newbie needs advise on masks

Hey everybody --

I'm new here, just got diagnosed w/ apnea and spent my first night at home with my new cpap machine last night. I put what I know about my equipment in my profile, hope it shows up.

Here's my question(s):

I woke myself up a couple of times mouth-breathing. I don't usually mouth-breathe while sleeping so I have to think it's the cpap that's causing it... could the pressure through the nasal mask be causing me to mouth breathe? I'm not sure how to describe it, but it seems like when I put the cpap on, I can feel pressure inside my mouth that's not there otherwise. So when I fall asleep, it makes sense that my mouth would open in response to that pressure.

I'm wondering if I would mouth-breathe if I used a full-face mask. I know that with the full-face mask, there's more risk of getting air in the stomach, bloating, etc., but if you don't mouth-breathe with a full-face mask, do you still get the air/bloating problem? I saw a couple posts here from people who say they don't mouth-breathe with a full-face mask. But do you get air/bloating?

Finally, the comfort question -- for my set-up study I used one of the nasal pillow systems, which worked well but wasn't very comfortable. Also, I tend to sleep on my side, and when I rolled onto my side, the nasal system got pushed out of place. So for my take-home set-up I requested a nasal mask, which is the one I'm using now. It also works well, doesn't get pushed out of place when I roll onto my side, but it's not very comfortable. Are the full-face masks likely to be any better, comfort-wise? How are the full-face masks for side sleeping?

I'm really glad to have found this forum! Look forward to getting to know you all.

Thanks -- Minerva

I too am a newbie here and fairly new to cpap, but I do know one thing: Masks are a very individual thing. Personally, I thought I would hate the nasal pillows because I didn't know exactly what they were. I thought they were talking about nasal prongs so I never even tried one. The sleep tech at my study tried to get me to and I wouldn't. I ended up with a basic nasal mask which was very uncomfortable and I was removing it in the middle of the night. This went on for months and I went back and tried a full face mask. That was even worse! It is impossible to get a good seal and sleep on you side with one of those monsters, at least for me. I went back to a few more months of misery with my nasal mask until I finally found this site and read about the differences between prongs and pillows. I still don't want to try prongs, but pillows are great! You have to be sure you have the right size, and you usually end up with a size larger than you would think. All my various attempts at using masks were all petites and smalls. I tried the small nasal pillows and they were all up in my nostrils. No way could i stand them! Then I tried the medium pillows. Wow! Finally, a mask that I can actually wear and make it through the night with!

As far as mouth breathing goes, there are many different opinions on how to combat that. Most seem to do some sort of taping the mouth shut which I have never tried. Personally, I would tape before I would ever try a full face mask again. That thing was the worst for me, but there are people on here who use them every night with success so it's an individual thing. Good luck! and you've found a great place to gather all this information!

Tonya

Welcome Minerva!

I can't say that I feel air pressure in my mouth with my mask on. You have to use your tongue to block the air flow into your mouth from the nasal cavity. As far as the pressure I have found that on days that my pressure needs increase that I have woken up a few times with my mouth open. It doesn't happen when my pressure is lower. I've also found that after a few nights on the higher pressure that I have not woken up with the mouth breathing. What pressure did your machine reach last night?

I am also finding that each day I'm getting more and more used to the mask being there. I took a rubber band and fixed the hose in an upwards position so that I don't even know it's there as I flip from side to side.

There are a few things you may want to try to help you keep your mouth closed. You may want to tape your mouth or use polident to help you keep your mouth closed. Or, you might need a chinstrap. For some people, nasal obstruction is so severe that full-face masks are the only option.

Hmmm...

The nasal pillow thing I used at the sleep center was one of the Mirage Swift ones, I think (at least, it looks like it in the picture) -- the main discomfort I had was that the angle of the part that was in contact with my nose was too acute, so that the outside edges of my nostrils were almost folded over from the pressure, whilst the inside edges were just in contact enough to seal. So I wonder if that's just a fitting problem? i.e., maybe a pillow with a flatter angle would work and be more comfortable.

The other problem with the Mirage was that since the hose comes out the side, whenever I turned onto that side, it would push the whole works out of position. But maybe one of the nasal systems that has the hose in the center would be more forgiving? The ones that have the hose going up over the head look really strange and uncomfortable -- are they? It seems like they would be trying to pull your nose up to your forehead!

I wish there were a 'lending library' of masks so that I could try them all and find the one that will work best for me...

The mouth breathing thing seems to happen even when my teeth are closed -- i.e., I dunno if a jaw strap would help. I'm not sure if I could handle taping my mouth -- but maybe... what do you use for that? Medical tape, I'm guessing?

My machine doesn't really tell me what the pressure is, I don't think -- the sleep tech says they set it at 6, and it ramps for 15 minutes, so I think it just goes to 6 and stays there.

I'm also noticing that I have a lot of gas today... thought that wasn't supposed to happen with the nasal masks?

Thanks for the quick replies!

Minerva

Sounds like you had a bad fit from the nasal pillows. See if your DME might have masks that you can try, or the sleep center itself. My sleep center will let you try masks out until you find one you like. They don't have every different kind out there, but they do have many. That's how I came by the ComfortLite 2. I was like you, I thought how could that thing possibly be comfortable. It is! The hose comes up to right in front of the crown of your head. The pillow doesn't interfere with it at all, and it both swivels and twists so it doesn't get tangled. I turn over a lot and once while using a nasal mask woke up to find I had basically rolled twice and the hose was wrapped around my neck. It would be very difficult for that to happen with the CL2 as the hose stays above your head all night.

As for the swift, I know many on here swear by it and so does the mask lady at my sleep center, but it just didn't work for me. Different people have different shaped faces and heads. The swift with the headgear coming down my cheeks and the barrel-shaped thing that the nasal pillows come off of, it just didn't work with the shape of my face! I could get it adjusted, but as soon as I moved it dislodged. I tried the CL2 and it works like a charm! Good luck in finding something that works for you! Be patient and you will succeed!

Minerva,

Although I'm a relative newbie as well, I was thrilled to find a post on this site about mouth taping and have been doing so ever since. I spent the first 10 nights fighting with my Activa Nasal mask never realizing that my jaw was dropping in my sleep and breaking the "seal", hence completly undoing any good that the mask was doing.

Wish I could find the original post for you, but here's a paraphrase:

1) Purchase 3M Paper Surgical Tape at your local drugstore -- about $2.50 a roll here in NYC.
2) Before tearing off, fold over a small section at the end to create a tab for easy removal in the morning.
3) Tear off a piece about 3/4" longer on each end than is necessary to cover your mouth. You'll be able to eyeball the measurement after 2 or 3 tries.
4) Apply a healthy does of Chapstick or other lip balm.
5) Purse your lips slightly (turn them inward), the opposite of puckering.
6) Apply the tape, making sure that it overlaps onto the skin at either end of your mouth, and press firmly to adhere.

There are several suggested methods to remove the tape without ripping off the skin on your lips, although I haven't found this to be the case. One way is to moisten the tape with warm water until it starts to fall off. I usually take of the tape without incident and have found that any sticky residue on my skin is easily removed with a little hydrogen peroxide.

Good luck!

PS - I'm expecting delivery of a Swift Nasal Pillow system on Monday and will let you know how it works for me.

You won't have to worry about mouth breathing since its a mouthpiece mask and the hose sticks out of the mask at a 90degree angle and swivels so it's almost never in the way whether sleeping on either side or back and even a little on your stomach (as long as your head is tilted a little to the side.