Smargie’s Therapy Thread...in Need of ASV Advice

Hello!

I just got my CPAP about 10 days ago. It started out alright... I had 5 days of good readings and an AHI average of about 5.4. And then suddenly it seemed like the machine were attacking me I began to get woken up over and over because the air blowing in my nose starting going directly into my mouth instead of my lungs. I am not usually a mouth breather, and assume I was given a nasal mask because I only breathed through my nose during my sleep study.

So I don’t know if something is happening with the machine or if it’s me opening my mouth. My AHIs have gone up to 98. I haven’t been able to reach anyone at Respironics yet (no customer service over the weekend) and I’m out of town today. I’ll try again tomorrow.

My questions are: Would a chin strap help? Is this problem one that should be discussed with the respiratory therapist at the supply store or my doctor? I can’t use it now if I want to actually get some sleep. I believe I was told I had to use it at least 4 hours a night to be compliant with my insurance. Am I going to get dinged?

Thanks for any feedback you can give me

Mouth leaks are common and there is [likely] nothing wrong with your machine.

Possible solutions:

• Fullface mask
• Chin strap
• Mouth Tape

Dog Slobber wrote: ↑

Mon Apr 01, 2019 10:08 am

Mouth leaks are common and there is [likely] nothing wrong with your machine.

Possible solutions:

• Fullface mask
• Chin strap
• Mouth Tape

a soft cervical collar

katestyles wrote: ↑

Mon Apr 01, 2019 10:34 am

Dog Slobber wrote: ↑

Mon Apr 01, 2019 10:08 am

Mouth leaks are common and there is [likely] nothing wrong with your machine.

Possible solutions:

• Fullface mask
• Chin strap
• Mouth Tape

a soft cervical collar

scunci!! <gives kate the side eye>

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

zonker wrote: ↑

Mon Apr 01, 2019 11:15 am

katestyles wrote: ↑

Mon Apr 01, 2019 10:34 am

Dog Slobber wrote: ↑

Mon Apr 01, 2019 10:08 am

Mouth leaks are common and there is [likely] nothing wrong with your machine.

Possible solutions:

• Fullface mask
• Chin strap
• Mouth Tape

a soft cervical collar

scunci!! <gives kate the side eye>

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

Ah yes - of course. Scunci.
I sort of count that in with mouth taping.

katestyles wrote: ↑

Mon Apr 01, 2019 11:24 am

scunci!! <gives kate the side eye>

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

Ah yes - of course. Scunci.
I sort of count that in with mouth taping.
[/quote]

have we got to the point where i become all pedantic and start a huge thread-hijacking argument?

no, we have not got to that point because you are such a nice person.

to the op, sorry, carry on.

zonker wrote: ↑

Mon Apr 01, 2019 11:35 am

katestyles wrote: ↑

Mon Apr 01, 2019 11:24 am

scunci!! <gives kate the side eye>

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

Ah yes - of course. Scunci.
I sort of count that in with mouth taping.

have we got to the point where i become all pedantic and start a huge thread-hijacking argument?

no, we have not got to that point because you are such a nice person.

to the op, sorry, carry on.
[/quote]

Can I hijack for just a second? I'd like to see a thread with pictures of all the do it yourself ideas from your scrunchis and djams mouth taping to the homemade hose covers and ways to manage your hose. Then we could post the link for new users. Its always easier to see a picture of everything.

babydinosnoreless wrote: ↑

Mon Apr 01, 2019 11:50 am

zonker wrote: ↑

Mon Apr 01, 2019 11:35 am

katestyles wrote: ↑

Mon Apr 01, 2019 11:24 am

scunci!! <gives kate the side eye>

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

Ah yes - of course. Scunci.
I sort of count that in with mouth taping.

have we got to the point where i become all pedantic and start a huge thread-hijacking argument?

no, we have not got to that point because you are such a nice person.

to the op, sorry, carry on.

Can I hijack for just a second? I'd like to see a thread with pictures of all the do it yourself ideas from your scrunchis and djams mouth taping to the homemade hose covers and ways to manage your hose. Then we could post the link for new users. Its always easier to see a picture of everything.
[/quote]

Seconded. Then we can sticky it at the top of the Forum. I have been thinking that a troubleshooting sticky might be needed.

This can be the start.
>Trouble shooting
> Leaks
>Mouth leaks
Solutions

• Full face mask
  Chin strap
  Mouth taping and Scunci
  Cervical collar

I use a chinstrap and it works for me. I have used a couple. This one has been the most comfortable for me. It's adjustable and made of a cotton type stretchy material. https://www.cpap.com/productpage/deluxe ... -mouthleak

Is mouth breathing a main cause of aerophagia or is it just as likely through nose breathing at a given pressure?

tyrone747 wrote: ↑

Mon Apr 01, 2019 1:57 pm

Is mouth breathing a main cause of aerophagia or is it just as likely through nose breathing at a given pressure?

I've only used Nasal masks/pillows and am not a mouth breather.

I used to suffer from aerophagia, I've since capped my maximum pressure and greatly reduced my aerophagia.

Wow!

Ok, what is mouth tape and how/why would you use a scrunci? How would a cervical collar help?

Why would this mouth leaking cause the AHI to be so high?

I would LOVE to see pictures of these interventions as katestyles suggests. Hijack away! It’s been helpful.

Is “flex” the way to adjust pressure while exhaling? I think I read that 3 is supposed to give the most relief and that’s what it’s set to.

Here is the new thread with some of the pictures. Hopefully we will get more pictures in there over the next few days but the scrunchi pics are there.

viewtopic/t175368/How-tohome-made-ideas ... lease.html

I use a bilevel machine which has pressure support rather than epr so I will let someone more experience explain that.

I also do not mouth tape. Surprisingly to me I am able to wear a nasal mask without my mouth falling open while I sleep. I thought for sure I would have a problem as when I am awake my mouth is always open and talking when I am awake.

The pic with the mouth taping is on page 15 of kates therapy thread. Here.

viewtopic/t174800/Kates-Therapy.html

Any significant leaks can cause ahi to go up because the machine is unable to treat the problem, at least as I understand it. However, I believe, most machines can handle leaks up to a certain point so the leak would have to be significant.

Smargie wrote: ↑

Mon Apr 01, 2019 10:01 pm

Wow!

Ok, what is mouth tape and how/why would you use a scrunci? How would a cervical collar help?

i'll take that in reverse order, because i think backwards. a foam cervical collar helps. it keeps the jaw closed and allows for a bigger opening of the throat. for some people, this is all they need to cut down leaks.

me? i need more help, because with just a foam cervical collar, my lips will part and i will end up mouth breathing regardless. i don't use tape to keep my lips together. i'm a full bearded fellow and can't figure out how to effectively tape because of the hair. fellow forum user jay aitchsee has proposed using a scunci. and it works for me.

please see the link that baby has provided for info on the scunci.

Smargie wrote: ↑

Mon Apr 01, 2019 10:01 pm

Why would this mouth leaking cause the AHI to be so high?

think of it this way. you're confusing the poor machine by giving it more to fight. less leaks means your machine can be more effective.

Smargie wrote: ↑

Mon Apr 01, 2019 10:01 pm

Is “flex” the way to adjust pressure while exhaling? I think I read that 3 is supposed to give the most relief and that’s what it’s set to.

not sure with your machine, so i may be speaking incorrectly. (if i am, someone will correct me.) but i think flex isn't the right term. is there something in your machine's menu called "EPR"?

Thank you, Zonker

When you say that leaking (which I guess is the proper term for mouth breathing) confuses the machine, are you saying that the AHI readings are then incorrect?

Last night I was able to use the CPAP again and was not awoken by chipmunk cheeks or big exhalations. I thought I’d slept well, but do not feel rested today. And my AHI was 98 I just took a nap for an hour and 20 minutes and had an AHI of 57. I’m really confused! Last night and today felt the same as it did the first 5 nights I used it when the AHI was always between 5 and 6.

I also looked at my doc’s rx and see that she ordered an APAP, which I understand is like a CPAP which adjusts pressure automatically when you are exhaling, so you don’t have to fight against that incoming air. So the flex/EPR question no longer matters.

Why would I be having a higher AHI with the CPAP on than I did without it during my sleep test? And why, after 5 good first days, would I suddenly start leaking? Is this something I should call the RT about?