mouth breathing

I am on a 'Respironics Bipap ASV Advanced' with an average Epap of 14.5%. My sleep doctor said he would like to up my pressures but was afraid that it would make the leaks worse. My biggest problem is that of the 4 five masks I have tried in the 5 months, is that they all leak. Not large enough leaks to show up on the led readout but enough to keep me awake and disturbed. A friend had a new nasal mask that he lent me along with advice to try it with my mouth taped shut. The nasal mask was unbelievably comfortable but the drawback was that with my mouth taped shut, I swallowed a lot air leading to a build up of pressure in my chest. Once I reach up and touched my cheeks and they were all puffed out with air. I removed the tape and called it a failed experiment except that I learned or believe that I learned that I may breath in thru my nose, I exhale thru my mouth. This fact may account for why all 4 of my masks leak around the mouth area. If I tighten the lower straps to stop the leaks, I get deep marks on my neck and a very sore neck. I don't know a whole lot about mouth breathing but I think it is causing a problem with leaks. Is there anything the Cpaptalk members can suggest as a possible next step?

jmbo wrote: Once I reach up and touched my cheeks and they were all puffed out with air.

We call that chipmunk cheeks. Air goes up the nose and down the airway and when it comes to the mouth the air tries to exit the airway prematurely. The problem is because the tongue isn't blocking the entrance from the back airway to the mouth.
When in proper position the tongue acts like a door and blocks the air from ever entering the mouth.
Easy to keep the tongue in place while awake (usually tip of tongue on roof of mouth or behind front teeth) but not so easy when we are asleep and the tongue slacks off on its job.

Chipmunk cheeks has been talked about often here on the forum and you can use the forum search feature to read about it and various ideas on how to limit the problem and/or teach the tongue to not get lazy.

It can happen with either nasal masks (both over the nose and nasal pillows) and even with full face masks. Highly annoying for sure.
People can and to teach their tongues to stay in position...it takes time though.
I did it and it took about 2 months. Others have done it but taken longer and some unlucky people never mastered it.

Mask and leaks are the most difficult part of this therapy to master. Finding a mask that is comfortable and leaks are easy to manage is difficult.

Which masks have you tried? Which one is the favorite?

Thanks for your response. I will definitely be researching "chipmunk cheeks". I see the humor in that and maybe I start using it as my username.
I have tried:
Resmed Mirage Quattro
Total Fit Life
Fisher/Paykel 432
Philips Respironics Amara
Then just for the trial of seeing how a nasal mask would work, I tried the ResMed Activa

So far my least favorite has been the '432'. I ended up with a bloody sore my nose. The Quattro did just about the same thing.
The Total Fit life wasn't too bad but a little claustrophobic and warm in summer.
My favorite so far is the Amara because it is light and comfortable with no break down of the skin on my nose. Unfortunately every
single mask leaks at the mouth corners.

I just passed the 6 month mark on cpap. When I started my machine was adjusted to a max pressure of 20 and it seemen to cteate a vicious circle; a leak would make the machine call for more pressure which led to more leakage and on and on.

The Doctor graciously allowed the DME to lower the max to 17. Of course the same problem never went away---what difference is 17 vs 20? Almost none. My mask still flew off my face.

I thought "Screw the Doc and screw the DME." I learned how to adjust my respironics machine by myself with the goal of finding the lowest pressure that would produce the lowest AHI. My max pressure is now down to 9 and my AHIs are 1.4 per hour. my 90% pressure is 8.5 so 9 is a good max because I don't need any more as I'm not right against the max pressure .

I don't know how scientific my adjustments were---all I know is that my mask almost never leaks unless I roll over a wierd way and make it leak. I do know I feel wonderful every day and am seeing a very low AHI number. BTW my study showed 53 AHIs an hour, so you now how I felt 6 months ago!

I am using the Quattro and it's ok. I am looking forward to getting the new "Air" model in a few weeks----not for lower AHIs or less leaksge but for the extra comfort from not having to tighten the straps so much.

Last---I did the mandatory Sleep Doc visit to qualify for keeping the machine. She said how are you. I said ok. I rec'd a copy of her bill which was $375.00----no wonder we're in trouble----hellp Detroit---here we come.