Mouth Breathing

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Sleeprider
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Re: Mouth Breathing

Post by Sleeprider » Mon Jan 05, 2015 6:01 pm

Granny, it doesn't happen often, but this time you're wrong. I was not being an alarmist, and you are certainly welcome to sit around and wear a mask without a machine running all you want; however what I originally said was correct. Using a mask without the machine on increases respiratory effort and risks rebreathing CO2.

When you put on any mask without operating the device, exhaled air is exhausted in small part through the mask vent, but mostly back into the CPAP hose toward the machine. It is rebreathed during inhalation, and concentrations of CO2 build as this cycle repeats. Only when the machine is running is exhaled air flushed through the vent.

From the Resmed Airfit F10 user manual (feel free to look at any mask, it will be the same): http://www.resmed.com/us/dam/documents/ ... er_eng.pdf
The mask should not be used unless the device is turned on.
Once the mask is fitted, ensure the device is blowing air.
Explanation:
CPAP and bilevel devices are intended to be
used with special masks (or connectors) which have vent
holes to allow continuous flow of air out of the mask. When
the device is turned on and functioning properly, new air
from the device flushes the exhaled air out through the mask
vent holes. However, when the device is not operating,
insufficient fresh air will be provided through the mask, and
the exhaled air may be rebreathed. Rebreathing of exhaled
air for longer than several minutes can, in some
circumstances, lead to suffocation. This applies to most
models of CPAP or bilevel devices.

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palerider
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Re: Mouth Breathing

Post by palerider » Mon Jan 05, 2015 7:36 pm

Sleeprider wrote:When you put on any mask without operating the device, exhaled air is exhausted in small part through the mask vent, but mostly back into the CPAP hose toward the machine. It is rebreathed during inhalation, and concentrations of CO2 build as this cycle repeats. Only when the machine is running is exhaled air flushed through the vent.
ffm's have anti-asphixiation valves to provide extra air and co2 flush when the machine stops operating.

nasal and pillow masks don't, because of the presumption that you'll open your mouth if you start feeling the need for 'more air'.

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Sleeprider
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Re: Mouth Breathing

Post by Sleeprider » Mon Jan 05, 2015 8:17 pm

Jake1 wrote:I use a pillows mask and I'm fine until I go to sleep, which is very difficult now, and I start to open my mouth a little and the whole thing gets out of control and I awake and take off the mask. The next time I wake up for whatever reason, like a trip to the toilet, I put the mask back on and turn on the machine. This may happen four times in a night. If I can't get back to sleep, I take it off. Would I be better off leaving the mask on with the machine off during down times?
Again Palerider, the O.P. I was responding to said he uses a "pillows mask"

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ChicagoGranny
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Re: Mouth Breathing

Post by ChicagoGranny » Mon Jan 05, 2015 9:09 pm

Sleeprider wrote:Granny, it doesn't happen often, but this time you're wrong.
1. Why don't you say that to RogerSC? He posted it.

2. You rather take on a poor, old Granny instead of a man?
Sleeprider wrote:Again Palerider, the O.P. I was responding to said he uses a "pillows mask"
3. So now you are going to confine your comments to nasal interfaces, even though,
Sleeprider wrote:From the Resmed Airfit F10 user manual
you quote from from the manual of a FFM?

4. Care to regroup?
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

Sleeprider
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Re: Mouth Breathing

Post by Sleeprider » Mon Jan 05, 2015 9:13 pm

Aw Granny, just keep'in it real and trying to give back a little.

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palerider
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Re: Mouth Breathing

Post by palerider » Mon Jan 05, 2015 9:21 pm

Sleeprider wrote:
Jake1 wrote:I use a pillows mask and I'm fine until I go to sleep, which is very difficult now, and I start to open my mouth a little and the whole thing gets out of control and I awake and take off the mask. The next time I wake up for whatever reason, like a trip to the toilet, I put the mask back on and turn on the machine. This may happen four times in a night. If I can't get back to sleep, I take it off. Would I be better off leaving the mask on with the machine off during down times?
Again Palerider, the O.P. I was responding to said he uses a "pillows mask"
so why'd you start talkin about the f10?

just tryin to confuse poor granny?

shame on you, I call elder abuse!

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ChicagoGranny
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Re: Mouth Breathing

Post by ChicagoGranny » Mon Jan 05, 2015 9:24 pm

Sleeprider wrote:Aw Granny, just keep'in it real and trying to give back a little.
Should we start keeping score?
"It's not the number of breaths we take, it's the number of moments that take our breath away."

Cuando cuentes cuentos, cuenta cuántas cuentos cuentas.

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WarmBodies
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Re: Mouth Breathing

Post by WarmBodies » Mon Jan 05, 2015 9:25 pm

However, when the device is not operating,
insufficient fresh air will be provided through the mask, and
the exhaled air may be rebreathed. Rebreathing of exhaled
air for longer than several minutes can, in some
circumstances, lead to suffocation.
Don't forget lawyers direct much of the precautionary sections of these manuals. I would ask the lawyers if anyone has ever suffocated from wearing a CPAP mask without the machine running. They would say, "It doesn't matter. It needs to be covered in the manual."

you are certainly welcome to sit around and wear a mask without a machine running all you want; however what I originally said was correct. Using a mask without the machine on increases respiratory effort and risks rebreathing CO2.
As already pointed out, FFMs have safety vents for exactly the point of use when the device is not running. Wearing a nasal mask, as soon as you feel the need for increased respiratory effort, you will reflexively open your mouth to breath.

But back to those lawyers and the manual.
Rebreathing of exhaled
air for longer than several minutes can, in some
circumstances, lead to suffocation.
Ask the ResMed lawyers this. Power loss while one is sleeping is not uncommon. So you are providing a machine and mask that can suffocate your users while they are innocently sleeping? You negligently failed to provide power-off alarms on your machines?

Then they have to remove the warning about suffocation or add the cost of a battery and power-off alarm to their machines. Hah!

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Sleep2Die4
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Re: Mouth Breathing

Post by Sleep2Die4 » Tue Jan 06, 2015 6:40 am

WarmBodies wrote:Ask the ResMed lawyers this. Power loss while one is sleeping is not uncommon. So you are providing a machine and mask that can suffocate your users while they are innocently sleeping? You negligently failed to provide power-off alarms on your machines?

Then they have to remove the warning about suffocation or add the cost of a battery and power-off alarm to their machines. Hah!
That's hilarious. "Smart" lawyers, but you could back them into the corner they created. Good job!

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LadyWolf79
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Re: Mouth Breathing

Post by LadyWolf79 » Tue Jan 06, 2015 2:43 pm

Jake1, I also am a relatively new CPAP user, and use the F10 mask because of mouth breathing. I find this mask one of the most comfortable, especially since I started on the Quattro FF, size XS. The F10 seals extremely well, and since I switched, I have had no leaks to speak of, unless I fail to seal it property before I reach my full pressure.

Hope this helps.

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DMHE
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Re: Mouth Breathing

Post by DMHE » Tue Jan 06, 2015 9:08 pm

I am also a mouth breather, but I am having so much difficulty with broken seals from the full mask. Seems like I'd do better with nasal mask and chin strap. However, the doctor sent the prescription to the equipment company. The BiPAP machine has been auto set. I can adjust the mask before getting in bed and then after a while seems like I feel the air blowing thru the mouth cushion and not in the nose of the mask. When I try to adjust headgear straps, I get the leak noises or the air blows into my eyes. It's very frustrating. I am a newbie with the machine for this the third week of therapy. I have tried to visit the equipment rep right down the street but she says the mask fits and thinks it's just a matter of time using it. Suggestions

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sleepydc
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Re: Mouth Breathing

Post by sleepydc » Wed Jan 07, 2015 10:44 am

DMHE, I know I'm a little like a person who discovered a hammer and then starts thinking of every problem as a nail, but for my FFM use I found it started working a whole lot better when I started using tape. Fo me, the tape solves most of the issues with "mouth breathing" and "draw drop," which interrrupts the seal of a FFM (full face mask) because my face changes shape when that occurs and the seal is broken. It's not for everyone, but here's what I'd suggest:

Some people end up using chin straps with FFM's. I tried and disliked chin straps. I have now been using surgical tape for about a year now, and it has worked wonders and works very well for me. I use silk surgical type tape you can get off of Amazon, 2" wide. There's also a 1" wide version. If you gently pull it off in the morning, there's usually no problem. Just type something like "3M-Durapore-Silk-Tape 2 inches x 10 yards - box of 6" or the like on the Amazon site. For me, it works very well with a full face mask (FFM) -- the FFM helps prevent pressure problems if my jaw does open slightly, and the tape substantially prevents my jaw from dropping and also thereby keeps my face largely in the same "position" as I fall asleep (thereby avoiding the inevitable leaks that can occur when your facial shape changes from the point of initial placement/tightening of the mask). .

I was actually worried about not being able to breath with the tape if there was a shut-down. I've found that this set-up, however, offers very few worries:

For the silk tape, apply a 2inch wide strip vertically from a spot just above your upper lip (the indentation just below your nose) down to just under your chin (with your lips closed and your jaw in a comfortable place). As you bring the tape and press it underneath your chin, "fold" the edge back on itself (maybe a 1/2 inch or so) so that the edge hangs a bit from your chin -- makes for easier removal in case of emergency. Because it's only 2 inches wide and vertically placed, your entire mouth is actually not taped -- you can, in a pinch, breath around the edges -- and the silk tape itself I've found by accident (in opening my mouth with it being placed) will also let a little air in if you open your mouth forcefully. In short, it doesn't take too much force to maneuver or breath around the silk tape, but at the same time the tape seems to mostly keep my jaw from dropping when I relax and fall asleep, which is the whole point. [The setup also seems to work best when combined with the technique, described elsewhere on this site, of learning to relax with the tip of your tongue against the roof of your mouth as your mouth is closed, which "seals" the mouth from the nasal passage and helps prevent dry mouth]. (In placing the tape, I've also found it helpful to focus on firming the contact with the skin at the point below the nose and under the chin more than the lips, which seems to leave a little area of the lip region feeling less taped, if that makes sense). [To remove with less "tear", try pulling up vertically from underneath the chin till you reach your lip, then pull across "horizontally" for the remainder.]

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Macpage
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Re: Mouth Breathing

Post by Macpage » Wed Jan 07, 2015 11:17 am

sleepydc wrote:DMHE, I know I'm a little like a person who discovered a hammer and then starts thinking of every problem as a nail, but for my FFM use I found it started working a whole lot better when I started using tape. Fo me, the tape solves most of the issues with "mouth breathing" and "draw drop," which interrrupts the seal of a FFM (full face mask) because my face changes shape when that occurs and the seal is broken. It's not for everyone, but here's what I'd suggest:

Some people end up using chin straps with FFM's. I tried and disliked chin straps. I have now been using surgical tape for about a year now, and it has worked wonders and works very well for me. I use silk surgical type tape you can get off of Amazon, 2" wide. There's also a 1" wide version. If you gently pull it off in the morning, there's usually no problem. Just type something like "3M-Durapore-Silk-Tape 2 inches x 10 yards - box of 6" or the like on the Amazon site. For me, it works very well with a full face mask (FFM) -- the FFM helps prevent pressure problems if my jaw does open slightly, and the tape substantially prevents my jaw from dropping and also thereby keeps my face largely in the same "position" as I fall asleep (thereby avoiding the inevitable leaks that can occur when your facial shape changes from the point of initial placement/tightening of the mask). .I would second this, and I want to thank Sleepdc for the information. It was this info in another post that led me to try taping with my ffm


I would second this, and I want to thank Sleepdc for the information. It was this info in another post that led me to try taping with my ffm. It might really help with the mouth opening. You've got nothing to lose and try the chin straps, headbands, etc. mentioned in posts. Something might work.

It sort of freaked me out to look in the mirror at night with a mouth taped. I thought for sure I would suffocate in my sleep. However, right from the start it really made the mask work better and was really comforting. In fact, I find it more comforting than the mask. I often wake-up and completely forget it's there. I can "never" say that about the mask! It also led me to be able to try interfaces other than ffm's. Even with some congestion, I'm still finding it works. I'm also pretty comfortable in my tape configuration that I can pop it off just by opening my mouth with force. Of course, there are some risks and safety concerns to research. You just have to be smart and comfortable with what works for you. Good luck!

Thanks again Sleepdc. Therapy changing advice for me!

Best,

Mike

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nanw

Re: Mouth Breathing

Post by nanw » Wed Jan 07, 2015 11:29 am

I have been on cpap for just under five years and have NEVER taken my mask off to take a bathroom break or to get up to wander around for a bit. I have used full face masks, the Hybrid, nasal masks and now pillows...... with the ffms I just keep on breathing and with nasal or pillow masks I just open my mouth.. I really cant see what the problem is here..... are your bathroom breaks that long that you are worrying about rebreathing your own air... STOP overthinking it, go with the 2 minutes it takes to go. It is more of a problem to take off your mask then fiddle with it to get it resealed than to leave it on. Relax, mask up and go to sleep.
Cheers
Nan

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palerider
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Re: Mouth Breathing

Post by palerider » Wed Jan 07, 2015 12:16 pm

sleepydc wrote:DMHE, I know I'm a little like a person who discovered a hammer and then starts thinking of every problem as a nail, but for my FFM use I found it started working a whole lot better when I started using tape.
we're all just glad you found tape, and not nails... that'd hold your mouth shut, for sure, but the side effects are unpleasant.

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