One of the best things you can do is during the day to wear the mask at or above the pressure it adjusts to during the night. While wearing the mask at pressure, adjust it so that leak is minimized. Ideally, do this in a bed while in different sleeping positions to see if that matters or not. Then remove the mask while keeping the headgear the same . . . what this allows you to then do at night is simply put the mask and headgear on without having to readjust the straps, because they should be at the proper length to minimize mask leak. Hope this helps.
I have an older Res Med machine that a friend gave me. My nurse who is a sleep specialist set the RAMP and when I went back in to get her to adjust the mask, she said she couldn’t put it higher then because of the RAMP setting. Mask doesn’t leak at low pressure, but still blows raspberries at 9-10. I’ve an appointment with the sleep doctor on Tuesday to get prescription for new CPAP machine and mask.
I’m wondering whether a nasal mask and chin strap would work to keep my mouth closed—I don’t breathe out of it.
I have had neck problems which make sleeping on my side not a good option.
I will try to take a nap with it today and follow your suggestion which makes sense. What is considered OK in a leak?
Thanks so much for responding.
I am a dentist working in dental sleep medicine. So far, the best solution that I have found to the mouth breathing/mask leakage problem is a combination oral appliance/CPAP combination called the Tap-Pap CS. It consists of a Tap 3 oral sleep apnea appliance with a nasal pillow system mounted to it. The whole thing is held stable by the oral appliance, so that there are no external straps needed. But the really brilliant part of it is that the appliance also supports a soft, comfortable INTRA-ORAL mouth shield that seals off mouth leakage from the inside. The higher the air pressure, the tighter the mouth shield seals. Works like a charm and you can move you head in any direction while sleeping without inciting any leakage. Truly revolutionary! a.b.luisi,d.m.d.
As a Myofunctional Therapist I treat mouth breathing. As humans we are obligate nose breathers so, if we breathe through our mouth that means that there is a problem. Mouth breathing can be caused restricted lingual frenums ( the tissue under the tongue), habit created by enlarged adenoid, tonsils, polyps, etc… And even after their removal the habit can still remain and create other breathing regulation and saturation issues, commonly found in patients with Sleep Breathing Disorders. Myofunctional therapists help to retrain patients to close their mouth and start breathing through their noses again. We also provide breathing re-education to help the patient’s body optimize the oxygen activity and normalize the breathing regulation. We work alongside ENTs and allergists to make sure that we are bringing down inflammation and addressing issues like polyps or enlarged tonsils. How you breathe during the day translates into how you breathe at night. Once the person has successfully learned how to breathe through their nose again, then it will happen at night- AND their mouth will be closed. The therapy is non invasive and reminds you of what your body was meant to do–Breathe through your nose.
I hope this helps.
Hi rsmarsiliani, Indeed, your information really does help. I am aware of the good work that Myofunctional therapists are beginning to do. In essence, you are getting back to the root cause of the problem. Actually, viewed in that light, therapies like CPAP and oral appliances are really band-aids just applied over the problem that sometimes work well enough. But, we must face the fact that some patients have neither the time nor the motivation to engage in behavioral therapies and that the other methods do offer a quick fix. I think that sleep physicians, sleep dentists, and others need to take a closer look at myofunctional therapy and to make a decision as to how it can be integrated into their prototocols. Points well made. a.b.luisi,d.m.d.
Why, then, do physical trainers all insist I inhale through the nose and exhale through the mouth? I’m just curious, no challenge intended.
Thank you! Myofunctional Therapy has been around, in its infancy, since the early 1900’s. It was more formally taught in Columbia University in NYC and in Florida around the 70’s. Currently, in Europe and South America the the field is really advanced. In Brazil is taught at a PhD level. We definitely need more research, but the research that we currently have, has spearheaded other research with renowned researchers in the field of sleep medicine like Dr.Guilleminault, who has seen the benefits of Myofunctional Therapy. This therapy requires commitment and some patients decide this is the therapy for them. I work alongside dentists who treat apneic patients with Mandibular Advancement Devices and patients who wear a CPAP. We are patient centric and believe that the patient should be aware of all the options available. Collaboration and information is key- I thank you for making this point. Below are some links to articles that may be interesting.
Pediatric Obstructive Sleep Apnea and the Critical Role of Oral-Facial Growth: EvidencesMyofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis
I was into sports and I was given a couple of directions on how to breathe as well. Over breathing, hyperventilation, irregular rhythm of breathing affects your body in a negative way like, changing your pH, creating inflammatory reactions and sports performance. But check out the book Oxygen Advantage if you are into sports. It may help.
By the way Hola! Its nice to connect with you besides a sleep convention! Its nice that we are both part of your forum!
rsmarsiliani and sleepdent, welcome, and great to have you here! Great discussion. We really want to emphasize the patient-centric approaches. Part of that is providing information on all therapies, which has been challenging for our field. I was very hopeful about 7-8 years ago that our field would begin to provide personalized therapy - close look at objective testing, symptoms, behaviors and patient preferences to help decide on appropriate therapeutic regimen. Alas, we are not there yet. BUT, as we can bring voice from the patient perspective, we will be advocating for those changes. Thank you for your participation!
rsmarsiliani, I too was advised early on in my sports career to breath in through nose and out through mouth. In fact, in some early yoga practice, I was advised the same way. I read Oxygen Advantage, and in my very first workout with mouth closed and with attention to reduced breath rate (completely counterintuitive!) my heart rate stayed lower and I did not lose my breath when compared to the very same exercise regimen the week before. Very interesting stuff. I have also now attempted to nasal breath at night, but have no control of mouth breathing during sleep. I am tempted to go with duct tape solution, which just might be 1001th use for that product!
Having a problem with mouth breathing, I’ve tried both the full face mask and nasal. It seems that I have to use a chin strap for both. With the nasal mask, I have to really tighten the chin strap, only to wake up during the night with a dry mouth as a result of air still leaking, plus having a headache from a tight chin strap. The full face mask is better, and can sleep through the night, but with a beard, I have a problem with leaks and I know I’m not getting the full effects of the pressure. Other than shaving, which I would rather not do, I’m not sure where to turn.
I am a dentist working in dental sleep medicine. There is a brand new device called the TAP-PAP CS that could possibly help you. To use it you need to have your own teeth(no dentures) in reasonably good shape. It uses a TAP3 sleep apnea appliance that fits over your teeth. The appliance secures a nasal mask to your nose without the use of straps, There is a soft, comfortable intraoral seal attached to the appliance that stops leakage through the mouth from the inside of the mouth. The more air pressure there is, the better it seals. There is zero air leakage with the TAP-PAP CS no matter how much you thrash around at night. To get one, you would have to find a dental sleep medicine dentist who carries the TAP line of appliances. You would need a consultation to see if it could be used for you. Remember, I have not examined you and this generic information simply points out possible topics of conversation between you and your health care providers, It should not be used as a substitute for actual medical advice. a.b.luisi,d.m.d.
Thank you for having me as part of the forum! I look forward to reading what everyone has to say! I think this is a wonderful way to bring more information to people and for us, as professionals, to learn what’s important to people and learn about what other professionals points of views.
Yes! I have to say if I am ever stranded in a desert island I would like to have duct tape with me. You will get your mouth to close on its own at night if you are able to do so during the day. It will take time and how much time depends on how long you have been breathing through your mouth. Also, it depends whats going on with your nose, do you have sinus infections, chronic rhinitis, polyps, deviated septum, etc… Those issues have to be addressed. Some people use mouth tapping, but not with duct tape, it would be with a 3M tape, but there are contraindications.
Wow, never knew such a mask existed! Have since looked up information and watched videos on proper fitting. It sounds very promising, and have scheduled an appointment to look into it. Thank you for your suggestion.
I know that some of my bearded patients had great success with just thinning the beard out. The slight trimming stopped the leaks on the mask. Anyone have this experience?
Actually, you never knew such a mask existed because it didn’t. This is new technology. Time marches on and things get better! a.b.luisi,d.m.d.
I had the sa,e problem. Switch to a different mask. Have them try you on options and see which has minimal air leak
I just saw this article on the subject of masks and mouth breathing I thought I would share: