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does anyone know why the air fills up the mouth and poofs out the cheeks?

When I first asked this, I got lots of great solutions for this problem, but so far, I haven't been able to find out some reasons for this to happen. Is it because the air builds up in the throat, etc, from the constant air pressure flow (mine is 8) and then it needs somewhere to go because I am breathing very slowly? So it builds up in there and poofs the cheeks out til the lips open and release it? That is what I am trying to learn about-what is causing this...

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If you have a swamp cooler in your home, that air has to have somewhere to get out, and if a door does not get latched, it will open the door to get out. If you pump pressure into your nose, it needs somewhere to go, and if you don't have your mouth sealed off, it will escape that way.

So, the cause is, your tounge is not sealing your mouth off well enough.
how does the tongue seal off the mouth exactly?

RChatty said:
If you have a swamp cooler in your home, that air has to have somewhere to get out, and if a door does not get latched, it will open the door to get out. If you pump pressure into your nose, it needs somewhere to go, and if you don't have your mouth sealed off, it will escape that way.

So, the cause is, your tounge is not sealing your mouth off well enough.
Because it has (obstructed) airway blockage with nowhere else to go
This problem with air filling occurs only with the mask on, and it will occur even when I put the mask on, and wait about a minute. I find it hard to believe that it's an obstruction while I am awake. Why would the docs not be able to identify the obstruction? I can be awake with the mask on and running, and within a minute or so, I can feel the air build up in my mouth. My tongue is not relaxed, I am awake and it happens. The common denominator for me is I breathe very slowly. And I think the air keeps coming, even at a slower rate, as I exhale, and builds up because I am not breathing in a rythmic manner. If it was a blockage, I dont see how it occurs when I am completely awake. I wish I could speed up my breathing. I had sinus surgery 6 weeks before (coincidentally) I started cpap. I had the test results the same week as my consultation about my sleep study. The reason I had the study was my doc could not figure out why I am tired and headaches, very tired, lethargy. I am very active, work out several times a week and way on the thin side. So far, nobody, including the surgeon can find an obvious obstruction. I could buy the obstruction thing completely, but being awake when that happens, has me baffled. I am getting a sleep study next week, to see if the sinus surgery helped at all-this could all be from my nose, not throat area, and also to check into an auto/bipap machine, whichever would be recommended. This is something I will have to look further into. I was never referred to a pulmonary doctor after the test, and maybe that type of doctor can explain this. Only my sinus surgeon has examined my throat and nose. And he insists everything in those areas look perfectly normal and do not show any signs of an obstruction. I'm still working on this whole thing
Cheryl,

You are overthinking this one and maybe worrying needlessly about it. It is common among CPAPers.

Some CPAPers call it "blowfish effect" and "chipmunk cheeks".

It happens to me and that is one of the reasons I use a full face mask. With a full face mask, when it happens, I just open my lips slightly and let the pressure out. If it happens while I am asleep, my mouth opens and relieves the pressure and I am not even aware that it happens. The downside is I usually start mouthbreathing at that point, but that is just something I have to live with and like I mentioned earlier the Biotene gel, if applied properly, really helps.

Are you using the Liberty mask which is a full face mask? If you are using a full face mask, the issue should not be a problem for you. If you are using a nasal mask, it may be a problem because when you open your lips to relieve the pressure, the pressure in your airway could fall below the therapeutic level.

Whadda ya think?
I have a tendancy to overthink many things, so you got that one right! haha. What bugs me is that most of the comments I read about cpap, the person knows what is causing the problem. For me, there has been no answer and I just don't buy it. It has to be something that somehow can be identified- i.e., tongue is too big, tonsils, whatever. It can only be so many things. After all, it is related to either the nose, sinus stuff or throat from what I have been able to figure out. My doctors look at all this and shrug and say they don't know what is causing it, but I got it. I have trouble with this. And it just bugs the heck out of me. so I am putting alot of effort into learning as much as I can and getting opinions from other cpap users. Seems to me that the medical profession only tells us so much. Now I have not been to a pulmonary doc yet, and think I should see one. Maybe that person could better explain this to me. And it torks me that I can't use a nasal pillow. If I could, I could eliminate 90% of my problem with this whole thing. But I am forced to stay with a fullface. And it is gettng better for me to sleep with it, but my nose is so beaten up from it and very red and tender. I use a cushion but it still leaves marks and even makeup isnt covering this up. okay, that is all my gripes for one day! thanks banyon

Banyon said:
Cheryl,

You are overthinking this one and maybe worrying needlessly about it. It is common among CPAPers.

Some CPAPers call it "blowfish effect" and "chipmunk cheeks".

It happens to me and that is one of the reasons I use a full face mask. With a full face mask, when it happens, I just open my lips slightly and let the pressure out. If it happens while I am asleep, my mouth opens and relieves the pressure and I am not even aware that it happens. The downside is I usually start mouthbreathing at that point, but that is just something I have to live with and like I mentioned earlier the Biotene gel, if applied properly, really helps.

Are you using the Liberty mask which is a full face mask? If you are using a full face mask, the issue should not be a problem for you. If you are using a nasal mask, it may be a problem because when you open your lips to relieve the pressure, the pressure in your airway could fall below the therapeutic level.

Whadda ya think?
As far as what causes OSA, the predominant cause is underdeveloped jaws. Do you have a recessed chin? Narrow jaws? Crowded teeth? Braces as a child? Teeth extracted due to crowding? Scalloped tongue?

When a person has a narrow jaw, the airway is narrower and the tongue and soft palate are crowded and more likely to block the airway when the muscles relax during sleep.

Narrow jaws are the result of our modern diet. We get plenty of calories during our developing years without doing much chewing. Chewing exercises the jaw and causes it to grow deeper and wider during our developing years. Take away chewing and we have a population with underdeveloped jaws. Our ancestors chewed on tough meats (and other things) and their jaws grew wider and deeper than ours.

Dr. Steven Park has written about this in his book, Sleep, Interrupted and also in blogs and articles on his website.

I have a great desire to know the "whys and hows" like you do and am glad to discuss them with you. My concern is that you don't let the intellectual pursuit of knowledge get in the way of dealing with your CPAP therapy in an instinctive way. There are many people who have very little knowledge of sleep apnea and CPAP, yet have a good "feel" for making the therapy work well for them and that, afterall, is our ultimate goal.

Good luck.
Cheryl said, "But I am forced to stay with a fullface. And it is gettng better for me to sleep with it, but my nose is so beaten up from it and very red and tender."

Which mask are you using?
mirage quattro

Banyon said:
Cheryl said, "But I am forced to stay with a fullface. And it is gettng better for me to sleep with it, but my nose is so beaten up from it and very red and tender."

Which mask are you using?
I've not been told I have any of those potential causes for sleep apnea. I am trying desperately to get along with this therapy, but as it is, each nite is so different from the one before. For example, last nite, the mask was so heavy on my face and the humidifier was warm, and I woke up wanting to scream. It was so hot anyway, here in Reno, but I was really okay with that, it was the mask on my face and the humidifier. Tonite I will turn it way down and see how that goes. I just can't seem to find a mask that doesnt pull my mouth open (mirage, liberty) and digs into my face, even with the straps as loose as I can make them. I am not cut out for this, I think, but I don't believe anyone could try harder than I have. Even my medical supply reps tell me I have the best attitude they have seen for so many failures and problems I have experienced. Maybe they are just "saying that", but I honestly and with everything I have, have tried for 4 months to make this work. It seems I can tolerate a mask for a few days, then it starts leaking too much, too heavy, whatever. I know nothing is perfect, and least of all, this situation. But if it makes me feel better, I so want to do it.

Banyon said:
As far as what causes OSA, the predominant cause is underdeveloped jaws. Do you have a recessed chin? Narrow jaws? Crowded teeth? Braces as a child? Teeth extracted due to crowding? Scalloped tongue?

When a person has a narrow jaw, the airway is narrower and the tongue and soft palate are crowded and more likely to block the airway when the muscles relax during sleep.

Narrow jaws are the result of our modern diet. We get plenty of calories during our developing years without doing much chewing. Chewing exercises the jaw and causes it to grow deeper and wider during our developing years. Take away chewing and we have a population with underdeveloped jaws. Our ancestors chewed on tough meats (and other things) and their jaws grew wider and deeper than ours.

Dr. Steven Park has written about this in his book, Sleep, Interrupted and also in blogs and articles on his website.

I have a great desire to know the "whys and hows" like you do and am glad to discuss them with you. My concern is that you don't let the intellectual pursuit of knowledge get in the way of dealing with your CPAP therapy in an instinctive way. There are many people who have very little knowledge of sleep apnea and CPAP, yet have a good "feel" for making the therapy work well for them and that, afterall, is our ultimate goal.

Good luck.
ResMed has many masks labeled "Mirage". Specifically which one are you using?
Be careful of that sore on your nase, I used to wear a quattro and got terrible skin breakdown on my nose- still have the scar. I had to switch to a FitLife Total Face Mask to get the pressure off my nose.
Perhaps you do need a new doctor, another sleep doctor, or pulmonologist who specializes in treating sleep apnea. Some people do not tolerate CPAP, perhaps a BPAP, a bilevel device that decrease the pressure when you exhale...The machine should breathe with you. a CPAP always has a set pressure. It does sound as if you need a new viewpoint for what is going on.

Good Luck.
Mary Z.

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