Mouth Seal and Cause of Sleep Disordered Breathing?

I was trying out a different size nasal pillow and noticed something that seemed interesting to me.

Since starting CPAP I was surprised how easy it was to maintain mouth seal. I can open my mouth wide open, move tongue and jaw around and even stick tongue out all without losing seal. About the only time I lose mouth seal is if I try to breath through mouth or talk.

What I just noticed is that I am capable of switching to mouth breathing with minimal leak and then able to maintain mouth breathing without actively trying to maintain a seal. I can open my mouth, move tongue and jaw around all while mouth breathing and CPAP seal will stay.

This had me curious so I did it in front of a mirror and realized when nose breathing my soft palate hangs low enough it sticks to the back of my tongue even when moving tongue around etc. Then when I switch to mouth breathing the seal is broken, the palate rises and then sticks to the back of my throat. I don't know what holds it in that position.

When playing with this the CPAP machine thought I was having breathing issues and started raising pressure. I was able to maintain a seal mouth breathing for the full programmed range (6-16 cm H2O) and the transition to mouth breathing actually got quicker and easier at higher pressure almost like the higher pressure was helping create the seal which was the opposite of what I expected.

I was just curious if most people are capable of this? Would it be the cause or at least a factor of my sleep disordered breathing which is primarily hypopneas and has been under control the first few nights of CPAP trial (only 6-7 cm required)?

I can do all that and even talk without losing the seal and having pressure enter my mouth.
Been able to do it since about 6 months into therapy. Wish I could document how it gets done because I could sell it and make a fortune...I don't think that the majority of cpap users know how to do it. I see too many complaints of pressure and mouth opening and chipmunk cheeks.

Pugsy wrote: ↑

Sat Nov 16, 2019 2:56 pm

I can do all that and even talk without losing the seal and having pressure enter my mouth.
Been able to do it since about 6 months into therapy. Wish I could document how it gets done because I could sell it and make a fortune...I don't think that the majority of cpap users know how to do it. I see too many complaints of pressure and mouth opening and chipmunk cheeks.

I know exactly what you mean.

I can do it, know how Io do it, but darned if I could describe to others how the could learn to do it.

Given, my first night on CPAP was with a nasal mask, and I didn't have a mouth leaking problem, I think some of us are just naturally capable of it. I also think others simply may not be capable of it.

The best way I have to describe it: Throat Kegels

Dog Slobber wrote: ↑

Sat Nov 16, 2019 3:10 pm

The best way I have to describe it: Throat Kegels

Dog Slobber wrote: ↑

Sat Nov 16, 2019 3:10 pm

I know exactly what you mean.

I can do it, know how to do it, but darned if I could describe to others how the could learn to do it.

Given, my first night on CPAP was with a nasal mask, and I didn't have a mouth leaking problem, I think some of us are just naturally capable of it. I also think others simply may not be capable of it.

The best way I have to describe it: Throat Kegels

Lol @ throat kegels.

I am sure it has to at least be in part due to physical structures and I wouldn't be surprised if it is the reason some of us have sleep disordered breathing to begin with since large palate is a known cause.

I don't even have to try to do this. First night I simply opened my mouth at one point and noticed it didn't leak, it made me wonder why there are so many posts about people with seal issues, having to learn to seal with your tongue etc. Then today(after third night) I noticed if I breath through my mouth my nasal passageway just naturally closes.

Here is one of my MRI images. You can see how my uvula almost touches back of my throat(was in my CT). I can also see how if the palate flips up over where the spine starts then it could be supported in that position. More CPAP pressure would cause more force to push down on the majority of the palate trying to flatten it which would cause it to push harder into the back of the throat providing a tighter seal. That is my guess at what happens anyways.

Dog Slobber wrote: ↑

Sat Nov 16, 2019 3:10 pm

Pugsy wrote: ↑

Sat Nov 16, 2019 2:56 pm

I can do all that and even talk without losing the seal and having pressure enter my mouth.
Been able to do it since about 6 months into therapy. Wish I could document how it gets done because I could sell it and make a fortune...I don't think that the majority of cpap users know how to do it. I see too many complaints of pressure and mouth opening and chipmunk cheeks.

I know exactly what you mean.

I can do it, know how Io do it, but darned if I could describe to others how the could learn to do it.

Given, my first night on CPAP was with a nasal mask, and I didn't have a mouth leaking problem, I think some of us are just naturally capable of it. I also think others simply may not be capable of it.

The best way I have to describe it: Throat Kegels

Anybody that can blow up a balloon without having to pinch their nose shut has the capability... Since it's the same mechanism that prevents the air from rushing out your nose, instead of into the balloon...

but, everybody likes to talk about 'tongue position"... go figure.

palerider wrote: ↑

Sat Nov 16, 2019 3:49 pm

but, everybody likes to talk about 'tongue position"... go figure.

Well we know it isn't tongue position because if we can stick out our tongues and blow raspberries at people....it's not the tongue doing the blocking.
But....maybe whatever exercise we do with the tongue to help keep that back door closed ends up being what is needed to seal things up.
Might be learning something new without knowing we are learning something new.

Pugsy wrote: ↑

Sat Nov 16, 2019 3:59 pm

Well we know it isn't tongue position because if we can stick out our tongues and blow raspberries at people....it's not the tongue doing the blocking.
But....maybe whatever exercise we do with the tongue to help keep that back door closed ends up being what is needed to seal things up.
Might be learning something new without knowing we are learning something new.

I would think that tongue position is probably important in some people.

There are only two ways to block the oral passageway.

a) Close your mouth.
b) Palate seal on the back side of tongue.

I am capable of fully opening my mouth and sticking out my tongue while my palate maintains a seal on the back side of my tongue but my guess is the users that struggle with mouth seal aren't capable of doing this or struggle with it.

Our bodies are designed to seal the palate against throat as part of the swallowing process. To my knowledge palate to tongue seals are far less important and probably more of a byproduct rather than necessity. Just having the uvula on the tongue side of the palate makes a seal that much more difficult in that direction.

Everything sticks to my tongue.

Pugsy wrote: ↑

Sat Nov 16, 2019 2:56 pm

Wish I could document how it gets done because I could sell it and make a fortune...I don't think that the majority of cpap users know how to do it. I see too many complaints of pressure and mouth opening and chipmunk cheeks.

My sleep doctor will not start anyone on other then nasal masks/pillows. I thought he was nuts. I have been a lifelong mouth breather. During the 1st week if I opened my mouth it was like an air compressor hose was suddenly disconnected. After two weeks I can breath in thru my nose and breath out thru my mouth without effort or discomfort. I don't know what changed or how it changed, only that it did.

harrywr2 wrote: ↑

Sat Nov 16, 2019 8:12 pm

Pugsy wrote: ↑

Sat Nov 16, 2019 2:56 pm

Wish I could document how it gets done because I could sell it and make a fortune...I don't think that the majority of cpap users know how to do it. I see too many complaints of pressure and mouth opening and chipmunk cheeks.

My sleep doctor will not start anyone on other then nasal masks/pillows. I thought he was nuts. I have been a lifelong mouth breather. During the 1st week if I opened my mouth it was like an air compressor hose was suddenly disconnected. After two weeks I can breath in thru my nose and breath out thru my mouth without effort or discomfort. I don't know what changed or how it changed, only that it did.

I am a mouth breather, any time I lay down, anytime I am active, and often when I am not active. I have been that way all my life. When I am at the dentist, I have a very hard time breathing through my nose while they work on me. I am laying down with my mouth open. Two things that make it hard for me to breathe through my nose. Sometimes, they have to cover my mouth for a moment to make me switch.

When I use my full face mask, no air goes though my nose. It's obviously exposed to the air flow, but I had to try it on purpose once, and I did not like the sensation.

I suspect there may be many undiagnosed cases of severe nasal blockage,
be it a deviated septum or something else.