I had this problem -- you described it exactly. It happened for a while and then just stopped. I think it was part of adjusting to the CPAP. Because I was having trouble opening my mouth I started taping. For a while the air escape continued to happen (cheeks puff out and air finds a way out) but eventually it stopped. I sleep perfectly now. I still tape but I'm extremely comfortable with it.
FYI, I described this initially to my doctor and he thought it might just be part of the adjustment. He did prescribe another mask, not full face, but I never ended up using it and I have stayed with the nasal pillow.
Some report success with keeping their tongue at the top of their mouth with it behind their teeth. Did not work for me though. I now use mouth taping.
Since I started this thread I have also begun mouth taping. My wife is happier because there is no longer the sound of air escaping my mouth. The number of "events" recorded by my machine has gone done, although I'm not sure that means anything.
I started taping and it has helped some, but once I'm deeply asleep and relaxed, my mouth still drops on the inside and the tongue with it blocking my breathing. I'm wondering what else I can try. I'm thinking of some type of oral appliance along with the CPAP that will not allow my lower teeth to fall and that will also keep my tongue from falling back. There are so many! I tried a TapPap nasal pillows but it only has the upper tray so my lower jaw would still fall and allow air to escape. Has anyone had success with an appliance that will keep your mouth closed, not allow you to breathe through your mouth, and keep your tongue in place - either with or without the CPAP nasal or nasal pillows mask? Thanks.
My understanding is that these oral appliances move the teeth and need frequent adjustments to help the teeth stay reasonably in the same place. What about a small full face mask so that your mouth is the same pressure as the nasal passages? They make some smaller ones that look pretty nice. Just a bit expensive.
Generally if your jaw drops open air pressure from the CPAP will force the lips open and cause a mouth leak. Probably the most direct solution to try is a chin strap. I found that many do not work, or were uncomfortable. The best one I used was the Breathewear Halo. In addition to helping keep the mouth closed it can also keep the mask straps in place. However, to be fair, it does introduce some additional level of discomfort. I used it for a while but found I still needed mouth taping. I eventually went to two layers of mouth tape and abandoned the chin strap. The first layer was 3M Micropore tape 25 mm wide. I then cover this with a larger 60 mm x 100 mm piece of Mefix tape. What I found was that the Mefix tape was flexible and stayed well attached, but it was not as moisture resistant as the 3M Micropore. For that reason I use the 3M to seal my lips, and the larger layer of Mefix to give it a bit more strength. I fold the edge of each layer over a bit so there is an easy way to remove it. This has allowed me to abandon the chinstrap. But the combination of chinstrap and tape does give the lowest leakage rates. I gave that up for additional comfort. For the most part I stay under the leak redline.
As far as your concern about the tongue falling back and blocking the airway, that is the basic purpose of using a CPAP. The air pressure is intended to keep the airway open. Air pressure stays in place while you are inhaling and exhaling, especially if you avoid use of the EPR or Flex features on the CPAP.
I am a dentist working in dental sleep medicine. At this very moment, I am in the process of developing TAPPAP nasal pillows with an intraoral mouth shield for Airway Management. This seals the mouth from the inside and prevents mouth leakage. I actually have about five products that could help you with your problem. My contact information can be found at www.naplescenterdentalsleepmedicine.com. Solving this problem is a piece of cake with our new line of products. Arthur B. Luisi, Jr,, D.M.D.
Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person
With OSCAR look at your Leak Rate graph where it is shaded (large leak/ LL), flat tops on this graph suggest mouth breathing. In OSCAR right click on the left header of the Leak Rate graph and click on Dotted Lines then select "Leak Rate Upper Threshold" to get a line across the graph for ResMed. Manually set the value for Philips Respironics. Severity depends on how much over this threshold and for how long it is in the Large Leak territory.
How to manage Mouth Breathing, not in any particular order.
Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.
Cervical Collar. A "soft" Cervical Collar (Releaf is popular). This helps support and align the neck and keeps the jaw/mouth from dropping. This is becoming a very popular option. Rarely used prior to mid 2016. Users are posting a high success rate with this device. When OA tends to occur in clusters at different times of night. It's an indication that an obstruction may have occurred when the chin tucks towards the chest. It's common, and the solution is either an ergonomic pillow or soft cervical collar that prevents the neck and head from being out of alignment and cutting off the airway, but they can be comfortable, prevent leaks and prevent an airway from closing up due to tucking your chin to chest and other issues. An Anti-Snoring collar, which has a small strap in back (Dr. Dakota is popular)
It's a very small investment that has worked very well for some people. More pressure may solve the obstruction, or it might go away with positional therapy.
Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw-dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to. There is one chinstrap that is notably different than others, the Ultimate Chinstrap, Search for it if you desire.
Ergonomic Pillow or CPAP Pillow, The purpose is to maintain a proper head and neck alignment while allowing for the mask maintaining the seal in multiple positions.
Mouth Guard The concept here is a closed mouth guard to keep the air from leaking out.
Taping. Definitely the most controversial. The purpose of taping is to seal the lips and prevent mouth leaks/mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth when taped, if I need to.
FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.
Dry mouth is a symptom mouth breathing that is uncomfortable. It can and does occur with some users of a Full Face Mask.
Many users use a product called Biotene to get relief from this symptom.