Considering dental appliance - can't solve large leak problem

Hello, everyone.
Have any of you had good experiences with dental appliances to treat sleep apnea? I used one years ago but it caused my teeth to move so I had to give it up. I have been using cpap for about four years. I've been successful by and large after many adjustments thanks to tips from this forum. However, over the past few weeks I have tried everything to deal with very large leaks to no avail. The leaks wake me up and my mouth is bone dry. This makes me think I am mouth breathing (do you agree?). I've switched to full face mask for a night or two but can't tolerate anything on the bridge of my nose (lots of pain and leaves a nasty sore). I use a Ruby chin strap plus those fabric headbands across the mouth. I am very, very tired every day which is why I may have to give up on cpap and go back to the dental appliance. Is there anything I'm missing?
Thanks to all.

Try nasal pillows.
The dental appliance moved your teeth once--it would again.
Eventually, the change would be permanent.
TMJ is a common outcome. It is painful--day and night.
Persistent pain ages you and weakens immunity.

chunkyfrog wrote: ↑

Fri Aug 19, 2022 7:15 am

Try nasal pillows.
The dental appliance moved your teeth once--it would again.
Eventually, the change would be permanent.
TMJ is a common outcome. It is painful--day and night.
Persistent pain ages you and weakens immunity.

As someone who gets daily TMJ pain I have to agree with the frog.

You could also try the nasal cushions like the one I use along with some thing to keep your jaw closed.

You need to try various masks (I'm sure you have) again, lying down, because even if a choice feels better than your present one, you may still need to tweak things, but at least be starting out with a 'best' pick, whatever happened in the past.

Thank you.
I hear your cautions about the dental device. I did experience TMJ with the old one I had. I have been using CPAP since I stopped the dental. But beginning in July, the large leaks started creeping up. In August, they got even worse. Last night, my large leaks were at 41% of the night, with a leak rate of 51.6. I have tried many masks. The beneath the nose nasal mask has been the main one. But lately I tried the the air fit n30i (on advice of sleep tech who thought it would move less if mask movement was the problem). The large leaking continued with that one. And more recently, on advice of another tech, used the air fit f 30i (a hybrid full face) and that blew air into my eyes so much after much adjusting that I gave it up and went back to the n30i. That brings you up to last night, when I taped my mouth closed thinking it must be mouth breathing (though I wear the Ruby chin strap). Well, my mouth was still bone dry all night and I had leaking almost the whole night.
These leaks interrupt my sleep and I have felt so sleep deprived I have trouble functioning. I am a loss and feel I have tried everything to solve this problem, which gets worse by the night. I am now at the point of feeling I should give myself a break from the cpap for a few nights just to get some sleep (though I know this is not the permanent answer). I am desperate to sleep. Thank you for letting me vent and please write back with any ideas I've missed. I'm out of ideas now myself.

Have you tried taping your mouth shut with the nasal cushion mask?

Hi, Pugsy,
Yes, I used the nasal cushion mask and taped my mouth shut with it last night.

Peacenana wrote: ↑

Sat Aug 20, 2022 9:21 am

Hi, Pugsy,
Yes, I used the nasal cushion mask and taped my mouth shut with it last night.

What were the results?
Did tape stay secure or come loose?

My AHI was great, less than 1 (this is typical for me). Large leaks were at 41 per cent and leak rate was 51.6. I used the N30i nasal mask and taped my mouth closed. Tape stayed on securely - had to rip it off in the morning. My mouth was very dry, which is as it's been since this increase in large leaks has occurred. Pugsy, do you think there could be something wrong with my machine? My supplier issued a "new" Air Sense 10 a few months ago and I've had no troubles since about a month and a half ago. I also replaced hose, mask framework and cushion, put in a new filter.
Thank you for any advice you can offer. I'm at my wit's end. I don't give up easily but this has me stumped and I'm sleep deprived.

If mouth is closed with tape until the tape is removed the next morning then that only leaves mask movement as the cause of the big leaks or perhaps a hole in something somewhere.

I doubt it has anything to do with machine function though……most likely mask movement itself.
How old is the mask, eadgear, hose, etc?
Maybe time to try a different mask???

Try my mask: pillows & covers mouth (oral cushion,), comes with 3 sizes of each, & 4 straps to adjust -- all designed to get a great fit. See name in my signature; I buy from our host cpap.com

Thank you, Pugsy and Muse-Inc.
Last night I went back to my regular mask (see below) and I taped my mouth closed. Around 4:30 I woke up and that's when I noticed that even with my mouth taped closed my cheeks were filling with air (chipmunk cheeks, "puffing" out). The leaks up until then were better - 4.24% large leaks and leak rate of 27.6. The puffing was bothering me so I removed everything around 5 and slept without. Does the mouth filling with air that I described mean anything to you?
Pugsy, I very recently replaced hose, mask headgear and cushions.

Sigh... I know what you're talking about.

I don't know how to avoid chipmunk cheeks - though I do know who to stop them, when I'm awake...
Most of the time, recently, I find them tolerable, but there was a long time when they were intolerable, and I slept with the type of full face masks that do not touch the bridge of your nose.

There are full face masks that don't touch the bridge of your nose - and you have to make sure not to tighten their straps too much.

This is a good video about mouth leaks:

CPAP Dry Mouth & Mouth Leak - 3 Tips To Fix

OMG ozij!!! I have just spent the last hour viewing the mouth leak video link you sent -- and others by the same guy. I have learned more from him in minutes than I have from my sleep doc and technicians in years!! And of course I continue to learn from people like you on this amazing forum!
For now, I lowered my Air Sense 10 pressure just a tad to see if it helps with mouth dryness and mask leaks. Also increased tube temperature and ordered those little mouth tape Nick recommends. I'll report back tomorrow. I won't get my hopes up too high, but I feel excited about the possibility of helping my two main cpap complaints:
Mask (mouth) leaks and very dry mouth.

Thanks, again!