Mouth leaks... out of things to try... Need Help!!

So I'm trying my P10 mask, and the mask is great. It is comfortable, doesn't leak, and avoids the issues I've been having with a regular mask.

(you can see a thread about the issues here, "Persistent sleeping position pain", mostly related to having my neck twisted too much):
viewtopic.php?f=1&t=106956

But the problem is that I have lots of mouth leaks. I actually got the sad face on my machine one day, and we all know how hard that is!



I have tried several different chin straps (don't work and give me a headache), some extremely sticky tape (still came loose) and even an ACE bandage wrapped around to form a chin strap. Even if the strap keeps my teeth together, the air still leaks out the sides.

I tried the FF mask again last night, and it was just as unworkable, with big leaks, aerophagia, and my front teeth aching from being pushed on all night (and I can tell they're starting to be pushed in).

Pressure is not that high, minimum of 8, and the 95% pressure was only a little over 9. But using the FF mask with my neck twisted, it goes up to 13 or 14. But the leaks keep partly waking me up enough to stop them by closing my mouth or whatever, as you can see from the oscillations in the graph, and this is having the same effect that the apnea has. I am mentally wrecked, very tired, and can hardly remember anything.

I'm usually quite inventive but this is taking a toll on me mentally so that I can't even come up with good ideas. I'm desperate to just get a good night's sleep!

I've heard of "mask rage" but in this case, since it's not the mask's fault, I feel like punching myself in the face a few times...

Not sure I understand how a FFM pushes against your teeth. I wear a Quattro FFM and the top fits around my nose and the bottom just below bottom lip. I'm a side sleeper and sleep on my sides with great success. I don't know much about other FFM but still think they shouldn't push on your teeth.

knothead wrote:Not sure I understand how a FFM pushes against your teeth. I wear a Quattro FFM and the top fits around my nose and the bottom just below bottom lip. I'm a side sleeper and sleep on my sides with great success. I don't know much about other FFM but still think they shouldn't push on your teeth.

Well, my teeth are inside my lower lip, and by pressing on my lip, it presses on my teeth.

I think I'm gonna try a football mouth guard, since it goes inside the lips, maybe the pressure will hold it against them from the inside...

I'm a newbie so may not have the best advice. It I switched my first nasal mask to a fisher paykel simplus full face. First one was medium and Too bit. Switched to small a bit better but leaks. Then I added the padacheek mask liner and it is perfect. Try the mask liners.

So what do you wish help in?
Making the P10 work?
Or maybe choosing a more suitable full face mask?
Full face mask users are going to tell you to keep trying masks till you find one that works.
I don't know what nasal pillow mask users are going to tell you since you have tried a lot of things except maybe try different tapes for mouth taping that won't come loose.

I am going to assume that the mouth opening/breathing is out of habit and not out of physical need from nasal congestion...is that correct? Let's make sure that nasal congestion isn't a factor at all before going down the other roads.

Pugsy wrote:So what do you wish help in?
Making the P10 work?
Or maybe choosing a more suitable full face mask?
Full face mask users are going to tell you to keep trying masks till you find one that works.
I don't know what nasal pillow mask users are going to tell you since you have tried a lot of things except maybe try different tapes for mouth taping that won't come loose.

I am going to assume that the mouth opening/breathing is out of habit and not out of physical need from nasal congestion...is that correct? Let's make sure that nasal congestion isn't a factor at all before going down the other roads.

I am certain that it's not nasal congestion. I don't think it's out of habit either. Even when I'm awake, and at low pressure (8), I have to concentrate to keep the air from blowing out from the back, around past my cheeks. I've been woken up many times by the leaks, and it's always the air blowing up my nose and out my mouth.

I just started another topic asking for specific advice on FFMs. I need one with a more generous lower-jaw "cutout", so I'm hoping someone can recommend one.

Corky1121 wrote:I'm a newbie so may not have the best advice. It I switched my first nasal mask to a fisher paykel simplus full face. First one was medium and Too bit. Switched to small a bit better but leaks. Then I added the padacheek mask liner and it is perfect. Try the mask liners.

Thanks. I've tried all 3 sizes of the Simplus, with liners.

I have been using cpap for almost a year ... had all the problems you are having.
It has taken that long to "learn/train" my tongue to stay on the roof of the mouth and keep the air from escaping, and it is almost perfected .
I now use a cervical collar to keep my jaw closed and that helps.
Weather you use a nasal pillow or full face, it is best to breath through you nose.

Moose, I'd advise you to keep wearing the pillows. I'm kind of like you. I'm a throat leaker and I've worn FFM masks for years. But they finally became unbearable due to the pain and stiff neck caused by the headgear. I had tried pillow types before, but the throat leaking made them unusable. Chin straps don't work because they don't close your throat (try it, even with your teeth clenched tightly together you can breath out through your mouth). Tape is more effective.
Out of desperation I switched to the P10. At first, the leaks were pretty severe, but after a week or so, they began to tame down. (I used to laugh inwardly when I read Pugsy's comments about learning to keep your throat closed - I didn't think it was possible. Pugsy, now I think you were right!) Now, the leaks are seldom over red line. I seem to have adjusted with a small base line of throat leak which doesn't disturb me or affect my therapy. In fact, my AHI and Flow limitations are lower and my pressure setting has gone from 9, 0 EPR to 7 with a 3 EPR and no stiff neck and pain from the headgear.
I kind of practice while I'm still awake by opening and closing my throat so my brain knows how to stop the leaks and I go to sleep with my throat closed. Seems to work. So practice and give it a while and see if the leaks don't improve. I don't necessarily keep the tip of my tongue against the roof of my mouth, it's the back of my tongue - like making a K sound.

Grayghost and Jay,

Thanks for giving me hope that it still might work.

I am going to try a football mouth guard tonight, to see if that helps. I'll just keep trying, since a FFM is almost intolerable...

This is what I use to avoid mouth leaks: I use a chin-up strip: http://www.chinupstrip.com/ which I buy on drugstore.com. Then I use Nexcare's gentle paper tape. It does not permit leaking through the tape itself, as micro-pore will. I use the one-inch wide variety. I tear a piece about 4 - 5 inches wide and tape diagonally across my mouth (from corner to corner). Then I do the same with a second piece, except it goes diagonally the other way. The two form sort of an x. I have found that the longer pieces work better than using short ones like I used to. After I put on the chin up strip and the two pieces of tape, I fold back a small corner of the tape so I have an end to grab for removal. Then I press on the whole thing to enhance the stick. That tape can be difficult to remove, even though it says it is good for frequent bandage changes. I use a nasal mask, I have never found a full face one to fit.

FlyingMoose wrote:

knothead wrote:Not sure I understand how a FFM pushes against your teeth. I wear a Quattro FFM and the top fits around my nose and the bottom just below bottom lip. I'm a side sleeper and sleep on my sides with great success. I don't know much about other FFM but still think they shouldn't push on your teeth.

Well, my teeth are inside my lower lip, and by pressing on my lip, it presses on my teeth.

I think I'm gonna try a football mouth guard, since it goes inside the lips, maybe the pressure will hold it against them from the inside...

That part jumped out at me, too. The lower part of the mask should be between your lower lip and your chin. If it's on your lip, then it may be too small. We don't know how high up you have the upper part of the mask seal on your nose, but try adjusting it so the bottom of the seal sits/fits between your lower lip and chin. If the top is then too low, your mask is too small. There should also be sizing guides to determine what size you should be using.

It's quite possible you also have it cinched down too tight, too.


Den

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Wulfman... wrote:

FlyingMoose wrote:

knothead wrote:Not sure I understand how a FFM pushes against your teeth. I wear a Quattro FFM and the top fits around my nose and the bottom just below bottom lip. I'm a side sleeper and sleep on my sides with great success. I don't know much about other FFM but still think they shouldn't push on your teeth.

Well, my teeth are inside my lower lip, and by pressing on my lip, it presses on my teeth.

I think I'm gonna try a football mouth guard, since it goes inside the lips, maybe the pressure will hold it against them from the inside...

That part jumped out at me, too. The lower part of the mask should be between your lower lip and your chin. If it's on your lip, then it may be too small. We don't know how high up you have the upper part of the mask seal on your nose, but try adjusting it so the bottom of the seal sits/fits between your lower lip and chin. If the top is then too low, your mask is too small. There should also be sizing guides to determine what size you should be using.

It's quite possible you also have it cinched down too tight, too.


Den

.

I have the next size up of the same mask, and it's much too big. The bottom goes below my chin. This would be OK except that it leaks at about 50lpm.

The top has to be in a very small range, if it's too low, it closes off my nose, and if it's too high, it blows air into my eyes. If they made a size maybe 1/4 to 1/3 of the way from medium to large, it would probly be perfect, but they only make three sizes.

I just ordered a F&P Forma, which is supposed to go below the chin (got a suggestion in another thread), even if I don't end up using it (and use nasal pillows instead), if it's better than the Simplus, I'll keep it around in case I have a cold.

FlyingMoose wrote:

Wulfman... wrote:

FlyingMoose wrote:

knothead wrote:Not sure I understand how a FFM pushes against your teeth. I wear a Quattro FFM and the top fits around my nose and the bottom just below bottom lip. I'm a side sleeper and sleep on my sides with great success. I don't know much about other FFM but still think they shouldn't push on your teeth.

Well, my teeth are inside my lower lip, and by pressing on my lip, it presses on my teeth.

I think I'm gonna try a football mouth guard, since it goes inside the lips, maybe the pressure will hold it against them from the inside...

That part jumped out at me, too. The lower part of the mask should be between your lower lip and your chin. If it's on your lip, then it may be too small. We don't know how high up you have the upper part of the mask seal on your nose, but try adjusting it so the bottom of the seal sits/fits between your lower lip and chin. If the top is then too low, your mask is too small. There should also be sizing guides to determine what size you should be using.

It's quite possible you also have it cinched down too tight, too.


Den

.

I have the next size up of the same mask, and it's much too big. The bottom goes below my chin. This would be OK except that it leaks at about 50lpm.

The top has to be in a very small range, if it's too low, it closes off my nose, and if it's too high, it blows air into my eyes. If they made a size maybe 1/4 to 1/3 of the way from medium to large, it would probly be perfect, but they only make three sizes.

I just ordered a F&P Forma, which is supposed to go below the chin (got a suggestion in another thread), even if I don't end up using it (and use nasal pillows instead), if it's better than the Simplus, I'll keep it around in case I have a cold.

We don't know what sizes you have or what your "mid-eye to chin" measurements are. But, maybe you also need to look at some different brand/manufacturer categories. CPAP.COM used to have a mask sizing guide, but there's no working link to it anymore. When I used it, my "mid-eye to chin" measurement put me in an in-between size and I could go with a Medium or Large. I ended up getting the Large size, but found in later years that I could also wear a Medium (reasonably well) after I acquired some of them. I also found that when I purchased a Large Quattro some years later that it was slightly longer in that measurement than the Large Ultra Mirage Full Face I had been using for several years prior. Longer to the point that it sat quite a bit further down on my chin. So, in that case, maybe a Medium in a Quattro would be "just about right".
If I remember correctly, the measurement for that dividing line of Medium or Large was 4 inches. You take a ruler and measure from an imaginary line that intersects the middle of the pupils of your eyes to the point between the bottom lip and chin (you can do it in a mirror).
But, as I said, the manufacturers have some sizing guides and templates to use these days.

What I'm saying is.......not all masks or full face masks are made or sized similarly and may take some experimentation or shopping around to find the right one.


Den

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