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My wife is complaining that the air from her CPAP is collecting in her mouth, expanding out her cheeks to the point where she finds herself letting air escape out of her mouth to relieve the pressure.  Oddly, she says this only happens when she wakes up in the middle of the night and puts the mask back on.  

I don't know what to tell her.  Anyone have tips?

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I fought that for six months and finally resigned myself to a full face mask. The full face mask was one of the good things I did for myself.

You wouldn't enter a foot race if you were the only one not allowed to breathe through your mouth and I see no need to sleep without breathing through my mouth when the brain calls for it.

Good luck to your dearest.
I find that getting up in the night while using CPAP can make it difficult to readjust when putting the mask back on, as my breathing pattern is no longer in sync with the machine, and it may take a few minutes to get comfortable again, relax and work with the machine again. When this happens, I have found it helpful to use the ramp function. This might depend on how high the standard pressure is for whether it would help or not. When I had a steady pressure of 7, this worked well. Now that I am using an APAP with a range of 5-12, the machine starts at 5, so low that the ramp is irrelevant. I also notice difficulty when I feel the need to yawn, and have found it best to briefly remove the mask, yawn, then replace it. I also find that I can get the machine to adjust better if I can take a deeper breath when it increases the pressure, rather than keeping the resistance to the pressure in my nose or mouth. If I am just not ready for the deep breath, then letting the air out of my mouth for that round can be a solution too.

With the APAP, I am wondering if it would be better to turn it off if getting up after sleeping awhile, then restart when ready so as to have the cycle start anew, rather than forcing me to try to adapt to the pressure that has probably increased while I was off the mask and the machine probably "think's" I am not breathing. I don't know if this would mess up the report for the night, with manually turning it off for a short time. (I haven't gotten to see the graph reports yet).

I hope this makes sense. I have been wondering how best to work with this variable pressure of the APAP while beginning sleep, and maybe I don't quite understand what it is doing. Since it is not an ASV-PAP, what triggers the higher pressure in the range?

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