Mouth Breathing, Chinstraps, and PAP Therapy Responses
Posted on December 4, 2007 by Dr. Krakow |Day in and day out, it is remarkable how many sleep apnea patients never achieve an optimal clinical response due to mouth breathing. The problem starts with the fact that so many people believe that mouth breathing is somehow normal and the problem ends with the fact that so many people are reluctant to use chinstraps. I went almost two years on an APAP device, imagining I was getting a fairly good response until I tried a chinstrap. Then, “all of a sudden,” I began waking up in the morning without a dry mouth and realized what I had been missing.
I too was one of those individuals that just couldn’t imagine putting yet another contraption around my face or head, yet once I effectively placed the chinstrap and obtained a much better clinical response, I was very grateful that so many different styles of chinstraps were on the market.
The biggest barrier to the use of the chinstrap, I believe, is psychological comfort, because when you first use one, it really feels confining. But, I think this physical sensation actually translates into a psychological feeling of discomfort, which is the more difficult sensation to overcome.
Currently, I use the Respironics Premium Chinstrap, which I personally believe is the best on the market for two reasons. First, it uses a behind the head strap to leverage the chinstrap in a snug but not too tight manner. Second, because of this design, the chinstrap component that goes under the chin and up over the head actually exerts force in a vertical fashion to pull the chin up. Whereas, you can find many chinstraps that are designed in a more compact way, these straps exert force on the chin in two directions, up and backward. This backward force occurs because the chinstrap imaterial runs in a diagonal from the chin towards the top portion of the back of the head. You can actually feel that it’s tugging your jaw backwards, which theoretically could worsen your breathing.
In sum, never sell short the potential value of a chinstrap in your efforts to achieve a great response to PAP therapy. If you awaken in the morning with a dry mouth, chances are high you need one.
I am about 2/3 of the way through your book “Sound Sleep Sound Mind”. It is fascinating because I’ve discovered much of what you say about physical issues by myself prior to reading the book.
I’ve used Breathe Right strips most nights for the past couple of years.
I don’t know what a “chin strap” is, but for the last couple of months I’ve had some improvement to dry mouth by simply taping a 6″ piece of Johnson & Johnson 2″ wide medical adhesive tape over my mouth each night when I go to bed. I fold over approx. 3/8″ on each end for ease of rapid removal. It’s sticky enough that it can be re-applied multiple times if you need to take a sip of water, sneeze, yawn, etc.
Unfortunately, for me this is not a 100% answer to dry mouth. Even during the day and breathing through my nose, I do not feel that my nasal passages sufficiently moisten my inspired air. It’s me, not the humidity, because I live in Redondo Beach CA, just a couple of miles from the ocean, and the humidity generally runs approx. 50%.
I’m convinced that dry mouth is the root cause of significantly increased tooth decay in recent years. Even using Water Pik, floss, and brush three times a day has not stopped the tooth decay.
My greatly improved diet (http://drfuhrman.com/) over the past five years has nearly eliminated my allergies, so I no longer use Nasalcrom or perilla extract. And I had a deviated septum repaired over 20 years ago (I’m now 54). But I’m still looking for more complete answers.
–Bruce