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My cpap dries out my throat -causing me to wake up - even with the humidifier's moisture setting on high

Has anyone else encountered this problem?  I have ordered a second humidifier to increase the moisture out during the night, but I am wondering if others have had success doing something else.

 

Regards,
Ray 

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Some of the newer machines have rather small humidity chambers.  There are now 2 machines on the market that not only have the heater at the machine, but also have a heated tube which keeps the air warm all the way to the mask.  One of these machines called the Icon also has a larger water chamber - 420 ml than most other machines.  You may want to check with your physician to see if you are eligible for these features as this allows you to much more precisely control the humidity levels that get all the way to the mask without any rainout.  Good luck

Bob said:


Ray, Whether surgery helps you or not depends upon what your exact problem is. I had multiple problems and needed more than one surgery to correct them all. My ENT said I was an excellent candidate and would do well with the surgeries. I did. He could not promise that I would be able to get off CPAP, but he said it would make things easier for me. After I had enough surgeries (4 different surgeries to correct 6 different problems), I was able to get off CPAP. He told me that two more (different) surgeries might be a possibility if I still needed help, but they were ones he did NOT recommend for anyone except those with severe cases. They were more dangerous than the ones I did have. Fortunately, I didn't need to consider them. He told me that one person who was going through those surgeries was so bad off that he was having those last surgeries so that CPAP would work for him!

 

You need to get a thorough examination from a qualified, highly skilled ENT, including a special CT scan. S/he can tell you if you are a good candidate or not. Only go through with it if you are a good candidate and are willing to follow through with all of the post-operative instructions. If you are only a border-line or fair candidate, you are likely to be better off not having surgery. 
Adi said:

I am really glad to hear that.  I am thinking that I might need throat surgery but am not sure it would really fix the problem,

 

Cheers,


Ray

Jo E said:

 Thank goodness for all of the surgery I had on my sinuses, nose and throat! I don't need CPAP any longer! And I can breathe more like normal people during the day too!
For allergies, you might want to try a nettie pot. I have also found taking good quality fish oil tablets reduces the inflammation of the nose. Breathing strips on the nose help. Or, digestive enzymes can also help in helping the body to "digest" the protein from allergens. You can get those at a health food store.

Adi said:

Hi - thanks for the responses.    

>could it be that you're opening your mouth at night and the pressurized air is escaping through your mouth, causing it to feel very dry?

 

That is exactly what happens.

 

I don't use a chin strap, does that completely close one's mouth?  I have bad allergies sometimes, and frequently can't breathe through my nose.  Which chin strap do you use?

 

I use a ResMed Escape II and a full mask.

 

Again, thanks for any information and your responses,

 

Regards,

Ray 

Corrine: I was warned that because Vicks is a petroleum product, you have a good chance of "greasing" the inside of your lungs and shutting down the possibility of oxygen intake into the blood stream! Rev Aaron

Corinne said:

Hi Ray,

I am having the same problem.  My doctor recommends putting Vick drops in the humidifier which I plan to try.  I'll let you know if it works.

Bests, Corinne

Ray,

 

Your responses to each section tell me that you think you may have a mouth leak.  Good move to try a chin strap.  If the dryness persists after you try the chin strap for several nights, you might try to get someone to check on you several times during the night.  You may have what i call a "lip leak."  A "lip leak"  is where your mouth is closed, but you exhale through pursed lips. The lip leak persists despite the use of a chin strap, and you will need help to determine if you have the lip leak.   The "lip leak" usually does not affect the CPAP therapy other than dryness.  Patients of mine that have a "lip leak"  more times than not complain of the dryness. 

 

Most lip leaks that I have observed do not resolve with the chin strap.   Most require a full face mask.  That being said, I recently had a patient that solved his lip leak the same way that one other that posted a response on this thread did.  He got a mouthguard that he was able to form to his mouth and used in addition to the chin strap, fixed the lip leak.  He is the only one I have personally talked to that has done this.

You also mentioned adjusting the blinds and the abundance of windows in your apartment in an attempt to help with the rainout.  Adjusting the blinds in most cases won't stop the drafts that occur around the windows.  I might suggest window treatments such as insulated curtains if the drafts are that bad.  It will also keep your apartment warmer.  However, they can be pricey.  Just a thought.  If your bed, and CPAP is next to the window, I might suggest moving them so they are not close to the windows.  Your CPAP will then not pull in the colder air.  This alone has fixed the problem for several of my patients over the years.

Let me know how the chin strap works.  Also the change of locaton if it happens,

Hope I helped,

John Krainik,CRT,RPSGT

 


Adi said:

Hi John,

 

   Thanks for such a wonderfully complete response.

>You don't mention the mask.  A full face mask almost always requires more humidity than a nasal device.  However, full face masks are often used when nasal devices are tried with a chin strap and a mouth leak persists.  If you need a full face mask for this reason then you need to find a way to fix the humidity issue.

 

I have daisy chained the CPAP with an extra humidifier, so I won't run out of moisture at night.

 

>There are a few people that suffer dryness regardless of what they do.  However, here are the things you can check and fix, if they apply, that may help.

 

1.  Assure that your humidifier is working.  Is the chamber warm? 

Yes

2.  Do you have a mouth leak?  Several things happen with a mouth leak that will cause dryness.  The machine tries to compensate for the leak.  This causes the air to flow through the humidifier faster, and as a result will not pick up as much of the moisture.  Try a chin strap.  If you still have a mouth leak even though the chin strap is tight, then you will require a full face mask.

I am getting a chin strap to keep my mouth closed.

 

3.  Do you have a mask leak?  The same thing happens as with a mouth leak.  Fix the leak.  A different mask may be necessary that doesn't leak with the machine running.  Different masks require different techniques to fix the leak.  Some have straps that help hold the mask in the proper position.  Different type seals can actually work better not tightened as much.  If you have facial hair, the only solution may be to shave.  Remember, you need to have a mask that works with your face.

No, I don't have a leaky mask. I keep it pretty tight.

 

4. Is your machine on the floor?  If it is, get it up to the height of your head.  People who keep their machine on the floor draw in air that is cooler.  The temperature of the air is a direct factor as to how much water the air can hold.  Cooler air is not able to carry as much water as warmer air.  Raising the machine to head level from a cold floor a can raise the temperature of the air going though your machine to take care of the issue.

 

It is on a bed stand next to my head.

 

5.  What is the temperature of the room?  Again as above, the temperature of the air limits the amount of water the air can hold.  When I worked for a DME, I found that most humidity deficit AND rainout issues went away when the patient kept his room 68 degress and higher.  In the sleep lab, I allow the patient to have the temperature to his/her liking.  The ones that keep the room >68 degrees have much less dryness issues, if any, and virtually no rainout issues.

I don't control the temperature of the room as well as I should.  I have a studio in NYC with lots of windows.  I have started closing the blinds fully to moderate the room's dryness.

 

6.  Check the humidifier on your machine.  I just found out last week, that at least one manufacturer has a mode on their humidifiers that limits the heat on the humidifier to prevent rainout.  No matter how high you turn up the humidifier, the machine will limit the temperature of the humidifier to prevent rainout, totally dependent of the room temperature..  If you have one of these machines, you need to contact your DME supplier or the manufacturer to find out how to disable this feature.  If you do this, you may have a rainout issue if your room is too cold.

 

I do get some rain out, especially after I started daisy chaining it.

 

7.  A big issue in many cases, but people just don't realize it.  Are you drinking enough water?  If you are not, you may have an issue regardless of how much water you can add to via your humidifier.  Remember, you need adequate amounts of water.  Other liquids don't count.

 

Probably not actually.  This is a very good suggestion and I will drink more at night.

 

8.  You may need a visit to your ENT and/or your PCP and be sure that there is nothing else going on. 

 

>I am interested to see how the second humidifier works.  If the first humidifier is working properly, I don't believe that the second will be able to add any appreciable humidity.  Again, the maximum water content of the air is primarily determined by the temperature of the air.  Any excess that you can squeeze into it will rainout.

 

I will let you know, especially once I start using the chin strap as well.

 

 

Regards,

Ray

 

John Krainik said:

Ray,

 

You don't mention the mask.  A full face mask almost always requires more humidity than a nasal device.  However, full face masks are often used when nasal devices are tried with a chin strap and a mouth leak persists.  If you need a full face mask for this reason then you need to find a way to fix the humidity issue.

There are a few people that suffer dryness regardless of what they do.  However, here are the things you can check and fix, if they apply, that may help.

 

1.  Assure that your humidifier is working.  Is the chamber warm? 

2.  Do you have a mouth leak?  Several things happen with a mouth leak that will cause dryness.  The machine tries to compensate for the leak.  This causes the air to flow through the humidifier faster, and as a result will not pick up as much of the moisture.  Try a chin strap.  If you still have a mouth leak even though the chin strap is tight, then you will require a full face mask.

3.  Do you have a mask leak?  The same thing happens as with a mouth leak.  Fix the leak.  A different mask may be necessary that doesn't leak with the machine running.  Different masks require different techniques to fix the leak.  Some have straps that help hold the mask in the proper position.  Different type seals can actually work better not tightened as much.  If you have facial hair, the only solution may be to shave.  Remember, you need to have a mask that works with your face.

4. Is your machine on the floor?  If it is, get it up to the height of your head.  People who keep their machine on the floor draw in air that is cooler.  The temperature of the air is a direct factor as to how much water the air can hold.  Cooler air is not able to carry as much water as warmer air.  Raising the machine to head level from a cold floor a can raise the temperature of the air going though your machine to take care of the issue.

5.  What is the temperature of the room?  Again as above, the temperature of the air limits the amount of water the air can hold.  When I worked for a DME, I found that most humidity deficit AND rainout issues went away when the patient kept his room 68 degress and higher.  In the sleep lab, I allow the patient to have the temperature to his/her liking.  The ones that keep the room >68 degrees have much less dryness issues, if any, and virtually no rainout issues.

6.  Check the humidifier on your machine.  I just found out last week, that at least one manufacturer has a mode on their humidifiers that limits the heat on the humidifier to prevent rainout.  No matter how high you turn up the humidifier, the machine will limit the temperature of the humidifier to prevent rainout, totally dependent of the room temperature..  If you have one of these machines, you need to contact your DME supplier or the manufacturer to find out how to disable this feature.  If you do this, you may have a rainout issue if your room is too cold.

7.  A big issue in many cases, but people just don't realize it.  Are you drinking enough water?  If you are not, you may have an issue regardless of how much water you can add to via your humidifier.  Remember, you need adequate amounts of water.  Other liquids don't count.

8.  You may need a visit to your ENT and/or your PCP and be sure that there is nothing else going on. 

I am interested to see how the second humidifier works.  If the first humidifier is working properly, I don't believe that the second will be able to add any appreciable humidity.  Again, the maximum water content of the air is primarily determined by the temperature of the air.  Any excess that you can squeeze into it will rainout.

 

Please let me know. 

 

John Krainik,CRT, RPSGT

Hello Ray:

Another suggestion is check and see if your Cpap Unit has the option for 

'Climate Control Tubing'.

Res Med Escape Unit has that option, as well as Fisher & Paykel Icon.

This type of tubing has a copper wire the full length of the 6ft tubing/hose and improves the delivery of the humidification to the airway, and reduces or eliminates the condensation of water in the tubing.

For many folks the high flow of air needed- to deliver your Cpap pressure, causes a side effect of nasal swelling sometimes w/congestion.

Which is why the "Climate Control Lines" are an option.   

The ResMed S-9 has the climate control tubing which works great
Hmmmm Generic universal climate control tubing sounds like a business opportunity for someone.

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