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Background:  My husband has struggled with leaks using a full CPAP face mask and a nasal mask; periodically he even snores with the it in place.  His jaw tends to drop back, resulting in intermittent mild to moderate snoring, so in addition he is using a chin strap.  He is not a mouth breather when awake.  Diagnosis is UARS with the majority of his respiratory events occurring during REM sleep.
Current Problem:  He is experimenting with a nasal pillow, which he prefers over the mask; however, I have noticed in the wee hours that he puffs air out from his lips (lips are closed, air escapes in a puff followed by lip closure).  His new DME provider suggested that he tape his lips to prevent this.  This morning I could hear constant leakage and noted that his cheeks were fully puffed out and air was escaping at the corners.   
Question:  What is happening when air needs to exit from the mouth versus the nose while using a nasal pillow?  Does anyone have additional suggestions? 

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His pressure may be too high. He also may want to look into one of the oral devices to help keep his lower jaw in place.
Thanks for your response, Rock! I will have him pursue a pressure change. Someone suggested that increased humidification would help with this? What do you think about that?

Interestingly, I use a mandibular advancement device for my UARS with great results...6 months after I received it (insurance covered a portion), the same insurance company denied my husband's prior auth. We are on a 4th appeal (possibly found a loophole). Meanwhile, he uses the CPAP faithfully, but it is such a struggle and symptoms are not noticeably improved.
UARS is a funny thing like that. Sometimes finding the exact pressure can be tough. I should have mentioned humidity as well. I would troubleshoot all possibilities before talking to a doc about a pressure change.

I do not know if it would work, but boxing mouthguards are heat and boil. They hold both the upper and lower jaws firm. You can pick them up at most of the larger sporting good stores or martial arts academies. An idea brought to you by the fighter in me.

SaraLynn said:
Thanks for your response, Rock! I will have him pursue a pressure change. Someone suggested that increased humidification would help with this? What do you think about that?

Interestingly, I use a mandibular advancement device for my UARS with great results...6 months after I received it (insurance covered a portion), the same insurance company denied my husband's prior auth. We are on a 4th appeal (possibly found a loophole). Meanwhile, he uses the CPAP faithfully, but it is such a struggle and symptoms are not noticeably improved.

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