chapped lips and chapped nares

But in spite of some serious leaking (at least in my opinion and my sore lips' opinion), Encore Viewer was happy as a lark about my leak rate: Solid light green "normal mask fit" line across the whole night---even the stretch where the leak rate was double what I usually get with this mask for a while. And the S1's LCD also said 0% time in Large Leaks for the night, of course. What the heck do you have to do to trigger that nasty Black LARGE LEAK line in Encore Viewer anyway?

I agree wholeheartedly--this seems somehow very WRONG. The leak would have to be the size of a jet plane's wash and last for 30 or more minutes to somehow register on this thing.

It makes me mistrust the PR S1 some, although empirically I admit that the PR S1 may simply be doing a very good job to compensate for the leaks. And when I see anybody reporting any type of large leak on a PR S1 machine, I KNOW they are in big trouble to have any percentage at all show up there.

For hydration I like the Sobe zero calories http://www.sobe.com/#/lifewater.

Diet tonic water and salty fries is good also.

Thanks to all for the tips on what to do with the chapped lips and nares.

I think that keeping myself properly hydrated may indeed be the key. Wintertime hydration has always been an issue. As my husband keeps reminding me: The fact that I'm small (5' 1" and 104 lbs) means that I've got a relatively large proportion of surface area (i.e. skin) to lose humidity and heat through and a relatively small volume to retain it with. Also is part of why I'm chronically cold in the winter time (in spite of loving winter).

So this week I'm focusing some extra attention on keeping myself properly hydrated and the lips properly protected. And if there are no more migraines (knock on wood), I'll be able to keep the straps on the Swift FX at "appropriately loose" and keep my leaks where they ought to be. The lips can already tell a huge difference from the last two nights in a row leak wise: While I had the chapstick in hand all night long and I woke up 3 or 4 times, I didn't actually use the chapstick a single time because the lips weren't screaming at me on any of those wake ups.

I wish I felt as rested today as I did yesterday. But I don't. *sigh*. Of course, I didn't get any stretch of 2 1/2 hours of sleep without a wake up either. And the AHI was a bit higher than normal, but not alarmingly so. So it's back to the grind of daily life until next Sunday's trips to the slopes.

There really is something to Dr. Barry Krakow's unfragmented, sound sleep ideas from Sound Sleep, Sound Mind I think. And counter-intuitive as it sounds, I think the time-in-bed, sleep-time-restriction that my PA has me on (BEDTIME: the LATER of 1:30AM or when I get sleepy; WAKE UP: 7:30AM seven days a week), is proving to be a useful tool in helping my body start to consolidate my sleep and wake up less---now that the arousals from the apnea are largely taken care of through BiPAP therapy of course. But in reading through Sound Sleep, Sound Mind, it is becoming clearer to me that pre-CPAP, there must have been multiple things fragmenting my sleep beyond the OSA. And I'm beginning to think that as the CPAP therapy started to take care of the OSA fragmentation, all these other things were then given free reign in my unconscious and sleeping mind to cause further fragmentation of my sleep. And that more than likely created additional problems with my already difficult adjustment to xPAP therapy. And, of course, that fed (and continues to feed?) the insomnia monster. But this is really fodder for another thread which I need to properly write up and post at a later time some time this week. Suffice it to say that I'm finding Sound Sleep, Sound Mind a profoundly interesting and thought provoking book right now.

Hi Robysue,

I found Shea Butter a couple of years back in this Buzz Latte lip balm made by Bare Escentuals and I thought it was the greatest thing on earth. Till last year, my lips were so so bad, I looked like a clown because above and below my lips would turn so red. They were dry, cracked, etc. I wasn't even licking them because I heard the more you lick to make them wet actually drys them out from the salt in your saliva. Long story short, I was getting so chapped and my lips were splitting, I was almost thinking about tryin Neosporin or something. THen I found Carmex. It has helped sooooo much. I was slathering it on like you at night and during the day. Everytime I woke up, I'd put some on. I have never had to have a tube of lip stuff on my nightstand till last year. Carmex has really helped. I don't have to use it as often anymore, even this winter. But I think somewhere, my body must've become dificient in something, to have caused this because it was not an issue very much before. I haven't figured it out yet, but Carmex helps.

Even if you can't use the Carmex, you may find some interesting reading on their site, as I did. They seem to have put a lot of things in this particular product. Some other poster mentioned about something getting into your lips possibly. Carmex also mentions issues about germs and what they put it into their product to alleviate/heal this as well as other issues.

I really love Carmex now, and it is so cheap, and I find it everywhere by all the store check outs. So maybe even if you can't use this particular product, maybe you can read what issues their product addresses in addition to just basic lip moisture(which I thought was interesting) and possibly see if any of that is a source for you to address and possibly find it in a product you could use.

Here's the link, hope it helps some. . .
http://www.mycarmex.com/how-it-works/default.aspx

To Robysue and everyone else who has dealt with super chapped lips/nares/skin:
It can be positively torturous. I'm one of those people who can't stop itching a mosquito bite until it bleeds (not the best habit living in NH)... needless to say I don't succeed with the 'don't lick your lips' or the 'don't scratch off the dry skin' approach.

Staying hydrated is a wonderful, practical, and proven effective suggestion. For those of you like myself that hate drinking water, try adding a little bit of flavored seltzer or a fresh fruit slice to your glass. I use orange rings or even apple or pear slices sometimes. Anything that adds even a hint of flavor or texture (think bubbles), seems to help.

If I had to swear by one product to heal chapped skin, it would be aloe. Plain old aloe.
Break off a leaf on your plant or buy it at the drugstore. I use it on my face, my lips, my hands, my legs, my nose (especially after it's taken a beating from tissues after a cold)... you get the picture. It's natural, it's effective, it's hydrating, it's cooling, and as long as you use the real stuff, it's not sticky or smelly. It's also dirt cheap and easy to find.

There have been a lot of great suggestions already, and I hope that you each find something that works for you. Just a suggestion.

I'm not sure how it'd work on your nares but O'Keefe's Working Hands may work for you. I found it to be the only thing that worked on my chronically dry hands. Search for okeefescompany. I buy mine at Lowe's in the paint remover area.

Big S wrote:If you don't have your machine in a classic mode it should be since you're in Buffalo.

What i think Big S is referring to is changing the setting of the PRS1 humidifier to "classic mode," so that it will put out more humidity. The details are here.


viewtopic/t57682/viewtopic.php?f=1&t=51 ... ic#p472275

Ok, since guestinva resurrected this thread, I thought I'd post an update.

The chapped lips problem continues to wax and wane on a semi-periodic basis. The rare nights where I have a leak that is significant for me will greatly aggravate the chapping. Fortunately, these nights are actually pretty rare; I get one maybe every couple of weeks or so. The last time I had a non-flat leak line was a about a week or so ago.

A note about what I mean by a "leak that is significant for me": My mask's intentional leak at my pressures is advertised as 20-25 L/min; on the vast majority of nights, my leak line is flat to very flat at somewhere around 17--20 L/min. So a night with a Big Bump in the leak line for me means there's a spot that usually lasts between 5 and 30 minutes in the leak line where the leak goes from that flat baseline to bouncing up around 35--45 L/min. Very, very rarely I'll have two bumps in one night. These Big Bumps in my leak line are NEVER flagged as "Large Leaks" in Encore. And back when I was using the S9, the bumps hardly ever poked above the Red Line. And as I said before, the frequency of these nights with Big Bumps is quite low: I have Big Bump nights at most two or three times a month. And they are often correlated with head cold symptoms or migraine headaches (which cause me to loosen the straps on the Swift FX even more than normal.) So if these leaks are mouth breathing, then I'm not doing enough of it on a regular enough basis to worry about it in my opinion. And I'm simply not going to deal with the further sensory overload of taping my mouth or dealing with a chinstrap on a nightly basis to fix a problem that crops up two or three times a month: the risk of further aggravating the nightly insomnia by increasing the sensory overload just ain't worth it in my humble opinion.

However, the Big Bump nights do strongly correlate to nasty chapped lips: After a Big Bump night, I inevitably wake up with badly chapped lips. No surprise really---pre-CPAP sleeping under a fan in the summer time would cause me to wake up with badly chapped lips too. But once the lips are chapped it takes a long time (and a lot of chapstick and lip balm) to get them to heal. The nightly exposure to the exhaust flow from the FX bouncing of the covers really aggravates them.

I have found:

• Keeping myself well hydrated is critically important. Not enough fluid makes the chapping take much longer to heal.
  
  Various (unflavored) chapsticks and lipbalms do a lot to soothe the lips and it's not too much trouble to sleep with a chapstick in my hand at night.
  
  A hanky over my lips at night does wonders to shield the lips from the fearsome exhaust flow of the Swift FX. If only I could figure out a way to keep the hanky on my lips when I turn over ...
  
  Wind and rain bother the lips a lot during the daytime. No surprise there. And we get a fair amount of wind in Buffalo all winter long. The spring rains are now starting (mixed with snow at times; alternating with snow at other times). So keeping the lips well protected during the day is critical.
  
  Washing the face greatly irritates the lips regardless of which facial cleanser/soap I use. Since my face is dry as well, I've simply stopped washing the face every night. Only wash the face when I take a shower and use a moisturizer afterwards. And though it seems almost unAmerican, I don't take a shower every day either---daily showers dry my skin (and face and lips) too much for comfort.

And I'm still looking for a sweet spot on the humidifier. MD Hosehead---I know about classic mode and tried it briefly; but I'm currently back to using the standard "smart" mode, whatever the heck it is called. My nose actually seems to prefer the humidity level to be on the drier side---whenever I increase the humidity setting from 3 to 4, I get much more congestion. Even at 3 I sometimes find the heat and humidity a bit too much. So many nights I've got the humidity set at 2. Maybe I'll try classic mode again though in the near future.

Robysue

One think that worked for me, particularly my nares, was a product called Nozoil. Not sure if it is available in the US, but if things are as bad as they seem for you, it might be worth importing it for a try. I found it worked better than Lansinoh, chapstick etc. It's a sesame oil based product designed specifically for chapped and dry noses from CPAP/oxygen. Big pluses for me were:

because it's oily it seems to be less absorbed and lasts a lot longer through the night;
it does not affect silicon;
it does not have a strong smell; and
I found it helps with sealing the FX.

Not sure about lips as I did not have your problem.

Also if you seem to prefer your humidity on the drier side, have you tried just filling the tank and not turning the humidifier on at all? I suspect you have but you had not mentioned it in this post.

I seem to recall a post where someone had fashioned some duct tape on the FX to redirect the flow of the exhaust so it was more out than down and did not bounce off the covers. However, I cannot find it now. Maybe you could go a bit further and attach a short tube to take the exhaust out of range of your face? No idea if it will work, but if you a desperate enough...

i'll throw my 2 cents in...even though you seem to have plenty of suggestions so far! i am a chapstickaholic....but you might consider burt's bees products if you'd prefer more natural ingredients for your lips. i am allergic to lanolin...so products with that in them causes my skin to peel. something to consider! the very lotions meant to hydrate you could be making your skin worse! and lastly, i like to use grapeseed oil on my skin. it's all natural...available at the grocery store...relatively cheap...and is not too greasy or sticky. i don't use it at night....but apply it to my face in the morning. helps with the dryness....and helps the mask marks go away sooner...

following

An additional comment about lanolin--some people develop a sensitivity to it after using it for a while. I have tried to avoid overusing it for that reason.

Hydration tip: I just discovered a product called Metromint. They are flavored waters WITHOUT artificial sweeteners (or natural for that matter). The Chocolatemint is like drinking Girl Scout Thin Mints. I have started drinking much more water since discovering this product.

Drowsy Dancer

Thanks for all the continued good tips.

Some clarifications:

By the word chapstick I mean a variety of brands of Chapstick's competitors as well as good ol' Chapstick itself. Love the Burts Bees, but the peppermint in the "unflavored" original variety tastes too good and sometimes makes me lick the lips. Which is a big NO NO. Carmex is great stuff (for me): Like the way it feels, smell doesn't bother me (kind of like it, actually), and it tastes bad enough to discourage the licking of the lips. (And Carmex does a great job of protecting my checkbones during skiing when I rub it on right under where my John Lennon style granny glasses hit my cheeks; better than Chapstick by a lot.) And if I see a brand of chapstick stuff that I have not yet tried at the store and it's not too expensive AND it's NOT flavored, I'm always game to buy it. And the original and various other unflavored, but "medicated" versions of Chapstick are "bleh" but don't encourage lip licking in me. So when I need one and that's what's easy to find, that's what gets bought: Like at the bookstore at the college I teach at---have to have a chapstick at the office too since teaching tends to chap my lips. There's something about talking for very long periods of time (lecturing for 3 or 4 hours in one day, for example) that triggers the chapping too.

The worst of the clown-face type chapping seems to be behind me (for now). But constant vigilance is required to keep it at bay. *sigh* And I wish I could say that with spring coming that the chapping would be done until next winter. But I know better: Even before CPAP I could get chapped lips at any time of the year if the conditions were right: Sleep under a fan on one of those 70+ degree nights where there's no air stirring and 90+ percent humidity? My lips will get chapped. [And I'm really dreading those nights when they come this summer since we effectively don't have A/C: Our unit is old, noisy, and doesn't cool very well and we seldom ever turn it on. And at night it seems to cool even less effectively. And whatever we might do, buying a new A/C unit ain't going to happen right now. Not with kids in college.]

I've also found that using multiple products---switching around each time I need to put something on the lips---seems to be more effective than using the same thing all the time. And using layers of products actually helps too. The moisturizer that I'm using for my face (something called Thentix) does a decent job of helping with the lips when there's nothing else going on. And it makes a great base coat for the chapstick du jour. And at night, on top of the chapstick I'll smear on a bit of the lanolin if I'm using it for the nares. Don't always need to do that though.

And at the time I wrote the original post, the nares themselves were badly chapped. The immediate cause of the nare chapping was an extraordinarily large set of mask leaks over a two day period. And the mask leaks were caused by my loosening both straps on the Swift FX to the point of ridiculousness because of a massive two day long migraine headache: The straps were aggravating the migraine something fierce. So the pillows were not particularly stable against my nares. So they kept slipping any time I moved in bed (which wasn't much due to the migraine). And once they slipped, there would be air blowing on the outside of the nostril instead of inside it. Fortunately the nares have healed completely and don't seem to be giving me much trouble anymore. And I don't tend to get migraines that severe very often: Once or twice a year maybe. And more minor migraines are pretty easy for me to deal with.

I also appreciate the tips for maintaining proper hydration. That does seem to be a key to keeping the chapping under control as well. At the time of the original post, I was still taking topiramate. One of the side effects is dehydration and the neurologist who prescribed it warned me about that and told me to be extra careful about making sure I was drinking enough water. But it was really very hard to drink enough liquid to keep myself hydrated---and I'm someone who *likes* water: Tap water, bottled water, water foutain water, flavored water (if it's not too sweet): I'll drink it all and enjoy it.

But my experiences with the chapped nares and lips does make me wonder: If I ever did have to use a nasal mask or a full face mask, would the air blowing at my face cause it to get chapped? I rather think it would.

I use Burt's Bees lip balm almost every night. Walgreen's has their own store brand which is identical but much cheaper.

Carmex and ChapStick both contain petrolatum which will rapidly degrade the materials in CPAP masks.

I do believe ChapStick has added some natural products to their line. Not sure about Carmex.

Check the ingredient list for "petrolatum" or "petroleum jelly" - these are the ingredients you want to avoid in order to preserve your mask life.