Replies to This Discussion

Permalink Reply by Ron Cheney on July 9, 2010 at 10:54am

Cheryl, I switched to the Respironics BiPAP Auto with Bi-Flex and the System One heated Humiodifier. I also have the ResMed Swift FX Nasal pillows system. I really cant explain why the nasal pillows work and my mouth stayes closed but it does. I beleave its because I switched to the BiPAP system. good luck

cheryl said:

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.

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Permalink Reply by Mary Castrovilla on July 9, 2010 at 6:15pm

Hi Bob,

Can you tell me more about your mouth guard? Does it only cost one dollar at Wal Mart? do you have to boil it?
I have gone through about 5 guards, all of which didn't work.(couldn't boil etc, cut into cheek. -AND they cost $25 to $30

THANKS TO ALL ON THIS SITE!

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Permalink Reply by cheryl on July 9, 2010 at 9:36pm

Well that is what I think is happening, though my pressure is low, an 8, I still think the constant flow builds up. I would love to use the swift FX and I believe I am being tested with a bipap or some other type of cpap. And it's interesting that now you are doing so well. You have given me some hope that I may be on the right track moving on to another sleep study and the bipap or auto, whichever one the ENT has prescribed for the test. Also, do you have a portable battery for your system? I may be travelling with my folks next month and may need to get one..I have heard from my med supply that for my cpap, I can get a marine battery 12 volt at Costco and the other particulars at Radio Shack for very cheap..just wonder if yours has one...thanks for your input

cheryl said:

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.

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Permalink Reply by Heather Dent on July 10, 2010 at 1:55pm

Hi Cheryl
I am a mouth breather too. I had the very same problem with the Liberty.....mouth relaxes and hangs open and causes the seal to break because the mask part is very small (covering mouth only) and lips are closer to edge of mask pillow. It is virtually only a mouth face mask with pillows above. I also found that after one week the pillows started to make my nostrils chapped (even though I had on board humidifier set high enough).. After about 2 to 3 weeks the cushion of the mask has stretched badly (due to "jaw drop") and leaking gets progressively worse, that you need a new cushion. That isn't sustainable. But if you like the smaller, less obtrusive features of this mask, DeVilbiss makes one called a "hybrid" (HYB 8500) that is almost identical, except that they were smart enough to design it with a little chin holder/flap at the bottom, to prevent the "jaw drop" of mouth breathers. It also has awesome headgear straps (5 points of adjustability) I'm not sure if DeVilbiss is the manufacturer or the distributor, but you can investigate it online at hybridmask.com I already had purchased a Quattro mask (when I bought my cpap machine) discovered this information, but I kept the info as I intend to eventually order one.

And YES, you are right about breathing too slow........it does have the effect of causing the "chipmunk syndorme" (puffy cheeks due to air collecting) in the mask, which results in periodic leaks from the pressure of collected air in mask. That might still happen with the hybrid, I'm not sure. I use the Quattro full face mask and when I ran into the same problem (caused by my slow rate of breathing), I adjusted the EPR (Expiratory Pressure Relief) and also the IPR (Inhalation pressure relief) on my CPAP machine, until I got it to stop altogether. Just tweaking those things eradicated the problem completely. I think that will work with other masks. But only if you have one of the Resmed S8 Series machines or better, because Resmed is the manufacturer who patented these features. I know nothing about Respironics.......whether they have the equivalent or not ? Truth be told, shallow breathers and slow breathers need those features and even then you have to experiment with them. (By the way this does not change your prescribed pressure derived from your titration study.) The Resmed "AutoSet - Advantage is an S8 Seriens machine that is both CPAP and APAP, and the APAP is better at solving the problem without al the tweaking. But that's not what my sleep doc prescribed......it's Canada and he is trying to save the gov't health are some money!

If you go on the Resmed.com website you can read how those features work.
That's about all I have to share....hope the above is helpful.
Heather

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Permalink Reply by cheryl on July 10, 2010 at 4:26pm

Wow Heather, thank you for writing! WE have alot in common with this cpap thing. And that hybrid is on my mind as I was going to purchase it online-my supplier doesnt have it on hand and the cost is about double what I find online. Thank you for all the info on cpap too. mine is a resmed s8 and I have the EPR at 3, but haven't seen an IPR feature. I went online to get into the clinical menu and adjust the pressure, mine is an 8, so I tried it at 7, as my report from the sleep lab said that pressure 7 was also able to control the apneas, although they only measured that for a few minutes..whatever...I will have to see if I have that IPR feature. I am hoping next week to get an auto/bipap or whatever (still not well versed in this) but my ENT surgeon who did my nasal surgery just prior to starting cpap wants to see if the sleep lab will show if the surgery has helped at all. I have gone full circle and actually went back to the mirage quattro. I slept okay with it, last nite, but had an awful time getting to sleep. Once I did, I was okay, but it weighs on my face and my poor nose bridge area looks like I've been beaten..okay, exaggerating..haha...and you are the first to agree with me that the obstruction in my case is the fact I breathe too slow and this air fills up in my mouth. I might not have stated that correctly, but no obstruction can be seen, but there is a problem, I do know that. Now if I could just get to use a Swift FX or something, I would be happy. But until this chipmunk stuff stops, no way...thank you again, you've been very helpful to me.

Heather Dent said:

Hi Cheryl
I am a mouth breather too. I had the very same problem with the Liberty.....mouth relaxes and hangs open and causes the seal to break because the mask part is very small (covering mouth only) and lips are closer to edge of mask pillow. It is virtually only a mouth face mask with pillows above. I also found that after one week the pillows started to make my nostrils chapped (even though I had on board humidifier set high enough).. After about 2 to 3 weeks the cushion of the mask has stretched badly (due to "jaw drop") and leaking gets progressively worse, that you need a new cushion. That isn't sustainable. But if you like the smaller, less obtrusive features of this mask, DeVilbiss makes one called a "hybrid" (HYB 8500) that is almost identical, except that they were smart enough to design it with a little chin holder/flap at the bottom, to prevent the "jaw drop" of mouth breathers. It also has awesome headgear straps (5 points of adjustability) I'm not sure if DeVilbiss is the manufacturer or the distributor, but you can investigate it online at hybridmask.com I already had purchased a Quattro mask (when I bought my cpap machine) discovered this information, but I kept the info as I intend to eventually order one.

And YES, you are right about breathing too slow........it does have the effect of causing the "chipmunk syndorme" (puffy cheeks due to air collecting) in the mask, which results in periodic leaks from the pressure of collected air in mask. That might still happen with the hybrid, I'm not sure. I use the Quattro full face mask and when I ran into the same problem (caused by my slow rate of breathing), I adjusted the EPR (Expiratory Pressure Relief) and also the IPR (Inhalation pressure relief) on my CPAP machine, until I got it to stop altogether. Just tweaking those things eradicated the problem completely. I think that will work with other masks. But only if you have one of the Resmed S8 Series machines or better, because Resmed is the manufacturer who patented these features. I know nothing about Respironics.......whether they have the equivalent or not ? Truth be told, shallow breathers and slow breathers need those features and even then you have to experiment with them. (By the way this does not change your prescribed pressure derived from your titration study.) The Resmed "AutoSet - Advantage is an S8 Seriens machine that is both CPAP and APAP, and the APAP is better at solving the problem without al the tweaking. But that's not what my sleep doc prescribed......it's Canada and he is trying to save the gov't health are some money!

If you go on the Resmed.com website you can read how those features work.
That's about all I have to share....hope the above is helpful.
Heather

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Permalink Reply by dr. martin bassiur on July 11, 2010 at 9:35pm

I have many patients who use oral appliance therapy with nasal pillows- the appliance maintains a lip-seal throughout the night and improves O2 %s - there are certain appliances that can also be attached to the airway tubing. The appliance is also useful with full face masks as there are some patients who cannot tolerate CPAP throughout the night and often remove the mask- having the oral appliance in place still provides significant benefits for patients with high AHI values.

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Permalink Reply by Ron Cheney on July 12, 2010 at 1:27pm

Cheryl, I don't have any kind of batery, but I do beleave that Respronics does sell some kind of battery system for there line. Good Luck on your sleep study. SHUT YOUR MOUTH. lol

cheryl said:

Well that is what I think is happening, though my pressure is low, an 8, I still think the constant flow builds up. I would love to use the swift FX and I believe I am being tested with a bipap or some other type of cpap. And it's interesting that now you are doing so well. You have given me some hope that I may be on the right track moving on to another sleep study and the bipap or auto, whichever one the ENT has prescribed for the test. Also, do you have a portable battery for your system? I may be travelling with my folks next month and may need to get one..I have heard from my med supply that for my cpap, I can get a marine battery 12 volt at Costco and the other particulars at Radio Shack for very cheap..just wonder if yours has one...thanks for your input

cheryl said:

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.

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Permalink Reply by Mary on July 12, 2010 at 10:10pm

OK first off, its not true that if you have a full face mask then you do not have to worry about keeping your mouth shut, I am using a respironics bipap and am still having hypopnic episides as well as apneid episodes. So got the pressure cranked again. I am now at 18/14. Using my mrage quatro mask I have a good seal until I fall asleep and my mouth opens.. .not just falls open but opens wide enough to break the seal.I have tried tightening the straps before I go to bed to the point where they are almost digging and still I open my mouth.My cheekbones are high and full, so the dropping of my jaw during sleep chnages the side contours and the mask no longer fits on my cheeks. I did not have this problem unitl this last change in pressure. So now, instead of waking up every few minutes gasping for air, I am waking up adjust my straps.

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