Mouth Breathing Fixed but AHI now up. BREATH RIGHT & CPAP?

I've worked for a couple of months trying to find a solution to my mouth breathing (FF mask, PapCap, Chin strap). I finally found a beanie that keeps your head cool during the night to wear over my long silky hair. Then I put the Premium Respironics Chin Strap, and last my Activa LT nasal mask and headgear. The beanie cap keeps the chip strap from slipping around and I'm finally getting night without mouth breathing or leaks.

But all my work has resulted in my AHI going up to 5.9. Apparently my previous AHI's measured 1.5-2.5 because when my nasal breathing got obstructed, I just breathed through my mouth. Now that I can't mouth-breath with chin strap fixed, I'm having a lot more Obstructive Apneas. Hyponeas are about the same and CA's are neglible (Only when I'm settling down to get comfortable and holding my breath as I turn). So I upped my pressure from 16 to 17 to see if I can bring down the Obstructive Apneas. The OAs tend to cluster together and then I have an hour or two with no events. Then more clusters of OAs. I think the OAs are during REM sleep.

Since no CA's are evident, I'm thinking about upping my pressure to 18 for a few nights to see if AHI comes down. I have a checkup with sleep doctor January 10. Maybe I should just wait and discuss it with my sleep doc. I know 5.9 is not high but it is not below 5.0 (therapeutic target for me).

I do have a severely deviated nasal septum with nearly closes off left nares but my right nares is wide open. However, I spend 75% of my sleep time on my right side so my right nares gets clogged. My left nares just doesn't let enough air through so I get OA events. I'm not willing to start retraining myself to sleep on right side. I'm wondering if I tried a BREATH RIGHT strip to keep my left nares open, I could cut down the OA events during REM. Anyone tried using BREATH RIGHT with CPAP?

I found those strips took my skin off after a couple of nights. I tried them before cpap.

Why not try a mask like the hybrid? or any other full face mask?

I think that the main impetus for getting leakage down as far as possible is because it gives you a more accurate AHI reading. That is why I too kept striving for lower leakage even though my titrated AHi scores were great - I felt as if my earlier leaks were giving me a false confidence as to the extent of successful therapy.

My hunch is that the AHi scores you are now getting are probably a truer picture of your titrated apnea status than the lower numbers you saw with more leaking.

That of course does not eliminate your concern over the truer AHI you now see, but it focuses your attention on now working to get your AHI down lower if possible.

Somebody please correct me quick if I am wrong on this!

Nate

I have never had much luck using Breathe Right strips before I was diagnosed with SA, but the only way to find out if it will work with PAP therapy for your specific problem is to probably just try it and see what happens .

I don't know how long you have been using your new set-up (Beanie, Premium Respironics Chin Strap, Activa LT nasal mask and headgear), but you may have to give it some more time to let your body adjust. Nasal only breathing is a big change to what you were doing before so in time your AHI may eventually come back down to where it was before you made your change to the new set-up.

An example I could give of giving it some time to let your body adjust, about 4 1/2 months ago I made a change to my APAP pressure range of 14cmH2O - 18cmH2O to 13cmH2O - 17cmH2O (I had noticed my 90% pressure was only getting to the high 14cmH2O to low 15cmH2O range) and I also removed my exhale relief as I felt it might not be needed anymore. At first my AHI went up a little to 3.0 - 3.8 (was averaging 1.8 - 2.3) but after a few weeks the AHI started coming back down and now is averaging 0.2 - 0.6 most nights and my 90% pressure is 13.4cmH2O - 13.9cmH2O . The results have worked out great for me but it did take some time. Hopefully a little more time will prove to be helpful for you too!

I hope I'm wrong on this, but when you were mouth breathing, your tongue had possibly more room to extend, and so was not "confined" to a certain space. But now you are trying to keep your mouth shut (and rightly so). But this requires the tongue to "fold" back in your mouth, thus increasing the chances of OAs. I don't see how nasal strips are going to help the OA issue. As I see it, the only thing that will help is the use of a dental appliance with the cpap, which will extend your lower jaw, thus lifting the tongue away from the throat. I'll be interested to hear if the nasal strips improve your situation. Like I say, I hope I'm wrong.

DH uses the Breathe-Right strips WITH his Autoset--and his Fitlife total face mask.
I wonder why you are not wearing a full face mask because of the deviated septum--seems like a logical choice.

I'm afraid I'm not much help with your specific query, but I'm curious about your 'cool beanie' - got a linky, perchance? Not only do my mask and Zeo straps tend to slide a bit on my hair, but my head and neck tend to get hot, even with short hair.

I use breathe right strips and I tape my mouth shut - used to need gorilla glue duct tape but over time I seem to fight it less and i now use 3mm medical adhesive tape ( I find 3" width works best - i get it over the internet). I also put the skin-prep stuff i posted about in an earlier thread to help prevent skin damage from both adhesives - it seems to work. I can't say for sure it lowers my ahi but i do know that the breathe-right strips makes it feel like my nose breathing is easier

I use nasal strips but not Breath Right with nasal pillows. They are too expensive. Costco sells them but they're still around 30 cents a pop.

I buy generic ones on ebay from a vendor. I buy them in bulk so they run about 14 cents each. They do stay on all night. They used cheaper adhesive in the past and I had to use extra tape to keep them on but they have fixed their product.
http://www.free-nasalstrips.com

I don't have a deviated septum, just congestion all the time. I am going to grab a box of Breath Right the next time I go to costco. If the Breath Rights work better, I'll dump the generic ones.

Bullfrog has used the generic strips, and found every off brand but Target to be completely unusable
--just not sticky enough. Even the Target strips pull free too early, but sometimes make it all night.

Yes,took the skin off my nose..Plus, in the middle of the night they would start pulling apart..I turn'd my ramp off,,I have problem's with my nose to..I have found that if I cut the ramp off that work'd.Also,I turn the temp up on my machine& my nose will open up more.I use salt water up my nose&use Flonase every evening before going to bed.

chunkyfrog wrote:DH uses the Breathe-Right strips WITH his Autoset--and his Fitlife total face mask.
I wonder why you are not wearing a full face mask because of the deviated septum--seems like a logical choice.

Been through that on Forum before. I have very short face. Only two FF masks come in Petite (Amara) or Extra Small (Quattro). Both leaked horribly. I tried everything (Pad-A_Cheek mask liner, Aloe Vera Gel, tight on bottom, loose at top). If I moved the mask down to stop them leaking into my eyes, they leaked at my chin. If I moved mask up to avoid chin leak, it leaked into my eyes. They were just TOO long to fit my face.

Can't wear hybrid or nasal pillows due to my deformed nose.