You're not getting therapy.
This link shows a list of masks, pressures and expected leak rates for each mask at those pressures (thanks to TedVPAP):
http://www.resmed.com/assets/documents/ ... sa_eng.pdf

You might want to look at your daily data, with the large leak on a time line so you can see when you're leaking worst. Could you post a large leak plot from your daily data?

As I said earlier, a papcap and/or a leak strap are excellent methods for reducing large leak due to mask torque when turning over during sleep. It will stop the dry mouth, arrest the large leaks and allow you to get therapy. I hope this helps.

I use a full face mask and when I'm able to keep my mouth shut I don't have dry mouth. That's not very often, so with a climate control hose and humidity I still get a dry mouth. Biotene helps some. ResScan and Sleepyhead software show that I have little or no leaks. On a night when
I have a great sleep and no awakenings my mouth is very very dry.
When I wake with a dry mouth it indicates that I slept good, no headaches, no falling asleep at stop signs and feel like a new person each
morning.

zenful6219 wrote:I've been using a CPAP for about a year. For the last several weeks, I've been waking up during the night with a very dry throat and mouth. As indicated in my profile, I use a CPAP equipped with a heated humidifier set to level 5 (max) and wear a FF mask, and a 6-foot hose. Perhaps I'm not understanding properly, but I thought the humidifier was supposed to prevent dry mouth and throat.

I think I have the same (or similar) mask but I have not seen a lot of leaks, nor has my sleep doctor when he reviews the data on my SD card, but I also wake up a lot with a dry mouth and sometimes throat. I think that is because I am a mouth breather and there is not much I have found that helps. There are several OTC sprays’ that do help but only temporarily.

I too would really like to know about a way to prevent this other than to take a sleeping pill and hope I sleep through the night anyway.

pax
Roger

DreamDiver wrote:You might want to look at your daily data, with the large leak on a time line so you can see when you're leaking worst. Could you post a large leak plot from your daily data?

As I said earlier, a papcap and/or a leak strap are excellent methods for reducing large leak due to mask torque when turning over during sleep. It will stop the dry mouth, arrest the large leaks and allow you to get therapy. I hope this helps.

If I can figure out how to plot the large leak data on a timeline using Sleepyhead, I'll certainly post it.

Below is a timeline (12/29 - 12/30) for "Leaks" from my CPAP's daily data:


LeaksGraph 12-29 by zenful6219, on Flickr

DreamDiver wrote:I have that mask. If I'm not mistaken you should be seeing total leaks with 90% range of 40-somthing or below, depending on your pressure settings. You're averaging 67 liters/min, with your 90% reading at 85.40 liters/min. I could be wrong, but I think that means you're large leaking most of the night. That's probably why your mouth is dry. You're not getting therapy.
This link shows a list of masks, pressures and expected leak rates for each mask at those pressures (thanks to TedVPAP):

The pressure on my CPAP is set to 8 and from the chart, 32 Liters/min should be flowing through my mask. I believe you are correct in stating that I am not getting therapy. I've had the same machine and type of mask with headgear for about a year, but it's only been in the last month or so that I've experienced the dry mouth and throat. I can't imagine what's changed. The mask seems to fit snugly, maybe even a bit too snug sometimes. If it's any looser, I definitely notice leaks. I do have facial hair around the bottom of my mouth (where the bottom of the mask rests) -- the hair is about 1/4 inch long, which is normal for me.

zenful6219 wrote:The pressure on my CPAP is set to 8 and from the chart, 32 Liters/min should be flowing through my mask. I believe you are correct in stating that I am not getting therapy. I've had the same machine and type of mask with headgear for about a year, but it's only been in the last month or so that I've experienced the dry mouth and throat. I can't imagine what's changed. The mask seems to fit snugly, maybe even a bit too snug sometimes. If it's any looser, I definitely notice leaks. I do have facial hair around the bottom of my mouth (where the bottom of the mask rests) -- the hair is about 1/4 inch long, which is normal for me.

I have facial hair too, and have had little trouble due to facial hair.

If you've lost a lot of weight, your mask may no longer be the correct size for your facial structure. Consider getting a new full-face cushion for the mask, or trying a new mask altogether if this is the case. Cpap.com has great fitting guides for these masks. If you have had the same mask for a year, they can change shape with use and age. If the silicon parts are really yellowed, that's a good sign you may need a new mask or at least a new mask cushion.

Also consider that your body may now, after a year of living with it, just be getting comfortable with the mask, so you may actually be getting deeper sleep. In doing so, your facial muscles may be relaxing more. You may also be turning slightly in your sleep, allowing the mask to torque, pulling it slightly away from your face -- just enough to cause a large leak.

I know I keep harping on it, but truly, either the papcap or the leak strap will cut down considerably on leaks caused by turning over and mask torque.

The papcap has an extra advantage in that it the under-chin strap can be set to keep the chin closed enough that your mouth doesn't stay too widely open, even when relaxed. I keep my papcap strap set so there is about one quarter to one eighth inch clearance between my upper and lower teeth and lower teeth -- allowing my mouth to stay closed throughout the night, without having to clench my teeth together. As a result, there is no difference in pressure between the air column of the nose and the mouth with the full face mask. Given that there are no large leaks, no air is forced constantly through my mouth, hence there is no dry mouth. It's just like sleeping without a mask. I cannot accomplish the same with a nasal mask. At least that has been my experience.

I'm not as familiar with the sleepyhead software as I would like to be. There are two nearly identical lines with different colors, but no legend in your graphic. I'm guessing the purple line is a look at what the large leak line would be if you subtract the expected 32 liters/min expected at a pressure of 8 cm h20, and the beige line is the actual reading without subtracting the necessary leak amount. If this is the case, your leak graph seems to confirm my suspicion that you are drastically large-leaking during almost all of your night. I hope the above suggestions will help you find a solution that works for you.