Posted by cjm36 on May 28, 2003 at 12:53:26:

In Reply to: Mouth Leaks posted by bbm300m on May 28, 2003 at 08:36:08:

Hi. I hope your first call was to your equipment provider (DME) and your doctor to mention these problems. They are your first line of defense and help with these problems. Of course, you have this friendly neighborhood to fall back on for advice and information. I hope what I'm about to suggest to you will be of some help.

This sounds like a classic case of the patient not getting the right equipment. A little background on why this is: all of us CPAP users have been to the sleep lab once or twice. We usually go once to get diagnosed and then a second time to get "titrated" or in other words to get our optimal pressure discovered.

If you have been given a straight CPAP machine with the pressure set at 15cm, this means that your optimal pressure was discovered to be 15 during your titration study. However, this does not mean that your body needs 15cm/h20 of air pressure coming at you every minute of the evening. This means that 15cm will safely cover all your apnea events when they do happen throughout the evening. There are some patient cases where a person needs this pressure all the time, but don’t focus on that right now.

What I’m talking about is there's a better technology called an Auto-CPAP machine. An auto CPAP machine will respond to your events when needed, but then reduce the pressure for those periods when you're breathing better. It effectively has a lower pressure for the whole evening. But, auto machines are not routinely given out to new patients because insurance companies consider them a luxury.

Enter you as a unique patient, as we all are. You are reporting to us that you experience mouth leaks and a dry sore throat to boot. The dry sore throat is coming from a leak between your soft palate and your tongue base. The air is escaping out your mouth and drying it out. It would seem to me that this problem could be helped a bit by lower pressure throughout the evening, hence the auto-CPAP machine. Ask your provider and your doctor if you can get a trail with an auto-CPAP machine.

A little more on this mouth leak problem: You may not be able to solve this problem completely, but there is hope to make it much better! You've got to get a trial on a different type of FF mask. Full Face masks are the response to mouth leaks. RedMed masks a very good FF mask called the series II. It comes in different sizes. If you get a professional fitting for the size that you need, I'll bet you'll be able to wear this mask and sleep on your side. The head gear and mask design are very good.

You may also need to turn up the heated humidifier a notch to help the mouth breathing. This will help with the seal between the soft palate and the tongue base. Under no circumstances should you go to extreme measures such as taping your mouth shut to solve the leak problem. Some people do this but it is a very dangerous practice.

Chin straps don't help a lot of people. It was worth a try though. You'd be almost better off if you could try some exercises when you're awake. Try focusing your thoughts on your soft palate and tongue and exercise those muscles. I know this sounds weird, but it helps some people.

In summary, ask your service provider for a ResMed FF series 2 mask with headgear. Also ask for a trial period with an auto-CPAP machine, preferable one with a built-in humidifier, and, set that humidifier up as high as it can be set without getting overwhelming condensation in the hose and mask. Those are my suggestions. Complain loudly until they get this problem solved for you.

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