Dry mouth and high AHI with Auto CPAP

Hi, I'm a real newbie. I have some questions. (Big surprise, huh?) I'm using a Respironics Dream Station Auto CPAP with A Flex with heated humidifier and a small Amara view full face mask. Its been about 10 days of using it 7 hours per night. I wake up each morning with a horrendously dry mouth/throat, even though I've turned up the humidity to 5. I'm a mouth breather which is why I chose the full face mask, but it doesn't seem to help.It gets so bad it wakes me up a couple times per night.
The other issue is when I check the AHI results its at about 15! I was under the impression that it was supposed to go down to 5 or less if CPAP is working?
The machine says that mask fit is 99% so I don't think leaking is a problem. The ramp is on 4, time 30 minutes, start 4 cm H2O, min 4 cm H2O, max 16 cm H2O, Flex is 3. I'm kinda mystified why this isn't working. any ideas? This is all pretty discouraging.
Thanks for any help!

If you are a mouth breather shouldn't you use a mouth breathing mask like this:

http://www.directhomemedical.com/hc452- ... 0uCJWf2ZLM

Such a mask seals better around the mouth than your present mask.

Did you have a sleep study and if yes what mask did it recemmend?

I suspect the minimum pressure is too low and it is taking the machine too long to get to where it needs to effectively hold the airway open....that is assuming the AHI is primarily Obstructive Apneas and Hyponeas.
If it is primarily Clear Airway / Central apnea events then we need to have a different discussion.

So the first thing to do is figure out what the vent breakdown is for that AHI of 15 and you will need the software to see the breakdown...the LCD screen doesn't show the breakdown.
Do you know about the software?
https://sleep.tnet.com/equipment

The dry mouth...mouth breathing will just dry out the mouth....some people more than others...despite having the humidity set to maximum...the setting of 5 is the maximum without the heated hose but with the heated hose you can add more humidity to the air. Do you know about the heated hose option?
I don't know if increasing the humidity will be enough to help very much with the dry mouth or not...but it's worth considering.
Do you take any meds that might make the mouth dry out more easily which compounds the problem?

These humidifiers were originally design to help hydrate the nasal cavity and that cavity is much smaller than the oral cavity so for some people the humidifier simply can't crank out enough moisture to hydrate the mouth sufficiently. For those people they often have to use one of the oral hydrating products like Biotene or I think that OraJel makes a hydrating gel that people like. Someone will come along and tell you what they use with good results. Fortunately I don't have that problem so I have no experience with any of those products.

So...let's get the software and figure out what the AHI is made up of...and see what the pressure is doing.
I suspect the 4 cm minimum needs to be increased...and we don't know about the maximum until we see some reports. But I won't advise blindly an increase in pressure without seeing some reports because if the AHI is primarily Clear Airway events then increasing the pressure probably won't help and might make things worse.

How to post images of your software reports so we an see what you are seeing...check out this thread for examples of what we like to see.
viewtopic/t103468/Need-help-with-screen-shots.html

The mask that Avi suggested....the Oracle...will very likely greatly increase your dry mouth issues plus you can't use your nose at all to breathe with that mask. It isn't a mask that I would suggest a newbie go trying.

I occasionally mouth-breathe, and to help with the dryness, I use a squeeze of this stuff before I put on my mask every night. It has helped me a lot. Might be something you'd like to try out. Good luck.


http://www.walgreens.com/store/c/orajel ... 894826ba34

rosevader wrote:Hi, I'm a real newbie. I have some questions. (Big surprise, huh?) I'm using a Respironics Dream Station Auto CPAP with A Flex with heated humidifier and a small Amara view full face mask. Its been about 10 days of using it 7 hours per night. I wake up each morning with a horrendously dry mouth/throat, even though I've turned up the humidity to 5. I'm a mouth breather which is why I chose the full face mask, but it doesn't seem to help.It gets so bad it wakes me up a couple times per night.
The other issue is when I check the AHI results its at about 15! I was under the impression that it was supposed to go down to 5 or less if CPAP is working?
The machine says that mask fit is 99% so I don't think leaking is a problem. The ramp is on 4, time 30 minutes, start 4 cm H2O, min 4 cm H2O, max 16 cm H2O, Flex is 3. I'm kinda mystified why this isn't working. any ideas? This is all pretty discouraging.
Thanks for any help!

Oh, it's "working" alright........just that everything you've got configured in your machine is not therapeutic and counterproductive to what you need or expect.

Wide open settings (minimum too low), too much humidification, Ramp time too long, etc., etc.
If you aren't doing nasal cleansing before bedtime, that would be a suggestion. (you need to be able to breathe through your nose if possible)
Too much humidification is likely to cause more nasal congestion, so you might want to try turning it waaaaay down or off.
Also, mouth-breathing is going to cause "dry mouth" no matter what type of mask you use.

Get Sleepyhead software and see what is happening while you're sleeping.


Den

.

Thanks for the replies! The dryness is pretty horrendous. Last night I tried using Biotene oralbalance gel, but it didn't do a heck of a lot for me, I still woke up with painfully dry mouth. I'll certainly try this other gel since you had a good result with it.
As for the software, I looked it up on the website you suggested and it says Encore. I'm not sure what I should do next. Is there some sort of tutorial for pulling this info from the machine??
I had an at home sleep study, and it had no suggestions about which mask to use.
Thanks!

About the humidity setting...some people need the maximum and some people do better with minimal to none extra humidity. Den does well with minimal but I need maximum...and there's no way to know what you are going to need until you maybe try lower and this is mainly for the nasal mucosa.

Nasal mucosa are funny little things in that they react the same way with either too much or not enough moisture..and what they do is respond like a typical allergy response. The mucosa swells and starts to produce moisture (runny nose) along with sometimes itchyness and sneezing.
If you aren't having any nasal issues with current settings...be careful about trying lower because you might end up where I was when I tried lower. Bad, bad nasal issues until the nasal mucosa got back in balance.
Now if you are having nasal congestion now and didn't have it before starting cpap then maybe your nasal mucosa isn't happy with the moisture and they might be happier with less.
I just wanted to warn you about the humidity thing....turning it down or off works for some people but not others.
Humidity preferences are highly personal/individualized and something that we just have to figure out for ourselves because what works well for me or Den might not work so well for you.

Are you using the heated hose? If so, at what temperature?

On the link above where you saw Encore mentioned...above it is SleepyHead...which I think is easier for newbies than Encore but if you want Encore I can help you with it.
Encore is Windows only though...so if you have something other than Windows on your computer it won't work.
SleepyHead works on Windows as well as Macs.

With regard to the humidity settings.......I believe I ALWAYS use the word "TRY" in my statements about it.
It's true that everybody's different with regard to humidity settings, but the users need to be willing to experiment with their settings to find what works best for THEM.


Den

.

Why are you a mouth breather? Do you have chronic nasal congestion issues of some sort that force the mouth breathing?
If so, has the nasal congestion gotten worse with the start of cpap therapy?

I think that I have always had a little bit of congestion, especially during allergy season (in spite of using allergy meds). The congestion hasn't gotten either worse or better since I started using CPAP that I can tell. Maybe I should have an ENT check it out?

I have always been a mouth breather but have learned to keep my tongue up under the upper teeth for most of the night and it helps knowing that with the FFM if I decide I want to breathe thru my mouth I have that option all night. Just knowing that has allowed me to not do it very often and sometimes I just open my lips just a small amount. This has helped tremendously with the dry mouth. Not 100% but I also take meds that give me dry mouth.

If your nasal congestion impacts your day to day quality of life then maybe a visit to the ENT would be in order.
Might be something that is easy to remedy and help with overall breathing and not just at night.
I know I am totally miserable if for some reason I can't breathe through my nose. I have found that the higher humidity settings actually help clear up any minor nasal congestion that I might have. I guess sort of like a hot steamy shower seems to help when we have a cold.

I lived in Las Vegas (pre cpap though) for 5 years and my poor nose was always feeling "dry" and congested a bit from the dry air out there. I never did get adjusted to the dry air and when I go back for a visit I find it starts all over again but now I take my Simply Saline spray with me and use it often so my nose is a lot happier.

Maybe if you could breathe totally through your nose then you wouldn't mouth breathe so much and that would help with the dry mouth. Worth checking the nose out by ENT..

I get the dry mouth with CPAP even though I'm not a mouth breather and can't explain why. The Orajel for Dry Mouth works better for me than the Biotene spray because it seems to last longer and tastes better. I do keep the spray Biotene at the bedside because, with nasal pillows, I can use a spray during the night when I forget to use the Orajel before bed and wake up with a cotton mouth.