Throat "flapping in the wind"?

This morning I woke up to a feeling of my throat flapping as air passed through it. Anyone else experienced this? It sounds like a flag flapping in the wind. I was using my CPAP but it didn't seem to be preventing the problem. My guess is the turbinates closed up and prevented enough pressure from reaching my throat to open the airway. Anyway, my throat is not enjoying the experience today.

You didn't list your equipment so I guessing air was escaping thru your mouth if you are using nasal pillows.

balor123 wrote: my throat is not enjoying the experience today.

You recently switched from FFM to nasal pillows. Bet you are mouthbreathing and the escaping air is drying out your throat.

You might also have an ineffective therapy due to mouthbreathing.

It is true that I use nasal pillows but I switched to them in Jan. I use a chin strap to keep my mouth closed. I guess that's not enough? What else can I do? I use a Resmed S9 auto and SwitchFX I think.

Your tongue isn't blocking the "doorway" between the oral cavity and the airway behind the mouth. It normally can do a great job while awake but once asleep it tends to slide down and open the door.

With cpap therapy and nasal pillows the air goes up the nose into the nasal cavity and then proceeds down the airway. If the tongue is doing its job then the air doesn't enter the mouth and proceeds down past the mouth to the soft tissues of the airway just below the oral cavity where the air pressure keeps those airway tissues from collapsing.
When the tongue opens the door then the air pressure will try to exit the airway through the mouth. Simple physics at work there.

The tongue needs to learn to stay in position and keep that "door" blocked. Easy to do while awake and not so easy to maintain while asleep. Normally placing the tongue in the roof of the mouth will keep the doorway closed and sometimes with lots of practice the tongue learns the habit of staying in that position. Even now as I type this my tongue rests in the roof of my mouth just behind my front teeth (doesn't touch teeth).

Not all mouth breathing means that the entire night's therapy was totally trashed. Maybe you only did it for 10 minutes a couple times a night. The leak line graph needs to be evaluated to know for sure how much it may have negatively impacted therapy.
I still mouth breath on occasion...sometimes big short term leaks (15 to 20 minutes) and sometimes minimal leaks but the rest of the night my tongue keeps that door blocked. I am not going to wear a FFM to fix 30 minutes of maybe mouth breathing. It would cause more problems for me than it would fix.

Now if your leak graphs show evidence of prolonged big leaks....you need to do something about it but sometimes you have to pick which battle is most important.
Figure out first if the leaks from mouth breathing are actually negatively impacting therapy to a great extent. Then decide which is the greater unwanted item...leaks or FFM.
In the meantime practice all the time with keeping your tongue in the roof of your mouth so that it becomes a habit.

Thanks for the explanation. I try to keep my tongue there during the day and when my nasal passages are open I can manage but that's only about half the time. Problem is, I wear a nightguard while sleeping and it's impossible to keep my tongue there while sleeping because it gets in the way. Know any solutions to this problem?

balor123 wrote:I wear a nightguard while sleeping and it's impossible to keep my tongue there while sleeping because it gets in the way. Know any solutions to this problem?

No, sorry but the mouth guard does present a problem. I didn't realize that you wore one. What do you use it for?
Upper or lower? Dentist provided so high dollar?? Wonder if the mask I use now (see link in my profile) would/could replace the one you are using now?

Checking ResScan, median is about 4-8 L/min, 95th is up to about 16 L/min, and max is about 24 L/min. How bad is that?

I wear a mouthguard to protect against grinding and clenching. Also, to hold my teeth in position after getting braces as a teenager. I wear a lower hawley appliance as well. I think it may have contributed to my anterior open bite

balor123 wrote:Checking ResScan, median is about 4-8 L/min, 95th is up to about 16 L/min, and max is about 24 L/min. How bad is that?

Not bad. 24 L/min is where ResMed says the machine starts losing the ability to compensate for minor leaks. Even if you went above 24 L/min for a short time it wouldn't be the end of the world.

the 95% leak number just means that for 95% of the night your leaks were at OR below that number. It's easily skewed by just a short time with leaks up to 24 or so. So I don't get real excited about it. I have seen 95% leak showing at 27 L/min and in real life I had a 30 minute big leak...rest of the time I was below 24 L/min. People tend to forget the "OR BELOW" part of the definition.

So whatever mouth breathing/leaking is going on...it isn't large enough to negatively impact therapy but if you are waking often with it..then it is affecting sleep quality which of course we don't like to see.
This is where you get to decide which is worse....a FFM or waking up with the occasional lips flapping?
It takes very little mouth breathing to dry out the mouth and cause discomfort...sometimes so little that it won't even show up on the leak graph (I have tested it myself).
For me using a full face mask creates a whole mess of problems that are much worse than a couple of wake ups with dry mouth or evidence of maybe a little mouth breathing with or without wake ups.

I don't know if the Tap Pap mouth guard would be a good substitute or not. If you wore an upper appliance...maybe.
I would want to discuss it with my dentist if I were in your shoes. It would help with the grinding and clenching but not so sure about the other since you have had braces in the past.
The Tap Pap mouth guard has nothing right behind those front teeth...leaves a nice little spot for the tongue to rest.

But back to your original issue...it's up to you which is the worst evil here...throat flapping sometimes but not enough to impact therapy but might impact sleep....or wearing a full face mask and the issues you have with FFM.
Nothing is ever perfect. Pros and cons to all masks. We just have to decide which one has the pros outweighing the cons.

Regarding mouth breathing and chinstraps etc. In a post from the way-back-machine someone suggested this interesting experiment: Put on your chinstrap fairly tight (you can leave your mask off). Next open your lips a little bit (should be easy to do) and now try to breathe some air in and out. It's not too hard to open your lips because they are a separate muscle system from your jaw muscles... even if your chinstrap is super tight. Step two: With your chinstrap still on, pinch your lips together with your thumb and forefinger and try the same thing. Nothing gets in or out does it? The moral of this tale is that your lips can part enough, even with a chinstrap, to let air in and out, even if your chinstrap is as tight as a tourniquet. Maybe some tape on the lips will help or maybe it won't. Some people like denture adhesive. Now you know.

Yes I've noticed that. It's possible to breath entirely through your nose with your mouth wide open and vice versa, especially while asleep. The chin strap does seem to relax the jaw muscles a bit though. I could tape my lips shut but that seems really dangerous, no? I mean, we have two means of breathing for a reason. I guess you'd probably wake up but seems like a recipe for large desaturations.

balor123 wrote:Yes I've noticed that. It's possible to breath entirely through your nose with your mouth wide open and vice versa, especially while asleep. The chin strap does seem to relax the jaw muscles a bit though. I could tape my lips shut but that seems really dangerous, no? I mean, we have two means of breathing for a reason. I guess you'd probably wake up but seems like a recipe for large desaturations.

Thanks for mentioning something I left out: Breathing thru the nostrils is not exactly what I was talking about - that should completely be taken out of the equation for this experiment. Seal 'em off with tape, a clothespin, cotton packing or whatever for this experiment to work.

Essentially this experiment is about how chinstraps (irregardless of the nose) aren't really going to keep air in or out of your mouth, no matter how tight your chinstrap is. However, IMO, they are very useful for helping keeping one's tongue on the roof of the mouth, thusly preventing 'chipmunk cheeks' in the first place and potentially aerophagia if the therapy airflow is unchecked and penetrates your lower esophageal sphincter (LES).

In other words, my original text was about an experiment to prove a point, not about something you should do nightly. Sorry if I didn't make that clear.

OK I understand. I don't keep my tongue on the roof of my mouth, mostly because my mouthguard gets in the way. During the day I keep it there sometimes. I've effectively trained myself out of the habit by this point wearing the nightguard for so many years.

I suspect I do get a lot of airflow into my LES. Is that what causes burping?

balor123 wrote: I suspect I do get a lot of airflow into my LES. Is that what causes burping?

Yes.