Mouth gag works to stop apneas?

I have been on CPAP only a short time, trying to figure out what is going to work for me. I am using nasal pillows but they do not work well as I am a mouth breather much of the time. (Note that I also used a full face mask in a sleep study, but my mouth worked so much I did not get a good seal). I have tried chin straps, both purchased and those my wife has made up from our own design, but even with them I am able to mouth breath, and hence, have apneas. Last night we constructed a gag for my mouth -- We cut a piece of thin flexible rubber from an exercise band purchased at the local sports store. My wife sewed a Velcro strap to it so I could then put the rubber over my mouth and fasten it behind my head. With it, there was no way I could mouth breath, even though my mouth opened somewhat. Results: I had a restful sleep and the gag proved to be more comfortable than any of the chin straps I had used. When I checked my stats via SleepyHead I found that my AHI was 0.25, and that was due not to apneas, but rather to 'clearing airways', whatever that means. I'm thinking this gag is the solution to my CPAP problem. Does anybody have any comments or further insight to this?

That is a really innovative solution, but please be aware that most nasal pillow masks do not have a large vent that would open in case of a power outage. If the power fails, you would be rebreathing your own CO2 without the ability to open your mouth. Please be careful. I use a UPS and it beeps if it is near out of reserve power.

We might if you'd post a picture here so others could see what it looks like and try it themselves.

Good to hear your makeshift chinstrap did the trick for you.

I do share the same concern previously posted about a power outage though. It would be wise to be careful.

One thing about using nasal pillow masks is their tendency to have little unintentional leaks. This generally leads to low moisture in your circuit and inturn your nasal passages can react by swelling up. This flow limitation prevents adequate ventilation of the lungs, CO2 builds up and then your brain tells you to open your mouth.

You might try refitting your mask or using some Lansinoh to help with the seal and see if that helps.

Julie wrote:We might if you'd post a picture here so others could see what it looks like and try it themselves.

Do you remember the scene from Pulp Fiction in the basement where there was this guy...

You need to figure out what causes your mouthbreathing. Chinstraps only work if you lose too much muscletone and "drop" the jaw. Otherwise it could be due to difficulty exhailing, which means you may need a full face mask (ResMed Quattro works well for many), using a C-Flex/EPR function if your machine has it, HEATED humidifier helps a lot and possibly may need a BiPap machine to get more comfortable with the pressure.

It isn't about loss of muscle tone. When we sleep, the jaw naturally sags, and the mouth often opens. It's common for a lot of people who don't have sleep apnea. We go to sleep, everything relaxes, and our jaw drops open. Some people can't use a full face mask and even when they do, when their mouth drops open, it can cause dry mouth. Heated humidifier does not help. Bipap has nothing to do with it.

I have posted about this before.
Regular chinstraps don't seem to work, because no chinstrap is strong enough, or inflexible enough, to stop your jaw from sagging open. And when your jaw sags, your lips open. When your lips open, you lose pressure which results in more apneas, your leak rate goes up, you wake up from lips blubbering, etc. And the whole goal here is to stay asleep and get quality sleep.

There is a chin strap called the Ultimate Chin Strap: http://ultimatechinstrap.com/ Do a search on this forum. You'll find many posts about it.

Some people here swear by the ultimate chinstrap. Others think it feels claustrophobic. If you don't suffer from claustrophobia, I highly recommend this strap. I have been using a home made version of the ultimate for more than a year. I made it out of a towel. It's soft and cosy feeling, not claustrophobic at all. I put it on first, before my Aloha nasal pillow mask goes on. I make sure it's snug, yet comfortable. I also make sure my lower lip is pressed up over my top front teeth, sort of bulldog style, so that the pressure of the cloth across my lips keeps them closed and in place and won't allow my lower lip to open when my face relaxes in sleep. Because it's fabric and not plastic or rubber, there is no issue with a power outage causing no air flow. In fact, the power has gone out while I've been hooked up with the chinstrap on. I woke up about 5 minutes after it went out. I could still breathe just fine, no problem with rebreathing Co2 at all. When I realized it was off I got up and hooked up my battery pack.

Just FYI, there are plenty of people here on this forum who tape their lips closed at night, and I don't think they have problems with breathing when the power goes out either, but input from them would probably be helpful. I can't use tape. I react to the sticky stuff with a rash. That's why I use the cloth strap.

The flexible rubber that you are using is simply a different version of the ultimate strap. However, if your skin is sensitive at all, you might find that prolonged contact with the rubber (or plastic) may cause you skin irritation after a while, especially if you sweat. The ultimate chin strap is made out of fabric. It does the same job, but is soft and cosy feeling, without causing irritation.

Since I've been using my home made version of this strap, I am never woken by my mouth gaping open, or my lips blubbering, and I'm not losing treatment from air escaping through my mouth. I get a great night's sleep with it. I have very few leaks, definitely not from my mouth, maybe the nasal pillows once in the while for very short periods. And as soon as I started using this strap, my numbers got better and better.

I can't help wondering:
Do you have six friends with good backs?

chunkyfrog wrote:I can't help wondering:
Do you have six friends with good backs?

I don't but I have one who is a fork truck operator and one with a backhoe.

RonMatson wrote:I have been on CPAP only a short time, trying to figure out what is going to work for me. I am using nasal pillows but they do not work well as I am a mouth breather much of the time. (Note that I also used a full face mask in a sleep study, but my mouth worked so much I did not get a good seal). I have tried chin straps, both purchased and those my wife has made up from our own design, but even with them I am able to mouth breath, and hence, have apneas. Last night we constructed a gag for my mouth -- We cut a piece of thin flexible rubber from an exercise band purchased at the local sports store. My wife sewed a Velcro strap to it so I could then put the rubber over my mouth and fasten it behind my head. With it, there was no way I could mouth breath, even though my mouth opened somewhat. Results: I had a restful sleep and the gag proved to be more comfortable than any of the chin straps I had used. When I checked my stats via SleepyHead I found that my AHI was 0.25, and that was due not to apneas, but rather to 'clearing airways', whatever that means. I'm thinking this gag is the solution to my CPAP problem. Does anybody have any comments or further insight to this?

I wouldn't consider subjecting myself to this risk unless I was hooked up to a full complement of hospital monitors - heart rate, pulse rate, etc. and a round-the-clock emergency medical team on duty with their equipment for resuscitation, etc. including chest paddles.

Come to think of it, have you ever seen anyone even in a hospital with their mouth strapped closed like that?

About a month or so ago, I concluded that I had spent far too many months obsessed with trying to get a flat or zero leak line on my chart, even though my AHI is very low (avg 0.63 last 30 days e.g.) and I feel great from xpap therapy. I never found a solution I was satisfied with, and I concluded that if I could spare my teeth and gums from the dangers of dry mouth I ought to be satisfied and stop trying to get a perfect leak line.

So, I found a spill-proof bottle at Walgreens with a hinged, rubber-gasketed cap on it. I keep it filled on my nightstand, and when I wake up a few times during the night with dry mouth, I flip the cap take a tiny swig, swish it around and swallow it and flip the cap back closed. Voila - no more dry mouth and my leak line is no big deal anymore either. Without a dry mouth, I think my mouth opens a lot less during the night because IMHO the cause and effect between open mouth and dry mouth is circular, not linear.

Best wishes, Nate

PS - I forgot to say what I keep the little bottle filled with! Sorry to disappoint, but the answer is: water. Not Jack Daniels!

RonMatson wrote: My wife sewed a Velcro strap to it so I could then put the rubber over my mouth and fasten it behind my head. With it, there was no way I could mouth breath, even though my mouth opened somewhat. Results: I had a restful sleep and the gag proved to be more comfortable than any of the chin straps I had used. When I checked my stats via SleepyHead I found that my AHI was 0.25, and that was due not to apneas, but rather to 'clearing airways', whatever that means. I'm thinking this gag is the solution to my CPAP problem. Does anybody have any comments or further insight to this?

Don't let the alarmists here scare you. We have quite a few members who accomplish the same thing you are doing by taping their mouths shut. I occasionally tape my own mouth and my husband (also a CPAPer) taped his for a long time.

If you have any concerns about power failures, order one of these and use it religiously, even taking it on trips.

http://www.acehardware.com/product/inde ... Id=3045268



My husband bought one and we use it at home and take it on trips. He has a second one he takes on business trips by himself.

There has been a time or two when it awakened us due to a power failure.

You did exercise some ingenuity and I am glad it works for you.

I tried the others, but I returned them and found this one to be far superior in terms of reliability and sound volume:



(Amazon.com)

I use it, but I still wouldn't seal my mouth shut with a rubber gag - that goes far beyond taping in terms of its risk.

Regards, Nate

My wife sewed a Velcro strap to it so I could then put the rubber over my mouth and fasten it behind my head.

As I understand it, this is not really a gag because it goes over your mouth instead of in it.

As one who has long experience with taping, your method looks safer. I never had to yank my tape off in a hurry, but would be reluctant to do so because it was surely take some chunks out of my skin or lips.

I think your rubber device could be yanked off very quickly and easily. Kudos for the design!

I have been messing around with taping my mouth. Why would you ever have to yank the tape off in a hurry?

In case you had to suddenly vomit in bed.