Posted by RenoTom on April 19, 2002 at 22:20:30:

In Reply to: Mouth Breathing Question posted by JohnK on April 18, 2002 at 07:11:06:

For some our bed partners witness the air escaping from our mouths leaving no doubt that we mouth breath. Others gather sufficient "circumstantial" evidence to dx mouth breathing. It usually is a combination of things that lead us to a mouth breathing dx, and the successful use of a chinstrap or other means of prevention providing the proof.
You offer some very good information in your post when you said ", I do however wake occassionally with mouth breathing. It is usually in the morning and only one or two times a week at most." I can read this to be two different situations which are very similar.
If you do some searchs and some reading, you will find that we sleep in 60-90 minute cycles of the 5 stages of sleep. Stages 1 & 2 are transition stages (waake to sleep), 3 & 4 are slow wave or deep sleep when we have our physiological "make overs", and stage 5 which is REM sleep for the physchological rework. It is important to understand that through the other stages we have a lot of physical activity, but during REM we go into a paralysis during which we have little physical activity other than cardiological and pulminary functions.
In the early cycles of sleep, we spend most of the time in the early sleep stages, but in later sleep cycles we gravitate towards the slow wave sleep and REM stages. We typically will have more and worse apneas during these times, and in many cases will require more pressure to prevent apneas. We also may mouth breath during these paralysis periods though we are able to control it during the rest of the night.
There have been many posts in past forums discussing waking up in the 3 to 5 AM time period with pounding heart and heavy breathing, tell tale signs of an apnea. For many the only times that these arousals occur is during the 3 to 5 AM time periods which leads to a reasonable thought that a slightly low pressure may be the answer.
I can apply the same theory to a mouth breathing conclusion. Just as the paralysis during REM allows for a more serious collapse of tissue in the airway, it can also allow the tongue or your mouth itself to fall open allowing you to mouth breath. This could be strictly an intermitent problem.
If your problem is mouth breathing, then the use of a chinstrap will enhance your CPAP therapy. Seldom would this cause discomfort or cause a set back. My personal experiece was an immediate improvement in night time comfort and sleep, and less daytime sleepiness.
If you have been having dificulty with acceptance of CPAP therapy, we can address that problem and improve your comfort with that. But if you are mouth breathing, then we should get that taken care or so that you can continue with effective CPAP therapy.
If you find that mouth breathing is a not a problem, or that you still are having a problem after mouth breathing is fixed, you may be having a pressure problem as I described. That should be addressed with your doctor as with all other potential remedies.
Hope this helps,
RenoTom

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