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I wake up choking, severe dry mouth...Please help.
Ok folks what is going on with me. Please help.
I am on my 6th week of APAP. I am jolted awake after about 2 hours feeling like I am being choked, I can't breath, my mouth is so dry, it is stuck shut. I grab my water and swish it around my mouth, put my mask back on and try again.
I have the humidifier set on 2. I have a ResMed AutoSet II, it is set on 11. I am using the F&P Opus 360 nasal pillows mask.
Thanks,
Donna
I am on my 6th week of APAP. I am jolted awake after about 2 hours feeling like I am being choked, I can't breath, my mouth is so dry, it is stuck shut. I grab my water and swish it around my mouth, put my mask back on and try again.
I have the humidifier set on 2. I have a ResMed AutoSet II, it is set on 11. I am using the F&P Opus 360 nasal pillows mask.
Thanks,
Donna
Views: 1958
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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It sounds like an oral leak to me. You might try raising your humidity.
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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on
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Rock, why would a mouth leak be a humidification problem please? My first thought was perhaps a full face mask might be in order. I'm not trying to be clever about this, I'm asking, as I get asked these types of questions all the time myself. I truly appreciate the time you give on this forum :)
Rock Hinkle said:It sounds like an oral leak to me. You might try raising your humidity.
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Permalink Reply by Donna B. on
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Could my difficulties be caused by a leak in the nasal mask? It fits properly when I put it on but what about while I am sleeping? I have no idea how many times I turn over during sleep, I just know that it scares me something awful to wake up choking !
Kath Hope www.hope2Sleep.co.uk said:Rock, why would a mouth leak be a humidification problem please? My first thought was perhaps a full face mask might be in order. I'm not trying to be clever about this, I'm asking, as I get asked these types of questions all the time myself. I truly appreciate the time you give on this forum :)
Rock Hinkle said:It sounds like an oral leak to me. You might try raising your humidity.
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Donna, please please try not to panic. I did my share of panicking at the beginning of my treatment. Rock will be back soon with some advice, and in the meantime (or someone else), but if you have to go to bed beforehand, just take your mask off if the inevitable happens, give yourself a few minutes to calm down, then try again. It does get better with time, but hopefully, there'll be an easy answer to your problem (such as humidification or wrong mask). Must get to bed now - it's 1.45 am here, but hope you get peace tonight.
Donna B. said:Could my difficulties be caused by a leak in the nasal mask? It fits properly when I put it on but what about while I am sleeping? I have no idea how many times I turn over during sleep, I just know that it scares me something awful to wake up choking !
Kath Hope www.hope2Sleep.co.uk said:Rock, why would a mouth leak be a humidification problem please? My first thought was perhaps a full face mask might be in order. I'm not trying to be clever about this, I'm asking, as I get asked these types of questions all the time myself. I truly appreciate the time you give on this forum :)
Rock Hinkle said:It sounds like an oral leak to me. You might try raising your humidity.
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Thank you Kath. It is 9pm here and I too am ready for bed. I did not nap today, even with the time change. I am making some progress :)
Kath Hope www.hope2Sleep.co.uk said:Donna, please please try not to panic. I did my share of panicking at the beginning of my treatment. Rock will be back soon with some advice, and in the meantime (or someone else), but if you have to go to bed beforehand, just take your mask off if the inevitable happens, give yourself a few minutes to calm down, then try again. It does get better with time, but hopefully, there'll be an easy answer to your problem (such as humidification or wrong mask). Must get to bed now - it's 1.45 am here, but hope you get peace tonight.
Donna B. said:Could my difficulties be caused by a leak in the nasal mask? It fits properly when I put it on but what about while I am sleeping? I have no idea how many times I turn over during sleep, I just know that it scares me something awful to wake up choking !
Kath Hope www.hope2Sleep.co.uk said:Rock, why would a mouth leak be a humidification problem please? My first thought was perhaps a full face mask might be in order. I'm not trying to be clever about this, I'm asking, as I get asked these types of questions all the time myself. I truly appreciate the time you give on this forum :)
Rock Hinkle said:It sounds like an oral leak to me. You might try raising your humidity.
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I am not sure the exact physics, or science behind it. What I have been told is it's all about creating a vacuum with a nasal mask. Humidiy can help this process. In the lab when we see an oral leak the first thing we do is raise the humidity. We always start with the humidity at 1 or 2. This is part of the process in finding the optimum settings. When I use a nasal mask my humidity must be at 3 or my mouth opens. I would suggeast raising your humidity first. If this does not work you may want to try a chin strap. the last resort, in my opinion, would be to switch to a full face mask. Most opf the time in my experience raising the humidity will fix an oral leak.
I will try to get you a better explanation as soon as I can.
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Ok Rock, I raised the humidity level to 3 last night, made sure the tank was full and off to bed I went. Again, woke up 2 hours later choking. I noticed that I was drooling excessively, my mouth would not stay closed and my mask was whistling. Ok, so I checked for a leak which seemed to be coming from my left nostril, I adjusted it and it went away. As soon as a rolled onto my side it came back ! I spent the next half hour trying to stop it from singing me a tune and finally gave up and went to sleep.
I called my DME guy Joe, I'm going Wednesday for a replacement mask of some sort, I can't go thru this every night ! I told him my tale of woe and he said, ok c'mon in and we'll take a look at the mask.
I still would appreciate your opinion and insight on just having a nasal mask as apposed to a full face mask.
I will give it another go tonight, just wish I could get a full night's sleep, UGH.
Thanks, Donna
Rock Hinkle said:I am not sure the exact physics, or science behind it. What I have been told is it's all about creating a vacuum with a nasal mask. Humidiy can help this process. In the lab when we see an oral leak the first thing we do is raise the humidity. We always start with the humidity at 1 or 2. This is part of the process in finding the optimum settings. When I use a nasal mask my humidity must be at 3 or my mouth opens. I would suggeast raising your humidity first. If this does not work you may want to try a chin strap. the last resort, in my opinion, would be to switch to a full face mask. Most opf the time in my experience raising the humidity will fix an oral leak.
I will try to get you a better explanation as soon as I can.
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Permalink Reply by Mike Burns on
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It sounds like your mouth is opening during sleep so adjusting the humidifier may help [ 3-4 ] .what I teach my patients is to put the mask on with the cpap running for 1hr before bed watching tv in bed and no talking during this time the go to sleep that teaches the brain to keep the mouth closed this could take a few days buy it works. Or go to cpap.com and buy a chin strap call red ruby. Mike b RCP, psgt
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Oddly, that's the exact same thing that would wake me out of bed 5 times a night before I received my first CPAP thirteen years ago. I"m wondering if something isn't wrong with the setting, fitting, etc, or maybe there are issues with APAP different from CPAP?
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Permalink Reply by Neal Buckner, LRCP on
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Donna,
In regards to why increasing the humidification will reduce the mouth breathing. The nasopharynx is responsible for humidifying the air we breath in. By the time the inhaled air gets to the back of our throats it should be darn near 100% humidified. If the air coming into the nose is too dry the mucus membranes respond by producing more mucus to humidfy the air. In order to do that the blood vessels in our nose engorge to provide as much blood as possible to create the needed secretions. The end result is swollen mucus membranes causing the nasopharynx to swell shut. This will cause folks to open their mouth to breath due to the reduced air flow through your nose. When you open your mouth the air flows right through and out your mouth and causes the sore dry mouth. By increasing the humidification coming from the CPAP machine you reduce the chance of excesive drying and swelling in the nose. The upper airway loves warm moist air.
In regards to the mask fit. Nasal pillows tend to dry things out more so than a nasal mask. Reason: When we exhale we also exhale humid air. With nasal pillows there is little dead space for you to rebreath that warm moist air. With a regular nasal mask there is surface area and dead space for exhaled moisture to hang out and be rebreathed.
Personally, I'm not a big fan of the Opus Nasal pillow system. For newbies I tend to set them up with a nasal mask like the Activa LT with action cell cushion. It allows the frame to move independantly from the cushion and provides an excellent seal even when laying on your side. Plus, the rebreathing of exhaled humidification reduces the irritation of the mucus membranes. Especially for those who just start. There is an acclimation period that needs to take place. Right now you are experiencing hyperrhinorea do to the airflow irritation. The drooling and nasal congestion is in response to dry air. I don't like full face masks either. The area that needs to be sealed lends to increase leaks and sleep disturbances.
Try a nasal mask until you get good and comfortable with using CPAP. Then try the nasal pillows when your are due for another mask.
Neal
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Hello, most of the time mouth leakage is caused from the difficulty of tolerating the air pressure itself. It usually causes dryness, irritation and congestion. And this is what triggers the mouth to open while asleep. But, sometimes the mouth will open at night due to just facial relaxation. the first question that should be asked, is do you also notice any nasal or sinus irritation in addition to the mouth dryness. If so, then Increasing the humidifier each night until the dryness stops is the correct first step. This would help reduce the irritation and poss stop the mouth leakage. If there is no irritation or congestion, then poss a chin strap will help control the mouth leakage. If the humidifier is at the max setting and you are still getting the dry mouth, then you will need to consider a full face mask. If this is a tolerance issue ( irritation and congestion ) and the humidifier helps but doesn't stop the issue completely, then you can discuss with your Physician about poss help with a prescription nasal spray.
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