How does mouth breathing impact sleep apnea?

That's been my experience so far. It can be pretty lose if your pressure isn't too high and you sleep on your back. I feel like my cheekbones take most of the weight and that's not a problem. But when I roll on my side and the bed or pillow ends up pushing against the mask, it pushes off those nice contours and I get a leak. I've found the Resmed FFM to be the most resilient but I still have to tighten it some to keep it in place. I didn't get enough forward growth on my maxilla I think so I don't have very prominent cheekbones. On someone else it might not slide around as much. I see that Resmed has a new mask though. Perhaps this one is easier on the nose and I can tighten it up around the nose/cheeks more and loosen up on the jaw.

The nasal pillows, by contrast, work great when the nasal passages are open. They rarely leak except when I put them on upside down (it happens sometimes). Biggest problem I have with the SwiftFX is that once I turn the pressure up past 10cm the noise from the vent by the pillows becomes very loud. There's also not many directions you can point it where it's not bothering something (a hand or a spouse). I've found that sleeping with the tube above my head tends to work but it's just barely long enough for that.

I just used SinusRinse for the first time btw. I'd been too scared of it up until now. 2mo of using Flonase has helped break that fear though. It's more a very confusing feeling but once you get over that it seems to go through. It didn't help much but I only tried the isotonic solution. I'll finish the bottle and then try to hypertonic solution next to see if I can reduce the swelling that way.

Have you tried PapPillow.com? Lots of people here use them - they have cutouts for the mask to dip into while you're side sleeping.

Yeah I have one - used it last night actually. It's ok. There is a cutout for the mask but I move around too much for it to help all that much. It's a bit stiff and thick for my neck over the long term but I can sleep with it. Maybe I'll adapt with more time.

balor123 wrote:Yeah I have one - used it last night actually. It's ok. There is a cutout for the mask but I move around too much for it to help all that much. It's a bit stiff and thick for my neck over the long term but I can sleep with it. Maybe I'll adapt with more time.

Balor, I have one too and found it too hard on my neck also, so I opened up the back seam very carefully and took out some of the stuffing... its just shredded plastic bits. Once I took out some and sewed the seam back up its fine.

balor123 wrote:That's been my experience so far. It can be pretty lose if your pressure isn't too high and you sleep on your back. I feel like my cheekbones take most of the weight and that's not a problem. But when I roll on my side and the bed or pillow ends up pushing against the mask, it pushes off those nice contours and I get a leak. I've found the Resmed FFM to be the most resilient but I still have to tighten it some to keep it in place. I didn't get enough forward growth on my maxilla I think so I don't have very prominent cheekbones. On someone else it might not slide around as much. I see that Resmed has a new mask though. Perhaps this one is easier on the nose and I can tighten it up around the nose/cheeks more and loosen up on the jaw.

Sounds like you need a mask that fits you better. I sleep with a full face mask, open mouth, and a pressure range from 11-17. My leak line is almost a flat line at zero. My jaw is relaxed, and I am comfortable with it. Oh, and I sleep on my side most of the night. If I roll onto my back, my mouth opens wider, which tends to cause my cheeks to flap. I don't like that, so I roll back onto my side. I haven't noticed that in a while. I used to sleep on my back a lot, but now I sleep mostly on my side.

Sounds like you need a mask that fits you better.

Yeah that would be nice. It's a hard problem. Not only do normal faces come in all different shapes and sizes but people with breathing problems also tend to have growth deformities. To most people they aren't noticeable but to someone trying to design a mask with a good fit it's a big problem. There are some people for whom no mask exists that will provide good performance. I'm lucky enough to have found one that's good enough but not great. Unfortunately, we tend to ostracize those people who struggle to find a mask that fits, rather than recognize and address the problem.

"growth deformities" --- what?? Are you just referring to e.g. narrower airways, smaller jaws, etc?

And "we tend to ostracize those people who struggle to find a mask that fits"... We do? News to me!

Unfortunately, we tend to ostracize those people who struggle to find a mask that fits

The proliferation of new masks types in the last ten years, puts the lie to this statement.

Unfortunately, we tend to ostracize those people who struggle to find a mask that fits, rather than recognize and address the problem

balor123,

I am perplexed as to why you would say that people who struggle to find a mask that fits are ostracized. As one who has endured that struggle, that has definitely not been the case with me. I have gotten nothing but support from wonderful members via PM or email. I can't thank those folks enough.

I do agree with you that more needs to be done to address the problem of poor fitting masks but to call that being ostracized simply is not accurate in my opinion.

And speaking of masks, have you tried nasal pillow or nasal masks by using a chin strap or tape? Many people (not all) who were told they were mouth breathers found they could wear one under these circumstances. And some people even learned to keep their mouth closed.

Obviously, there are no guarantees but you have nothing to lose my trying one as many on cpap.com have free return or low cost return insurance.

49er

Have you tried the SleepWeaver Anew full-face mask? It is made of cloth and the air causes the inside of the mask to balloon out and form a seal. Some users found it difficult to stop leaks with that mask, but I'd be willing to bet that many of those were simply over-tightening the mask. It needs to be pretty loose to allow the air to fully inflate the inside and form a seal. The manufacturer offers a 30-day money back guarantee, so it is a safe bet to try.

Also, if you are concerned about problems with your teeth due to using a full-face mask, just remember that you don't have to sleep with your mouth open just because you are using a full-face mask. If you are able to sleep with your mouth shut, you can receive all the therapy by breathing through your nose. The full-face mask will just be the safety net in case you do open your mouth. In fact, I have been using a chin strap along with my SleepWeaver Anew to try to limit my therapy to nasal breathing. However, if/when I do revert to mouth-breathing, the full face mask is there for me.

I am perplexed as to why you would say that people who struggle to find a mask that fits are ostracized.

"We" wasn't intended for the members of this board but just people in general. I did perceive some hostility on another thread about looking for excuses not to use my CPAP though and noticed some referred to the new pacemaker patients as "CPAP losers".

And speaking of masks, have you tried nasal pillow or nasal masks by using a chin strap or tape?

I love the nasal pillow. My nasal passage simply doesn't agree with them. I'm still hoping to avoid surgery there but it might come to that. I posted my machine data on another thread. Some days it looks great. Other days, lots of interruptions. I've noticed sometimes and my wife reports snoring, gasping, and generally loud sleeping at times so I'm pretty sure its my turbinates acting up during my sleep. During the day I've been having a good experience with SinusRinse so so I'm hopeful!

Any idea how I can measure EMG at home btw? I have mostly hypopneas so my heart rate and oxygen don't give good data. There's a nice diagram showing the difference between different types of disordered breathing here on page 9. That's what my overnight oximeter looks like as well. Even in my formal sleep study, my heart rate has never looked like anything but a mess (doctor said it's dreaming but gave my oximeter to my brother, who also has sleep apnea, and a friend both of theirs looked a lot smoother).

I've got about a dozen masks at home that I've tried over the years. My last home healthcare company was nice enough to let me keep them all but I don't have that benefit anymore. I find that it helps to keep several different kinds of masks around. Some kinds work well for a while and then I switch to another kind. There's just some variables that I haven't figured out how to control well.

"growth deformities" --- what?? Are you just referring to e.g. narrower airways, smaller jaws, etc?

Underbites, overbites, cheekbones that lack prominence, long faces, etc. In my case, due to chronic sinusitis in my late teens I started breathing through my mouth and my tongue didn't push my maxilla to grow in the right direction. It grew down instead of out while my mandible grew out. The cheekbones also didn't grow forward. You'd never guess looking at me but orthodontists and oral surgeons can spot this stuff quickly. I think this is when I went from mild to severe.

Also, if you are concerned about problems with your teeth due to using a full-face mask, just remember that you don't have to sleep with your mouth open just because you are using a full-face mask. If you are able to sleep with your mouth shut, you can receive all the therapy by breathing through your nose.

I've tried that but I need the nasal pillows to breath through my nose, hence the interest in the hybrid mask. I've also considered BreathRight strips. There's some rings or something you can insert too right? Where can I buy those? It doesn't solve the pressure against face problem though. I've seen some masks with chin supports that might be interesting if I can find them again. Last time I tried it the seal was terrible but maybe it'd work now.

Obviously, there are no guarantees but you have nothing to lose my trying one as many on cpap.com have free return or low cost return insurance.

How do they feel about people who buy 20 masks and return them?

Sounds like you need a mask that fits you better. I sleep with a full face mask, open mouth, and a pressure range from 11-17. My leak line is almost a flat line at zero. My jaw is relaxed, and I am comfortable with it. Oh, and I sleep on my side most of the night. If I roll onto my back, my mouth opens wider, which tends to cause my cheeks to flap. I don't like that, so I roll back onto my side. I haven't noticed that in a while. I used to sleep on my back a lot, but now I sleep mostly on my side.

Hmm... I wish I could replicate that. I've also found that if the lips part even a bit at higher pressures your mouth turns into a balloon. It's funny at first but not a great way to sleep. Fortunately, my pressure is only 7cm now so its not an issue for me.

Have you tried the SleepWeaver Anew full-face mask?

I just discovered that mask and it looks very interesting to me. I'm eager to try it but need to check if my insurance will cover it yet.

Hi balor123,

Ah, now I totally understand where you are coming from on the ostracization point. You can't worry about what people think and simply need to focus on doing what is best for you.

It is is sad that posts get falsely perceived as looking for an excuse to quit cpap. But unfortunately, that isn't going to change for various reasons.

Hmm, never returned 20 masks to cpap.com. But I am sure they are used to many customers returning them and that is why they have the return insurance feature. And with several, you don't even need to purchase that.

Best of luck.

49er

balor123 wrote:

I am perplexed as to why you would say that people who struggle to find a mask that fits are ostracized.

"We" wasn't intended for the members of this board but just people in general. I did perceive some hostility on another thread about looking for excuses not to use my CPAP though and noticed some referred to the new pacemaker patients as "CPAP losers".

And speaking of masks, have you tried nasal pillow or nasal masks by using a chin strap or tape?

I love the nasal pillow. My nasal passage simply doesn't agree with them. I'm still hoping to avoid surgery there but it might come to that. I posted my machine data on another thread. Some days it looks great. Other days, lots of interruptions. I've noticed sometimes and my wife reports snoring, gasping, and generally loud sleeping at times so I'm pretty sure its my turbinates acting up during my sleep. During the day I've been having a good experience with SinusRinse so so I'm hopeful!

Any idea how I can measure EMG at home btw? I have mostly hypopneas so my heart rate and oxygen don't give good data. There's a nice diagram showing the difference between different types of disordered breathing here on page 9. That's what my overnight oximeter looks like as well. Even in my formal sleep study, my heart rate has never looked like anything but a mess (doctor said it's dreaming but gave my oximeter to my brother, who also has sleep apnea, and a friend both of theirs looked a lot smoother).

I've got about a dozen masks at home that I've tried over the years. My last home healthcare company was nice enough to let me keep them all but I don't have that benefit anymore. I find that it helps to keep several different kinds of masks around. Some kinds work well for a while and then I switch to another kind. There's just some variables that I haven't figured out how to control well.

"growth deformities" --- what?? Are you just referring to e.g. narrower airways, smaller jaws, etc?

Underbites, overbites, cheekbones that lack prominence, long faces, etc. In my case, due to chronic sinusitis in my late teens I started breathing through my mouth and my tongue didn't push my maxilla to grow in the right direction. It grew down instead of out while my mandible grew out. The cheekbones also didn't grow forward. You'd never guess looking at me but orthodontists and oral surgeons can spot this stuff quickly. I think this is when I went from mild to severe.

Also, if you are concerned about problems with your teeth due to using a full-face mask, just remember that you don't have to sleep with your mouth open just because you are using a full-face mask. If you are able to sleep with your mouth shut, you can receive all the therapy by breathing through your nose.

I've tried that but I need the nasal pillows to breath through my nose, hence the interest in the hybrid mask. I've also considered BreathRight strips. There's some rings or something you can insert too right? Where can I buy those? It doesn't solve the pressure against face problem though. I've seen some masks with chin supports that might be interesting if I can find them again. Last time I tried it the seal was terrible but maybe it'd work now.

Obviously, there are no guarantees but you have nothing to lose my trying one as many on cpap.com have free return or low cost return insurance.

How do they feel about people who buy 20 masks and return them?

Sounds like you need a mask that fits you better. I sleep with a full face mask, open mouth, and a pressure range from 11-17. My leak line is almost a flat line at zero. My jaw is relaxed, and I am comfortable with it. Oh, and I sleep on my side most of the night. If I roll onto my back, my mouth opens wider, which tends to cause my cheeks to flap. I don't like that, so I roll back onto my side. I haven't noticed that in a while. I used to sleep on my back a lot, but now I sleep mostly on my side.

Hmm... I wish I could replicate that. I've also found that if the lips part even a bit at higher pressures your mouth turns into a balloon. It's funny at first but not a great way to sleep. Fortunately, my pressure is only 7cm now so its not an issue for me.

Have you tried the SleepWeaver Anew full-face mask?

I just discovered that mask and it looks very interesting to me. I'm eager to try it but need to check if my insurance will cover it yet.