Caution re taping mouth & no CO2 exit

In another thread I mentioned my concern about taping mouth shut, if nose became plugged during sleep. Granted, if you are that prone to stuffy nose you probably don’t want to use nose interface anyway, but regardless I’d want to check with a doctor. (Hopefully you have a good sleep doctor.)

Chin straps are common but vary in effectiveness, some ads say pulling up on fleshy front of chin pushes lower lip up so lips aren’t as likely to open. To me, a chin strap used reasonably allows the jaw to overcome it and open the mouth. There are many threads herein about chin straps.


Another concern is that some cheap masks out there do not have venting to exhale CO2. They are from established large suppliers of CPAP interfaces, typically for one-patient hospital use (cushion may not be replaceable). The supplier may have a separate vent/valve piece, such as the Respironics WhisperSwivel II which locks into some of the basic Respironics masks. (I purchased a used CPAP machine from an estate, with two Comfort Classic masks each having a standard swivel pushed into the air inlet – including instructions for WhisperSwivel II but no indication the user ever had any!)


User instructions for the WhisperSwivel II mention that if the CPAP machine is not on CO2 is not purged as effectively. another reason not to tape your mouth shut?

BigNortherner wrote: ... another reason not to tape your mouth shut?

The "legitimate gold-standard reason not to tape your mouth" -> The Full Face Mask

roster wrote: The "legitimate gold-standard reason not to tape your mouth" -> The Full Face Mask

I just don't understand what the big deal is with mouth taping. Yanking a strip of tape off your mouth is quicker than removing some of those FFM with the crazy head gear. And lets not forget about the dental appliance that some wear along with their masks. I use to wear one and after heating it up and biting it into position, the placement was nothing short of cemented. I could probably unwrap a mommy and it's 85' of shrouding faster than removing the oral device. So, 4" of tape is a non issue.

At least you understand the value of both methods.

Maple Leaf wrote:Additional Comments: Ultra Mirage Full Face mask when required

To reword my point, "Why tape when the FFM has been already been invented?"

One of my few complaints about the forum is the many responses to a new member using a nasal interface and mouthbreathing. These are the responses that point the member straight to taping without mentioning what I consider the gold standard solution - the FFM.

roster wrote: One of my few complaints about the forum is the many responses to a new member using a nasal interface and mouthbreathing. These are the responses that point the member straight to taping without mentioning what I consider the gold standard solution - the FFM.

Kinda like habitually slamming those that truly require antidepressant medication due to chemical imbalances. Take the FFM and leave in in a brown paper bag......
Are your feathers ruffled yet?

Maple Leaf wrote:

roster wrote: One of my few complaints about the forum is the many responses to a new member using a nasal interface and mouthbreathing. These are the responses that point the member straight to taping without mentioning what I consider the gold standard solution - the FFM.

Kinda like habitually slamming those that truly require antidepressant medication due to chemical imbalances. Take the FFM and leave in in a brown paper bag......
Are your feathers ruffled yet?

You can say "truly require" but patients are almost never tested for chemical inbalances before prescribing antidepressants. I have personally spoken to many people about the SSRIs they have been prescribed and not a single one of them was tested for chemical imbalances. The general rule is a 2- to 15-minute discussion with a GP or psychiatrist precedes the prescription.

Then they wait to see what happens. If the patient reports improvement, the doctor assumes the SSRI treated a chemical imbalance. The phenomenol promoter, Dr. Peter D. Kramer, of Prozac's astronomical sales describes this process in his famous book. That's not the kind of experimenting that can be relied on.

BigNortherner wrote:Chin straps are common but vary in effectiveness, some ads say pulling up on fleshy front of chin pushes lower lip up so lips aren’t as likely to open. To me, a chin strap used reasonably allows the jaw to overcome it and open the mouth.

I agree that chin straps definitely vary in effectiveness. They certainly don't work for everyone. But it HAS worked for me. I had minor mouth-leaking before using the PAPCap chin strap -- enough to make my mouth dry and raise my leak rate. It works great for me, with machine-reported leak rate of zero. I wear it quite loosely. I can part my lips quite a bit and my tongue still blocks my airway, which prevents air from leaking out.

I usually use AEIOMed Headrest and F & P Opus 360 nasal pillows masks, and occasionally the Activa LT nasal mask. I've tried many different full-face masks, in all sizes. They just haven't worked for me at all, whether I wore the headgear loose or tight. It must be my facial contours. The only full-face mask that has shown potential for me is the InnoMed Hybrid, which has nasal pillows and a cushion that covers the mouth.

Everyone's different.

The full-face mask is only a solution to keeping CPAP effective by bypassing nasal congestion and exposing mouth passages to the CPAP pressure as well, but it is not a solution to dry mouth which often comes from breathing through the mouth.

I do not see how depending on becoming awake enough to rip tape off your mouth is a good situation.
I agree that dental appliances can impede mouth opening, they vary in method - one seems to hook together - and IIRC one has a flange to reduce tendency of air to leak through lips even with teeth closed. Medical risk advice is needed.

The key to chin strap is a good design, many are too flexible, many do not stay in place properly. The wide soft type with split top are the only ones I use, but I will probably buy a PAPCAP later.

Yes, masks are often a poor fit. I tried my backup ones last week - Respironics gel nose mask and F&P 431 full face with proper forehead pad added by me. In the middle of each night I switched back to my special pillows in ADAMS setup with Conjo headgear, they seal well.

DreamOn wrote:

BigNortherner wrote:Chin straps are common but vary in effectiveness, some ads say pulling up on fleshy front of chin pushes lower lip up so lips aren’t as likely to open. To me, a chin strap used reasonably allows the jaw to overcome it and open the mouth.

I agree that chin straps definitely vary in effectiveness. They certainly don't work for everyone. But it HAS worked for me. I had minor mouth-leaking before using the PAPCap chin strap -- enough to make my mouth dry and raise my leak rate. It works great for me, with machine-reported leak rate of zero. I wear it quite loosely. I can part my lips quite a bit and my tongue still blocks my airway, which prevents air from leaking out.

I usually use AEIOMed Headrest and F & P Opus 360 nasal pillows masks, and occasionally the Activa LT nasal mask. I've tried many different full-face masks, in all sizes. They just haven't worked for me at all, whether I wore the headgear loose or tight. It must be my facial contours. The only full-face mask that has shown potential for me is the InnoMed Hybrid, which has nasal pillows and a cushion that covers the mouth.

Everyone's different.

This is my approach to mouth breathing:

1.) I use a Quattro FFM
2.) I have fitted it with the headgear from an F&P HC431 (Has a top strap)
3.) I use Pad-A_Cheek forehead and Nose bridge protector.
4.) I use Pad-A-Cheek lower strap cushions.
5.) Wash face before "donning mask"
6.) I have a regular routine for going to bed (time, no exercise 1 hour before, etc.)

This is after trying PapCap (second best so far but good, I find it uncomfortable) and a bunch of chin straps.
I have tried the Nylon cap style (too stretchy LEAKS!)
I have tried the Pad-A-Cheek anti-leak strap (don't need it with the HC431 headgear)

I still occasionally wake up with "dry mouth" when I have been sleeping on my back, but I can live with that.

YMMV

I guess "everyone's different"

Dave

park_ridge_dave wrote:This is my approach to mouth breathing:

1.) I use a Quattro FFM
2.) I have fitted it with the headgear from an F&P HC431 (Has a top strap)
3.) I use Pad-A_Cheek forehead and Nose bridge protector.
4.) I use Pad-A-Cheek lower strap cushions.
5.) Wash face before "donning mask"
6.) I have a regular routine for going to bed (time, no exercise 1 hour before, etc.)

Dave, thanks for those tips!

I'd love to be able to wear a full face mask sometimes, but it seems that my facial contours don't mesh with FFM frames. I've tried a bunch, and the InnoMed Hybrid is the only one that has shown promise for me so far.

I have been unable to wear the Quattro FFM. I tried for several weeks. I tried several sizes, with straps both loose and tight. With the Quattro, I had to tighten the bottom straps down so tight to prevent leaking that when I was on my back it pulled my chin down, which blocked my airway. So the result was high AI with that mask for me. I still have the Quattro, as I have intended to give it a try again someday. (I don't give up easily!)

I also have the F&P HC431, which didn't work for me either. I couldn't get it to stop leaking, no matter which size cushion I used. So I may combine the Quattro frame and HC431 headgear as you suggest and see if my results are better!

I too am one of those folks who cannot handle full face masks. At my split-night sleep study, the tech told me my mouth kept falling open (and I used to think my jaw only dropped because I was seeing heavenly bodies in my dreams) so I needed a full-face mask. She used a Quatro for the second phase of my sleep study (and I hated it, even though the data showed it worked), so the doctor's initial prescription was for a Quattro. I tried it for a few days, but could never get it to fit. I have a small lower jaw, so could never get a good fit at home. It leaked into my eyes, so I tightened it at the top, and got a bruise on my bridge and also plenty of leaks at the bottom.

I am glad that FFMs work for a lot of mouth breathers. For some others, the quest continues.

Seems like the Subject line gives the impression that mouth taping will impede CO2 exchange - that I know of that is not true. This exchange should take place thru the mask vent not thru your mouth.

fwiw - I am not a mouth taper but have tried it and I was able to open my mouth without my hands which is much better than chin straps I have used. With most chin straps both hands and lots of fumbling is required.

roster wrote: patients are almost never tested for chemical inbalances before prescribing antidepressants. I have personally spoken to many people about the SSRIs they have been prescribed and not a single one of them was tested for chemical imbalances.

What do you mean by testing for "chemical imbalances"? Do you mean ruling out other things like hypothyroidism, or do you mean that you think doctors should run a test to see the availability of neurotransmitters in the brain?

Then they wait to see what happens. If the patient reports improvement, the doctor assumes the SSRI treated a chemical imbalance.

And it may be that the antidepressant caused improvement not because it treated depression but because it treated... (drum roll, please) ...apnea. I'm not just saying this to ruffle your feathers, Rooster (although I'd be less than honest if I didn't admit to a bit of joy to bring this news to you in particular), but it's true: Antidepressants can improve apnea.

I suppose this is not the right thread to ask what kind of tape to use...

DreamOn wrote: Dave, thanks for those tips!

I'd love to be able to wear a full face mask sometimes, but it seems that my facial contours don't mesh with FFM frames. I've tried a bunch, and the InnoMed Hybrid is the only one that has shown promise for me so far.

I have been unable to wear the Quattro FFM. I tried for several weeks. I tried several sizes, with straps both loose and tight. With the Quattro, I had to tighten the bottom straps down so tight to prevent leaking that when I was on my back it pulled my chin down, which blocked my airway. So the result was high AI with that mask for me. I still have the Quattro, as I have intended to give it a try again someday. (I don't give up easily!)

I also have the F&P HC431, which didn't work for me either. I couldn't get it to stop leaking, no matter which size cushion I used. So I may combine the Quattro frame and HC431 headgear as you suggest and see if my results are better!

DreamOn,

Further information:

To get the HC431 to work at all (stopping the leaks and keeping it off my nose bridge) I had to use the Pad-A-Cheek Nose bridge pad. The HC431 has no micro adjustment (like the click stops on the Quattro).

Both the HC431 and the Quattro need the Pad-A-Cheek lower strap pads (I have Chipmunk Cheeks ). This allows me to "cinch them up tight with no real "pain".

Unfortunately, once I could get the HC431to stop leaking, I found that the HC431 is unusable for me as I noticed that it was irritating the sides of my mouth with the mask pressure on my teeth.

The Quattro with the HC431 headgear gives me the best fit and It doesn't make my head "hot" (sorry PapCap ) . I think it is because of the "top Strap" that keeps the mask in a more stable position but allows for more cooling. Also, the click stop adjustment means that I can dial in my pressure to eliminate the leaks.

I have the Quattro set up so that the bottom of my mask sits just above the "dimple" area of my chin. I am using the Pad-A-Cheek nose bridge pad (I roll the excess up and stuff up in the upper "corner" out of the way. Again, the Pad-A-Cheek Lower strap pads let me "cinch up" the straps to control leaking without undo irritation. This also helps keep my lips shut if I don't sleep on my back.

I am now sleeping through the night and my AHI is below 5.0 for the last week!!!

I derive no personal benefit from my narratives about the Pad-A-Cheek products. They just work for me! (thank you Karen ).

I also, take no personal credit for my solution to my problem. I gleaned facts from the posts of other members. (go figure ) Ijust kept trying things until I found "My Solution"

OBTW for those who don't have an HC431, I have seen the HC431 headgear advertised for $22.00.

And again YMMV

Good luck

Dave

park_ridge_dave wrote:DreamOn,

Further information:

To get the HC431 to work at all (stopping the leaks and keeping it off my nose bridge) I had to use the Pad-A-Cheek Nose bridge pad. The HC431 has no micro adjustment (like the click stops on the Quattro).

Both the HC431 and the Quattro need the Pad-A-Cheek lower strap pads (I have Chipmunk Cheeks ). This allows me to "cinch them up tight with no real "pain".

Thanks for the additional tips, Dave! I also happen to have the Pad-A-Cheek nose bridge pad and strap pads, so I can use those if I need to. I've printed out all your tips, so I can refer to them when I feel like experimenting with those full face masks again. I'm trying some other therapy adjustments, so I don't want to throw a different mask into the variables right now.

Karen at Pad-A-Cheek also just came out with an Anti-Leak Strap for the Quattro and Ultra Mirage: http://padacheek.com/PAC_AntiLeak_Strap.html. I've read some enthusiastic reviews about it, so I may try that or fashion one myself. It may be enough to allow me to wear the bottom straps looser.