Mouth Puffs - Help!

roster · Post by **roster** » Wed Jul 12, 2006 8:40 am

6 months on cpap and have been taping mouth securely last few months but the therapy is no longer working for me. I am looking for a post, that someone made, about chipmunk cheeks or pressurized air leaking into the mouth. Can someone point me to this post?

I have come to the conclusion that I am having slight arousals about once per minute due to small air puff in mouth that I then have to swallow to fall completely asleep again. I am trying to get a Hybrid Mask through Apria but until then I desperately need to get some sleep.

Any advice will be appreciated,

rooster (with no cock-a-doodle-do)

MJRigg · Post by **MJRigg** » Wed Jul 12, 2006 8:46 am

I think I'm having a similar problem...

I have to use a full face mask because I refuse to have surgery to correct a deviated septum. Every morning I wake up and belch loudly as soon as I sit up. I can feel my stomach inflating with air I swallow.

Any adivce?
M

oldgearhead · Post by **oldgearhead** » Wed Jul 12, 2006 9:17 am

Rooster,
What works for me is 2 things:
1) I tape just enough to part my lips a small amout to expell (On the exhale cycle) the air throug the paper tape.
2) I press the tip of my tongue just behind my lower front teeth. I'm not sure why this works for me. Unless I'm pushing my jaw forward enough to keep the tongue seal.

If it fits the curve of your face, the Hybrid will be your best bet..Good Luck.

roster · Post by **roster** » Wed Jul 12, 2006 9:26 am

[quote="oldgearhead"]Rooster,

1) I tape just enough to part my lips a small amout to expell (On the exhale cycle) the air throug the paper tape.

oldgearhead · Post by **oldgearhead** » Wed Jul 12, 2006 9:52 am

Rooster,
I only need to 'puff out' the 'Blowfish' when he shows up. Of course this is only when I'm awake. As for the tape position, I don't do anything special, because the air can be expelled right through the tape. I think the tongue position and timing the exhale to my machine are what keeps it from happing when I'm asleep.

inacpapfog · Post by **inacpapfog** » Wed Jul 12, 2006 5:09 pm

Taping my mouth never kept my cheeks from expanding with air! When cheek balloons would happen, I was constantly being awaken! Once I found a way to keep my cheeks from expanding, there was very little diverted cpap air to cause problems! My solution was the Deluxe chin strap. This strap looks like a wide, white ACE bandage. ( You could probably devise your own fix, just aim to keep the cheeks from expanding!) Good Luck!

Guest · Post by **Guest** » Wed Jul 12, 2006 6:29 pm

I've used a 2' ace bandage, right around the head and over the mouth, but not too tight! In fact not tight at all, just to cover the mouth.

roztom · Post by **roztom** » Wed Jul 12, 2006 6:47 pm

I'vre had that problem. I think if you mouth leak that is a prelude to mouth breathing.

After all once you expel air you are just as apt to take it in.

Many times I awaken to air escaping from mymouth. I am not conscious of breathing in thru my mouth, just air leaking from it.

I have tried a chin strap but it was really uncomfortable and would often slip off during the night.

I am going to try the Hybrid and see if that will improve things and cut down on the arousals.

Best,

Tom

rested gal · Post by **rested gal** » Wed Jul 12, 2006 7:41 pm

If a person is using an autopap machine in auto mode, I think it might be even more important to not let puffs of exhaled air out the mouth... even through a hole in tape. Autopaps need to sense what's happening with the air flow both in and out.

Guest · Post by **Guest** » Thu Jul 13, 2006 7:48 pm

My autopap records the 'exhale puffs'. Do all autos do this? (DeVilbiss)

rested gal · Post by **rested gal** » Fri Jul 14, 2006 1:01 am

Guest, can you post a screenshot picture of the page in your software data that shows that kind of data... for "exhale puffs"?

Or are you talking about the software data showing leak rate? If it's just the leak rate, I don't think there's any way to tell from the data alone whether the leak that was recorded was mask leakage or air leaking out the mouth. If the DeVilbiss machine differentiates between the two and reports them separately, that would be most interesting.

All the autopaps I've used (Respironics, Puritan Bennett, ResMed) do report the leak rate.

Guest · Post by **Guest** » Sat Jul 15, 2006 10:07 am

RG
Machine records AHI, Apnea events, Hypopnea events, Mixed events, Snores events, Mask leaks (minutes), Exhale puff events. Charts are simple and linear for nightly events line. Also there is a monthly daily pressure chart and cumulative pressure percentage chart. Machine is seven years old, so I've been following info here on newer ones of different mfr. The one added feature on the DeVilbiss is the ability to change the paramenters, both apnea and hypopnea flow reduction percent and duration (respective defaults are 10% flow reduction with 10 seconds duration and 50% with 10seconds).

Snoredog · Post by **Snoredog** » Sat Jul 15, 2006 12:30 pm

it's not just taping, it's keeping your tongue planted into the hard palate. You have to train yourself to do that. Once that tongue drops down you are a blow fish. Some say a dab of polygrip in the palate can assist that.

Taping the mouth is NOT to completely seal it against the cpap pressure, big misconception here. When you mouth breathe there is a whole sequence of events that take place:

-mandible drops
-lips part
-tongue drops or falls out of the hard palate
-when lips part, air escapes

Tape only keeps your lips from parting but even it can be too late in the sequence of events. If you are a blowfish, then you need to explore other events.

A chin strap THAT can put enough "vertical" pressure to prevent your mandible from dropping could help if it doesn't pull the manible back.

Pulling the mandible back makes your OSA worse as it narrows the lower airway. Most chin straps on the market today need to go in the dumpster. The hard part is keeping it in the correct orientation to prevent the mandible from dropping. Those that cup/hook on the chin are terrible for making OSA worse.

The only chin strap that I've seen to date with any chance of working is the one krousseau made in this thread seen yesterday:

http://cpaptalk.com/viewtopic.php?t=11125

You'll notice the strap she has made is not elastic like most chinstraps, it is velcro. She is using the mask headgear to hold it in place. This is what you need. Looks like a luggage strap or a camera bag strap to me.

The purpose of that strap is to keep the mandible from dropping. If you can prevent that from happening you can most likely stop your mouth breathing. But again the other aspect of that is keeping your tongue planted into the hard palate as that is what actually seals against the cpap pressure.

It is not easy, sometimes you give up and just use a Full Face mask.

Titrator · Post by **Titrator** » Sat Jul 15, 2006 1:06 pm

Hi Roster,

I sometimes get chipmonk cheeks and air through my mouth when I sleep on my back. As soon as I sleep on my side, this stops.

Are you sleeping on your back and have you tried to see if the problem is corrected when you side sleep?

Titrator

roster · Post by **roster** » Sat Jul 15, 2006 1:59 pm

Titrator wrote:Hi Roster,

I sometimes get chipmonk cheeks and air through my mouth when I sleep on my back. As soon as I sleep on my side, this stops.

Are you sleeping on your back and have you tried to see if the problem is corrected when you side sleep?

Titrator

I am really not sure, but it may well be that the chipmunk cheeks are not present when sleeping on my side. My natural sleep position is on my back and I have not been able to sleep more than one hour per night on my sides in half-hour spells. After the technician in my first sleep study told me there were a lot of apneas I had to wait about two weeks before I was titrated and took delivery of the equipment. During this two weeks I used tennis balls and tried to train myself to side sleep. This was a tough two weeks and I never got much past one hour per night on my sides.

Did you have to train yourself to side sleep?

rooster

Mask

Additional Comments: Will update when I double check.