msr0459 wrote:Every night since starting the nasal pillow, I've been awakened by air leaks from my mouth. I've tried a chin strap to no avail, and last night, I taped my mouth, and still, I would be awakened by air "puffing" my cheeks out, and/or air making noise blowing through the small cracks in the tape I guess. Either way, I'm sure at this point that the nasal mask is making things worse, due to my tongue falling back and letting the air out of mouth.
I'm going to swap the nasal mask for a full face today hopefully. I reaaalllly hope that I can tolerate it. I'm at the end of my rope, and it's only been a week!
If one or another FF mask doesn't get the job done for you, there's yet another thing you can try, to stop the mouth breathing with your nasal pillows mask:
This link is to a long discussion about frequenseeker's "DIY" (Do It Yourself) mouthguard to stop mouthbreathing and mouth air leaks:
Topic started by frequenseeker Dec 01 2004 subject: mouth leak solution, cheap DIY oral appliance
http://www.talkaboutsleep.com/message-b ... php?t=4750
Topic with pictures of
snork1's creation:
viewtopic.php?t=3265
Topic with pictures of a one piece design by
freelans:
http://www.talkaboutsleep.com/message-b ... 71242#7124
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Direct link to the photos of homemade DIY mouthguards:
http://www.tnlc.com/Lara/laura/osa/DIYmouthleakPhotos/
One that I made worked well for me. The first one I made did not, because I was trying to have it keep my tongue up against the roof of my mouth. That tongue position works for many people, but for me air can still gush out around the sides of my tongue at the back, along my back molars.
When I continued to work on the boil'n'bite again (and again, and again) I finally made one that literally shoved my tongue backwards almost to the point of gagging...to seal off the entrance to my throat at the back of my mouth. THAT worked. No CPAP air could sneak into my mouth from behind. Making my tongue form a wide dam back there kept the CPAP air directed the right way as I breathed through my nose. Kept it going straight down instead of detouring from my throat into my mouth.
msr, I know this all has to be discouraging to you so far. If this is any consolation, be assured you're not the only one who is feeling worse and LESS rested using CPAP than you did before CPAP.
Right now you've traded off the sleep disruptions of apneas/hypopneas for the sleep disruptions of CPAP mask issues. Perhaps even more sleep disruptions than before. And you're painfully aware of these "equipment" sleep disturbances. You were having sleep disrupting arousals with the OSA events before, but you were not aware of the arousals. They would wake you so briefly, you weren't aware of them. Now you are very much aware of mask issue wakeups, and difficulty getting to sleep with all this "stuff."
It will get better...easier to do...as you work through each problem one by one.
The mask is the key to being able to "do CPAP" comfortably enough to actually "sleep" again. Either a FF mask, if you can find one that lets you do that. Or perhaps a boil'n'bite to make your tongue dam off the air that is sneaking into your mouth while letting you use your less obtrusive nasal pillows mask.
I know it sounds counter-intuitive to think about deliberately SHOVING your tongue back there with a DIY mouthguard, since tongue "falling back"
is a big part of what can cause obstructive apneas/hypopneas for many people. But, it's usually not
just the tongue doing that. It usually also involves other soft tissues at the back of the mouth and in the throat...like the soft palate relaxing down to meet the tongue. And other soft tissues in the throat collapsing inwardly.
CPAP air will keep all those soft tissues (and the tongue) out of the way, so you don't have to worry about, "
Gee, if I fix a boil'n'bite that pushes my tongue BACK toward my throat, won't that cause even MORE apneas????" The CPAP air will keep things open back there, including the BACK of the throat, even with the tongue pushed back enough to seal off the FRONT entrance to the throat at the back of the mouth. And you'll finally be getting a truly therapeutic amount of air pressure since the CPAP air won't be getting lost by detouring into your mouth.
And wonder of wonders...you won't have to use a chin strap if you can make a boil'n'bite that works to keep the CPAP air back where it's supposed to be...in your throat. Your mouth can hang open and the boil'n'bite mouth guard will
still act like a dam to keep the CPAP air from shooting into your mouth from the back.
The long term benefits to your health and quality of life are worth sticking with this. But in "sticking with it" I don't mean to try to get used to it the way it is for you now. There are things to keep trying...things to handle the mouth breathing, whether the solution is a FF mask or a DIY mouthguard, and things to make the whole "new way of sleeping" more comfortable. You're obviously trying hard. You've come to the right place (this forum) to find more and more pieces that can make the HOW CAN I EVER SLEEP LIKE THIS puzzle come together for you.
Good luck!