I've been using various masks since I started BiPAP in August 2007, but all have been either full face masks or Hybrid & Liberty masks.  One way or another, there has always been a mask, or part of a mask, covering my big yapper.  I have always thought that I was a mouth-breather, but never really sure.

I've heard several people who use nasal or pillows masks say that the pressure of the air from the xPAP machine is what keeps their mouth closed.  When I heard that, I thought that sounded like hogwash.  But I asked about it at an A.W.A.K.E. meeting, and sure enough, the clinician said it's common.

I just received two nasal pillows masks: Mirage Swift 2, and Comfort Lite 2.  Last night, I slept with the Swift, the first time I've ever tried either a nasal or pillows type mask.  Before falling asleep, I felt like there was a natural tendency for my mouth and throat to remain closed.  At one point, I intentionally made my throat open, and a gale force of air came rushing out of my mouth.  But I had to work at opening my throat.

My wife says she didn't hear a peep out of me all night.  Trust me; if she had heard the kind of noise that I made when I opened my throat, she would have shoved both of our cats into my mouth!

I have yet to try the Comfort Lite 2.  But I must say I am mighty impressed with the Swift.  Small, light, comfy, unobtrusive, and the pillows sealed MUCH better than the pillows on my Hybrid and Liberty masks.

So I'd like to hear from you experienced nasal folks.  Have you heard of the phenomenon I describe above, about the pressure keeping your mouth/throat shut?  It seems to have worked one night so far; can I expect it to work every night?  I bought a chin strap, but didn't use it.  That will be my next step if this phenomenon doesn't work out.

By the way, I woke up at one point last night with a very dry mouth.  But I'm positive I wasn't mouth breathing.  Perhaps my mouth opened but my throat stayed shut?  Would that dry out one's mouth?

Can't call myself an expert, but have been using the nasal pillows, for the most part, the two months I have been on CPAP.  I find that the pressure keeps my mouth closed as well.  My tongue gets held up to the roof of my mouth and I have to work to get my mouth opened.  My wife says that I am not snoring as well.  

The issue I have is allergies.  When my nose clogs with the pillows, there comes a point when there isn't enough pressure to keep my mouth closed and I start mouth breathing.  Good to know that I won't suffocate while using the pillows.

Can't say that I have found a mask that works full face for me, but I will keep trying.

Good luck with the pillows, I have found them to be the best match for me to date.

I transitioned from FF to nasal pillows recently, and my experience was the same as yours. My mouth stays closed, and it's actually difficult to open it when I've experimented. However, a lot of chin straps are sold so this IS an issue for some folk.

Dry mouth can happen for a lot of reasons, and doesn't necessarily mean you're opening your mouth.


_________________
RemStar Plus w/C-Flex. New Breeze nasal pillow mask. Pressure: 9.

Thanks for responding.  It would seem that this mouth-closing from the pressure phenomenon is very real, at least for some people.  And it's good to know that the mouth can become dry for reasons other than breathing through it.

Jeff, when I was on straight CPAP (M Pro) my mouth would open, thus the wind tunnel sound would awaken me.  My doc switched me to a BiPAP within the same month of getting my CPAP, saying it would take care of my mouth breathing.  It did for a couple of weeks, then I started mouth breathing again.  Once I started using a Tiara Ruby chinstrap all has been wonderful.  FYI, I never once experienced the throat closing/tongue in roof effect.

ed: corrected chinstrap name



Last edited by lking on Sat May 03, 2008 8:27 pm; edited 1 time in total
_________________
OSA Sleep Test 8/29/07, AHI 64/Sat. 74%
Titrated 10/1/07 and 9/30/08
BiPAP Auto M Series w/Humidifier 15/10cm
OptiLife Mask; Ruby chinstrap


CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

jla930,
I have been using my resmed s8 for almost a year now and I have stuck with the Swift II, I have often wondered how my mouth stays shut now, even when I have snored for the last 10 years, at least that is what my wife says...just kidding honey.  I have been happy with the Swift II, with minimal complaints until I came across the Bravo website, this nasel pillow mask looked very similar to the Swift, but I feel that it has several better qualitys compared to the Swift II. I have a post that explains the differences between the 2 masks (in my opinion).  I am happy with the switch.  

Greg

I had to use FF masks (the Mirage Ultra, then the Quattro) when my pressure was at 7 because I couldn't stop mouth leaking....now that I've been retitrated up to 13 (!) I've found that I can suddenly consider nasal pillow masks again, since my tongue ends up "glued" to the roof of my mouth from the increased pressure (I still don't have a perfect lip seal, but the tongue seems to create an acceptable seal on its own).  

Now if I can just find the right nasal pillow mask....the Swift (original) I pulled out of storage leaves much to be desired and am trying to figure out what to try next (I pay out of pocket for masks).

mellabella wrote:

I had to use FF masks (the Mirage Ultra, then the Quattro) when my pressure was at 7 because I couldn't stop mouth leaking....now that I've been retitrated up to 13 (!) I've found that I can suddenly consider nasal pillow masks again, since my tongue ends up "glued" to the roof of my mouth from the increased pressure (I still don't have a perfect lip seal, but the tongue seems to create an acceptable seal on its own).  

Now if I can just find the right nasal pillow mask....the Swift (original) I pulled out of storage leaves much to be desired and am trying to figure out what to try next (I pay out of pocket for masks).

Mellabella,
I have used the swift II for about a year now, I have been told that the swift II has many improvements from the origional swift nasel mask.  I have since switched to the Bravo nasel mask, and I like it a little better, you can read my comparison between the two in the mask forums.  When I called the Bravo company, the cost was only about $80 if I ordered it directly, although they charged my sleep center $140 when they ordered it for me, at any rate my insurance paid for 90% so it did not matter to me.

@jla930

A typical titration starts off with Swift nasal pillows or other nasal mask, as some people are less claustrophobic starting CPAP therapy with these.  The tech generally switches to full face only if mouth breathing is evidenced or other reason why nasal mask is not suitable (such as not being able to breathe well through one's nose).

So, how did you come to using a FFM in the first place?  Were you not started on nasal mask therapy?

Blessings,
--pseudonym

For what it's worth.  I use the nasal pillows and I can open my mouth with no air leak through my throat until I speak and then the air dam breaks and air starts flowing freely.  Seems to be more to do with the back of my throat than my tongue, but I'm not a doctor, so I dunno.

I had to go to a Liberty from a Mirage because I couldn't keep my mouth closed.  I had an industrial strength chin strap and managed to inflame my TMJ. javascript:emoticon('')   I really loved the Mirage.  My pressure is a 10.  Even with the liberty I can open my mouth.  The Hybrid can keep closed as long as my nose is clear.  A little blockage and the mouth goes open.

Cornhusker wrote:

mellabella wrote:

I had to use FF masks (the Mirage Ultra, then the Quattro) when my pressure was at 7 because I couldn't stop mouth leaking....now that I've been retitrated up to 13 (!) I've found that I can suddenly consider nasal pillow masks again, since my tongue ends up "glued" to the roof of my mouth from the increased pressure (I still don't have a perfect lip seal, but the tongue seems to create an acceptable seal on its own).  

Now if I can just find the right nasal pillow mask....the Swift (original) I pulled out of storage leaves much to be desired and am trying to figure out what to try next (I pay out of pocket for masks).

Mellabella,
I have used the swift II for about a year now, I have been told that the swift II has many improvements from the origional swift nasel mask.  I have since switched to the Bravo nasel mask, and I like it a little better, you can read my comparison between the two in the mask forums.  When I called the Bravo company, the cost was only about $80 if I ordered it directly, although they charged my sleep center $140 when they ordered it for me, at any rate my insurance paid for 90% so it did not matter to me.

Thanks for the heads up...I will definitely dig up your posts on the Bravo.  Also, there is a Swift III (though they are calling it the Swift LT) coming out on May 30th that is supposed to be a further improvement on the first two models....am looking forward to hearing user experiences with that as well.

pseudonym wrote:

@jla930

A typical titration starts off with Swift nasal pillows or other nasal mask, as some people are less claustrophobic starting CPAP therapy with these.  The tech generally switches to full face only if mouth breathing is evidenced or other reason why nasal mask is not suitable (such as not being able to breathe well through one's nose).

So, how did you come to using a FFM in the first place?  Were you not started on nasal mask therapy?

Blessings,
--pseudonym

Pseudonym,

Sorry I didn't reply sooner; I haven't been logged on lately.

At the titration, before we began, the sleep tech seemed to think there was some evidence of mouth breathing from the original sleep study.  But he did offer to start the titration with a nasal or pillows mask.  At the time, I felt is safer to go right to a full face mask.  I didn't even try nasal or pillows at the time.  I regret that now.

As for the mouth breathing in the original sleep study, I'm not sure how this can be determined.  The question I have is this: if snoring is a by-product of apnea, and one snores through the mouth, does this in itself constitute mouth breathing?

Snoring is not necessarily a by-product of apnea.  Some people snore without apnea; others have apnea without snoring.  With OSA both seem to occur together fairly often, but snoring itself is not a reliable measure.  

Mouth-breathing may or may not produce snoring.  It compromises your CPAP therapy with nasal mask, however, so needs to be addressed.

If you snored during the Dx study, yes this is a good indicator you mouth-breathe.  Air passing by tissues is what causes the sound.  The tech will probably have noted that the sensors around your throat picked up something that could be attributed to snoring, then the tech may have turned on the camera to have a look at you and confirm the sensor reading.

Some people mouth-breathe all throughout their sleep cycle, some only at deep and/or rem sleep portions, some only in the last few hours of the night, and some only in certain positions (supine being common).  

Mouth-breathing is not the only cause of loss of nasal CPAP therapy effectiveness.  I do not mouth-breathe.  The air slips around my teeth and flutters out from under my lips.  My teeth are together.  So no chin strap alone is going to help this.  Some people with this issue find success with poligrip strips or gel to 'seal' their lips together.  (You can get your lips apart in a hurry if needed, just rewet and stick back together.)  Others tape their lips with a skin-friendly wound tape, if poligrip is not strong enough.  (Always leave ends long and fold over to make 'pull tabs' so the tape can be removed quickly.)   Either of these 'tricks' should be used in conjunction with a chin strap as a jaw relaxing and falling open will tug on the lips.

I went with a full face mask as my solution, as I find chin straps and poligrip disturbing.  YMMV of course.

Bottom line: Keep your CPAP therapy as effective as you possibly can.  You may wish to try chin strap and lip sealing as an alternative to FFM.  

Blessings,
--pseudonym