Replies to This Discussion

Permalink Reply by Vicki E Jones on July 8, 2010 at 5:35pm

First, we can't all wear a full face mask. With me it is facial contours, reactivity of bridge of nose to pressure and to materials (yes, I've tried cushions and liners, etc.). Also, I can only sleep on my back, due to Fibromyalgia, Osteoarthritis and other conditions of the neck and lower back and hips. I can' wear the total face mask, that covers the eyes, due to already having extreme dry eye chronic issues.

So I use nasal pillows. Since my lower jaw is retrognathic (too far back, looks like a receding chin) and that causes the Obstructive component of my sleep apnea (I also have Central Sleep Apnea, the neurological type), I wear an oral appliance, which does a limited amount of good due to long-standing TMJ limiting how much the lower jaw can be brought forward with the appliance.

Unfortunately, even with the oral appliance and a chin strap, my teeth stay in the oral appliance, but my lips still flop open, air gushes out, and the sleep technologist said (at my last overnight study) that is causing constant neurological awakenings, even if I think I've slept. i.e. I am not rested afterward.

So I did what I had to do: I invented a mouth flap. I stitched strips of velcro on the sides of the chin strap, cut a piece of neoprene to a shape that would work for me, and stitched the mates to the velcro on each side of the mouth flap piece. The mouth flap goes on after I put the oral appliance in and put the chin strap on. It goes over my mouth and attaches to the chin strap on each side. I adjust it so that it presses firmly on the lips, but not too tight, and prevents my lips from parting and air from gushing out.

• ▶ Reply

Permalink Reply by Vicki E Jones on July 8, 2010 at 5:36pm

Vicki E Jones said:

First, we can't all wear a full face mask. With me it is facial contours, reactivity of bridge of nose to pressure and to materials (yes, I've tried cushions and liners, etc.). Also, I can only sleep on my back, due to Fibromyalgia, Osteoarthritis and other conditions of the neck and lower back and hips. I can't wear the total face mask, that covers the eyes, due to already having extreme dry eye chronic issues.

So I use nasal pillows. Since my lower jaw is retrognathic (too far back, looks like a receding chin) and that causes the Obstructive component of my sleep apnea (I also have Central Sleep Apnea, the neurological type), I wear an oral appliance, which does a limited amount of good due to long-standing TMJ limiting how much the lower jaw can be brought forward with the appliance.

Unfortunately, even with the oral appliance and a chin strap, my teeth stay in the oral appliance, but my lips still flop open, air gushes out, and the sleep technologist said (at my last overnight study) that is causing constant neurological awakenings, even if I think I've slept. i.e. I am not rested afterward.

So I did what I had to do: I invented a mouth flap. I stitched strips of velcro on the sides of the chin strap, cut a piece of neoprene to a shape that would work for me, and stitched the mates to the velcro on each side of the mouth flap piece. The mouth flap goes on after I put the oral appliance in and put the chin strap on. It goes over my mouth and attaches to the chin strap on each side. I adjust it so that it presses firmly on the lips, but not too tight, and prevents my lips from parting and air from gushing out.

• ▶ Reply

Permalink Reply by Steven on July 8, 2010 at 5:37pm

Love this topic! If anyone has any medical info about this, let me know. My thoughts are below. I think the best way to prevent a loss of the tongue seal is to facilitate side sleeping with a slight incline. I think pillow position and support also have an impact on jaw position. Over flexion or over extension of the neck also seem to be a factor. Otherwise, duct tape.

When nasal breathing during sleep, the tongue normally forms an airtight seal against the forward hard palate. This creates a vacuum force at the roof of the mouth and at the soft palate (reinforced by swallowing?) This suction force pulls the soft palate down and forward, both opening the airway and making the rear (airway side) of the soft palate more rigid. If the tongue detaches, even slightly from the hard palate the vacuum is compromised and two things occur:

1. Air coming through the nasal passage must move at a higher velocity to account for the increased volume of the mouth and the loss of rigidity of the soft palate (mouth breathing may also begin). Imagine a vacuum with the vent open-faster air would be required to achieve the same force.
2. The suction against the soft palate does two things, first, the soft palate is held towards the tongue and second, it is made more rigid on the airway side. When the vacuum is lost, the soft palate falls back and becomes more flexible. (velopharynx closure?)

Both of these factors, increased inspirational velocity and a more flexible and “softer” soft palate would allow for a closure or reduction of the airway.

1. Does apnea/hypopnea occur in subjects who are nasal breathing with maintained tongue seal?
2. Does head/neck position have a bearing on tongue seal/position? (What is flexion for the tongue?)
3. Does jaw misalignment have a bearing on tongue seal?
4. Does side sleeping help maintain tongue seal?
5. Does elevation help maintain tongue seal?

• ▶ Reply

Permalink Reply by Sharon Stoner on July 8, 2010 at 6:47pm

Someone mentioned a mask that goes under chin, instead of under lips. I have a resmed mask that fits under lips. I have had to have periodontal surgery on my lower gums and this mask gets quite uncomfortable at times. Plus it leaves red mark on bridge of my nose. Is there any way to try on different masks before commiting to one. So far my ins. has covered my c-pap equipment, so I have no idea how much masks may cost.

Steven said:

Love this topic! If anyone has any medical info about this, let me know. My thoughts are below. I think the best way to prevent a loss of the tongue seal is to facilitate side sleeping with a slight incline. I think pillow position and support also have an impact on jaw position. Over flexion or over extension of the neck also seem to be a factor. Otherwise, duct tape.

When nasal breathing during sleep, the tongue normally forms an airtight seal against the forward hard palate. This creates a vacuum force at the roof of the mouth and at the soft palate (reinforced by swallowing?) This suction force pulls the soft palate down and forward, both opening the airway and making the rear (airway side) of the soft palate more rigid. If the tongue detaches, even slightly from the hard palate the vacuum is compromised and two things occur:

1. Air coming through the nasal passage must move at a higher velocity to account for the increased volume of the mouth and the loss of rigidity of the soft palate (mouth breathing may also begin). Imagine a vacuum with the vent open-faster air would be required to achieve the same force.
2. The suction against the soft palate does two things, first, the soft palate is held towards the tongue and second, it is made more rigid on the airway side. When the vacuum is lost, the soft palate falls back and becomes more flexible. (velopharynx closure?)

Both of these factors, increased inspirational velocity and a more flexible and “softer” soft palate would allow for a closure or reduction of the airway.

1. Does apnea/hypopnea occur in subjects who are nasal breathing with maintained tongue seal?
2. Does head/neck position have a bearing on tongue seal/position? (What is flexion for the tongue?)
3. Does jaw misalignment have a bearing on tongue seal?
4. Does side sleeping help maintain tongue seal?
5. Does elevation help maintain tongue seal?

• ▶ Reply

Permalink Reply by Mary Z on July 8, 2010 at 8:22pm

You can ask your equipment provider which masks go under the chin. I just tried one- a Fisher & Paykel, but did not like the design otherwise. You can also go on the site of any on-line retailer and read their descriptions of the masks choosing what might work for you. I know ResMed does not make such a mask. Maybe other folks on the forum know of masks that go under the chin.
Mary Z.


Sharon Stoner said:

Someone mentioned a mask that goes under chin, instead of under lips.

• ▶ Reply

Permalink Reply by cheryl on July 8, 2010 at 8:27pm

Mary, do you have one that you like? I know I tried an under the chin one, but it did not work for me. I was interested in a hybrid that is similar to a Liberty mask. That has an under chin thing on it, but my supplier doesnt carry it and I would have to order online. Can you tell me which one you use by name, or did I miss it in your comments...cheryl

Mary Z said:

You can ask your equipment provider which masks go under the chin. I just tried one- a Fisher & Paykel, but did not like the design otherwise. You can also go on the site of any on-line retailer and read their descriptions of the masks choosing what might work for you. I know ResMed does not make such a mask. Maybe other folks on the forum know of masks that go under the chin.
Mary Z.


Sharon Stoner said:

Someone mentioned a mask that goes under chin, instead of under lips.

• ▶ Reply

Permalink Reply by Matt on July 9, 2010 at 7:13am

oops

• ▶ Reply

Permalink Reply by Marcy on July 9, 2010 at 7:26am

I use a mouth guard since I grind my teeth at night. They are about $20. I use Doctor's brand. It keeps my mouth shut since it creates a suction.

• ▶ Reply

Permalink Reply by Ron Cheney on July 9, 2010 at 10:26am

I've been on CPAP/BIPAP for two and a half years now and I had a heck of a time with my mouth leaking. I started out with a nose mask and CPAP and my mouth would leak like a cive. Tried the chin strap and that helped for a while but eventually the mouth would open. Started using Painters tape (the blue stuff) and that worked well but eventually the tape would get a little moist and it too would start to leak. I then tried a full face mast and that worked much better but I would still try to breath through my mouth. The pressure would be ok and the CPAP therapy would be good but my mouth would be very very dry in the morning, started taping again. The combination of tape, full face mask worked well. I went to my doctor for a two year check and told him about the problem, he said that with the high pressure (I have a 12) that it would be hard to keep my mouth closed. We set up an other sleep study but this time using the ResMed Swift FX nasal Pillows and an Auto BiPAP system. WOW what a difference. With the reduced pressure (higher pressure only when I needed it) and the nasal pillows I slept the hole night with no leaks and no tape. When I used the full face mask eventually I would turn the wrong way and I would get a leak on the side or top. With the nasal pillows this does not happen. I've had the BIPAP auto and nasal pillow for about 6 months now and I am very happy with it.

• ▶ Reply

Permalink Reply by cheryl on July 9, 2010 at 10:44am

I did see a hybrid, similar to the Liberty...it nasal pillows into your nose and then wraps around themouth. I like it, but by 6 am, I wake up and still want to stay in bed. But the leaks are impossible to stop by then. All nite, it seems to not leak, but in the morning, even if I want to sleep more, I can't consistently get it to seal without tightening it so bad, it hurts, so off it goes. I wouldhave to purchas the hybrid which as the under chin thing, but I'm afraid to buy it because my chin is small and I'm not certain it would help with the leaks. Do you have a thin face also? I can't tell which people do, because the photos with the ID's on this site do not show the person, which is fine, but I feel like I am in a class alone, can't seem to find another person like me. so on I search...today I am trying a mirage quattro. I was tested with it, hated it and gave it back. But now I am more able to tolerate the Fullface, so since this is the top selliing one I hear, I shall try it again and see if now, that it's been awhile, maybe I can wear it. I still want to know why my mouth fills with air, can't seem to get an answer on that one...thanks Mary

Mary Z said:

You can ask your equipment provider which masks go under the chin. I just tried one- a Fisher & Paykel, but did not like the design otherwise. You can also go on the site of any on-line retailer and read their descriptions of the masks choosing what might work for you. I know ResMed does not make such a mask. Maybe other folks on the forum know of masks that go under the chin.
Mary Z.


Sharon Stoner said:

Someone mentioned a mask that goes under chin, instead of under lips.

• ▶ Reply

Permalink Reply by cheryl on July 9, 2010 at 10:45am

The one I found is just called a hybrid, and looks like a Liberty, but does have the under chin. You might look at that, and it is way less expenisve online than many others..I would like to try it, but my providers don't carry it and I'm scared to order online...cheryl

cheryl said:

I did see a hybrid, similar to the Liberty...it nasal pillows into your nose and then wraps around themouth. I like it, but by 6 am, I wake up and still want to stay in bed. But the leaks are impossible to stop by then. All nite, it seems to not leak, but in the morning, even if I want to sleep more, I can't consistently get it to seal without tightening it so bad, it hurts, so off it goes. I wouldhave to purchas the hybrid which as the under chin thing, but I'm afraid to buy it because my chin is small and I'm not certain it would help with the leaks. Do you have a thin face also? I can't tell which people do, because the photos with the ID's on this site do not show the person, which is fine, but I feel like I am in a class alone, can't seem to find another person like me. so on I search...today I am trying a mirage quattro. I was tested with it, hated it and gave it back. But now I am more able to tolerate the Fullface, so since this is the top selliing one I hear, I shall try it again and see if now, that it's been awhile, maybe I can wear it. I still want to know why my mouth fills with air, can't seem to get an answer on that one...thanks Mary

Mary Z said:

You can ask your equipment provider which masks go under the chin. I just tried one- a Fisher & Paykel, but did not like the design otherwise. You can also go on the site of any on-line retailer and read their descriptions of the masks choosing what might work for you. I know ResMed does not make such a mask. Maybe other folks on the forum know of masks that go under the chin.
Mary Z.


Sharon Stoner said:

Someone mentioned a mask that goes under chin, instead of under lips.

• ▶ Reply

Permalink Reply by cheryl on July 9, 2010 at 10:49am

I found this interesting, as Ron's problem is my problem. I am trying to get a bipap or autopap, which should help. I have a pressure 8 and I breathe very slow and feel the reason the air builds up and forces my lips open, is because I don't breathe fast enough or maybe need a different pressure with each breath. Can you tell me the cpap you have/ am getting another sleep lab next Wed. nite because I have constant morning headaches even withcpap on all nite and my ENT surgeon(I had sinus surgery 6 weeks before I started cpap a few months ago, I may need this type of cpap. Let me know Ron...regards, Cheryl..and I tried the taping and all that. My liberty mask forces my mouth open and the dry mouth is bad, but I used an ointment for it last nite and that was better...

Ron Cheney said:

I've been on CPAP/BIPAP for two and a half years now and I had a heck of a time with my mouth leaking. I started out with a nose mask and CPAP and my mouth would leak like a cive. Tried the chin strap and that helped for a while but eventually the mouth would open. Started using Painters tape (the blue stuff) and that worked well but eventually the tape would get a little moist and it too would start to leak. I then tried a full face mast and that worked much better but I would still try to breath through my mouth. The pressure would be ok and the CPAP therapy would be good but my mouth would be very very dry in the morning, started taping again. The combination of tape, full face mask worked well. I went to my doctor for a two year check and told him about the problem, he said that with the high pressure (I have a 12) that it would be hard to keep my mouth closed. We set up an other sleep study but this time using the ResMed Swift FX nasal Pillows and an Auto BiPAP system. WOW what a difference. With the reduced pressure (higher pressure only when I needed it) and the nasal pillows I slept the hole night with no leaks and no tape. When I used the full face mask eventually I would turn the wrong way and I would get a leak on the side or top. With the nasal pillows this does not happen. I've had the BIPAP auto and nasal pillow for about 6 months now and I am very happy with it.

• ▶ Reply

▶ Reply to Discussion

• ‹ Previous
• 1
• 2
• 3
• Next ›
• Page