How to Fix Chipmunk Cheeks with CPAP and Bilevel

[@Freecpapadvice]

Chipmunk cheeks? I show you several ways to stop this from happening with CPAP or Bilevel therapy. Thank you for watching! All comments welcome. Links: 1. Have a PAP Analysis with me at: axgsleepdiagnostics.com 2. As an Amazon Associate, I earn on Qualified Purchases: amzn.to/3drPax1 Check out this videos sponsor! cpapsupplies.com/lanky-lefty-27 Use my CPAPSupplies.com (affiliate link): bit.ly/38yPlXk Use Discount Code: LEFTYSUMMER for the month of June for 25% off. Past June? You can always used LEFTY20 for 20% off. 😂 cat channel video. Really got some people heated: kzbin.info/www/bejne/rZnNgoV7hKdqd7csi=orH4N9_vkwKxiPdC Check out my new Amazon Store: www.amazon.com/shop/thelankylefty27 (or....use my Amazon affiliate link every time you shop Amazon. I earn on all qualifying Amazon Purchases using the link. Thanks!) Join this channel to get access to perks: kzbin.info/door/g_Rj5qrxlCo4OX6MMq08gQjoin

[@PleasantlyConfused6816]

Thanks Lefty! I use the cover tape and rip a layer of skin off every morning , but it works.

[@gregcarson3444]

Yes indeed, chipmunk cheeks here. For me it was a multi prong approach. 1) Mouth Taping, cover roll stretch tape 2) chinstrap 3) V-com, using the v-com, I did up my pressure, from 10 to 12. Also thanks for the codes, always buy my v-com from CPAP supplies, the extra 20% - 25% helps.

[@jimcollins1922]

Thank you for producing this video. I am tire of wearing full face masks, but when I use a nasal pillow I have been getting the chipmunk cheeks. I had heart surgery last year and my charts are crazy and I finally got the attention of my plans sleep therapy group and just finished a sleep test where I did not sleep at all. I am being scheduled for a 10 day home test with a bipap. I really want that to work. I've lso just got a an F&P solo nasal pillow which I am going to start using. I am going to make sure that my doctor is aware of the bipap settings that she can set for me or I guess I can set myself. They have me pumped up to 20 now. Anyway I was most encouraged by your video and will review it several more times before my test and notify my doctor that I will want them to try the different settings.

[@lynndemarest1902]

I use cheap surgical tape from the grocery store. Works like a charm. I like making a little folded-over handle to make it easy to remove. (I call mine Dizzy Gillespie cheeks.)

[@Justin-lf5en]

Can you make a video showing how cpap works. But this time use the vcom attached to that special machine and a balloon or water bag like you did years ago. I’m a visual learner and I’d like to see how the pressure changes with the vcom

[@Freecpapadvice]

That's an excellent idea! Love it!

[@jrlee243]

I am hoping you or someone can help me. I have been on acpap for 10 years now. I moved to another country, and I can not find a sleep specialist anywhere. My pressure, to me, seems to be a bit much. I am constantly getting blotting when I wake up. I used to get my pressure reevaluated every so often, and they wouldn't change much. But something has changed in the last 4 years of me living in the country I am in now. The only thing I can think of is I have lost weight since moving here. I don't know if that could be it or what? I dig your channel. It's been a big help to me.

[@scowell]

I use my FF mask as a big nasal... I tape my mouth... with the FF mask (Vitera) the tape does not have to hold pressure in... if my tongue falls back I don't mouth-breathe... no drool... the mask stays a lot cleaner. Also, I lick from the inside to release the CRST... it tastes like nothing... it's just medical gum... really helps release for the tender parts of the face.

[@Marigold106]

You helped me find my optimal pressure, and the V-com has eliminated my chipmunk cheeks. CPAP is much more comfortable now I also tape, but wanted to mention that cover roll tape may be too strong for some with post menopausal skin. I tried it, but my skin ripped on removal (not my lips- they had chapstick, thank goodness). I use Nexcare Strong Hold, Pain Free, Gentle Removal Tape, and it works well for me. My skin used to be tough, but that has changed with age, and should be a consideration as well in choosing tape

[@cebruthius]

2:02 Oh my lord

[@Katsem]

Thanks for the tips. Right now my doctor has control of my settings and I’m not happy with the results.

[@RyanDuffy]

I think you were the one to suggest the tongue trick. What about chipmunk cheeks with a full face mask? I can’t wear them because my mom just fills up with air pressure *edit: my mouth*

[@Marigold106]

Your poor Mom!

[@GreylanderTV]

Bleep eclipse/halo, cover-roll stretch tape and V-Com, and I still get some chipmunk cheeks. Definitely a tongue (posture?) issue. When taped (with pursed lips) my tongue gets pretty good suction holding it up against my palate and teeth, but just as I falling asleep my jaw relaxes enough that air squeeze through the corner(s) with a Donald Duck sound. It's not horrible but definitely interferes with falling asleep a few times. I'm not sure how much it happens once I'm fully asleep. I'm not 100% sure I have the right pressure yet. But I do know that when I have a "good cpap night"(6+ hours of AHI < 1) I feel significantly better the next day than when I don't use cpap or I have a bad cpap night (usually something like falling asleep before remembering to hook it up, so I put on all the tape for nothing). But even a "good cpap night" seems like my sleep is pretty fragmented.

[@brod5352]

Yes, I have had chipmunk cheeks, and my V Comm has helped in that area. It hasn't stopped it completely, but the effect is greatly reduced. I tape my mouth, using that brown tape that breathes you have mentioned in previous vids. It works best as you can sneeze with the tape on. But I still get dry mouth. Why? if my mouth is taped shut, why am I getting dry mouth?

[@catallergiccat]

Thank you Jason for another video about leaks! There seems to be another difference between easy-breathe on and off, which is the descent time. It feels much quicker when easy-breathe is off, almost like instant, whereas it feels smoother when it is on. And there is no option to change it. Also, VAuto records flow limitation whereas s-mode doesn’t. I started taping my mouth FIRMLY after my stomach felt better (due to aerophagia), and I had a few nights of recovering sleep (more REM) because of minimal mouth leaks. However, unfortunately last night my aerophagia came back again, I woke up a couple of times with bloated stomach and pain .. could you please make another video for CPAP aerophagia sufferers? I have seen many GI doctors, gone through many imagings, they either gave me pills or told me not to use CPAP, not very helpful but understandable.

[@cebruthius]

Check for nutrient deficiencies: Vitamin D (calcium goes nowhere without it), magnesium, potassium. These are all involved in nerve conduction and therefore strength of the esophageal sphincters. Correcting these deficiencies cured my aerophagia.

[@catallergiccat]

@@cebruthius I actually did the blood work suggested by my GI doctor, everything was in the normal range. My lower esophagus sphincter is loose though.

[@cebruthius]

@@catallergiccat Sometimes it pays to be skeptical of "normal ranges." E.g. at 30 my testosterone was in "normal range" but my 70 year old father had a higher level 😆

[@catallergiccat]

@@cebruthius True, and I wish it was nutrition deficiency, as it is easy to fix. I do take supplements of different kinds, but don’t really feel anything.

[@ChillDfect]

Terrible problem, wakes me up regularly.

[@anns813]

Do you have information on the ASV machine I can watch?

[@jeffc6832]

I used to always have good tongue posture for the first 10 years or so that I was on CPAP. Then something changed so I spent the next 6 years chasing different FF masks and continuously battling leaks and chipmunk cheeks. Thankfully that all changed when I took your mouth taping recommendations and went back to a nasal mask. Now I'm using the F&P Solo and really liking it, though I'm struggling with the cushion sizing a little. My nose is too wide for the medium (have always been a medium for every other mask), too short to get a perfect seal on the large, and just a hair too narrow for the wide. Leak rate is in the 14 to 18L range. Not bad but I'd like to get it lower.

[@riknbkr330]

VCOM with EPR? Just wondering if EPR needs to be disabled if using the VCOM, with tape, at known pressure +1.... Great video btw!

[@ivanvelez7668]

Hi, nice video. I came across a video of this auto cpap machine from Lowenstein medical Prisma20A. Supposed to be the quitest machine out today. Yes it is expensive at $2,000 + also heard that it way better than the resmed auto sense 10 and 11. you should do a review on the Prisma20A.

[@teddyc.newton4874]

Sure did have chipmunk cheeks, soooo I went with ResMed 20 full face Air Touch mask. My total numbers dropped dramatically. Almost never have air leaks and is without a doubt the most soft comfortable mask 😷 I have ever used! 😬 💤 🛌 💤💤💤💤💤

[@Katsem]

Both the Air Touch and Air Fit F 20 leak for me. My Bipap was set at 20 and 16. It was lowered down to Cpap level 6 so I could meet Medicare’s required use during the trial period. In essence I’ve had no therapy in 3 months. Things better improve real soon. I have an appointment next week to discuss new pressure levels.

[@ASpectacular3777]

Jason, could you address aerophagia? I never had it until I started ASV. I wonder why? Too strong pressure? I’m at the Lowest. ASV (not Auto), EPaP 4, PS 3-10. Thank you.

[@SiblingCreature]

I've experienced the chipmunk cheeks from time to time, but it's never been a persistent issue. I've found the tongue positioning technique to be really helpful with both that and avoiding mouth leaks in general. I'm not sure I agree with your use of the word swallow in describing it though, all you need to do is suck on it. (Regardless of how wrong that may sound to those of us who are still children despite our age. 😆)

[@Paul-cy9ej]

Does your tongue stay in that position, or relax once you fall asleep?

[@SiblingCreature]

@@Paul-cy9ej It normally does stay in position. The advice I read was to practice it while awake, and I've found after a while of doing so that I normally need to make a conscious decision to actually release it from that position.

[@Paul-cy9ej]

@@SiblingCreature Ok, this is giving me hope. How long did you practice while awake before you could sleep like that?

[@SiblingCreature]

@@Paul-cy9ej I don't really remember sorry... I don't recall it taking long to make a habit of it though. I hope it works for you.

[@garytillman9380]

I I use v-com on the F40 and the F20 airtouch no works perfectly no chipmunk cheeks.

[@beckmartinez5715]

So no V-com with bipap?

[@catallergiccat]

I remember in one of his videos he said he wouldn’t recommend that. But I tried for a few weeks, because I have suffered with aerophagia badly, even when using a bilevel, especially while I tape my mouth firmly. Unfortunately, I still get aerophagia.

[@cebruthius]

It makes no sense, like taking coffee and sleeping pills at the same time.

[@catallergiccat]

@@cebruthius theoretically yes, but my feeling is the air delivery is much gentler with vcom, which seems to improve aerophagia, it could be just me.

[@amypeterson7463]

I started bilevel almost a month ago. I sometimes get chipmunk cheeks, but I more often get air aphasia. Do you have any fixes for that?

[@cebruthius]

For me, the aerophagia was caused by nutrient deficiencies: Vitamin D (calcium goes nowhere without it), magnesium, potassium. These are all involved in nerve conduction and therefore strength of the esophageal sphincters. (These keep the air out of the esophagus)

[@DianeRuotsalainen-ne8cr]

Only happens to me when I start falling asleep on my back. I can sort of feel a bubble of air coming up beside my tongue. Solution is easy for me -- just turn on my side. But it's kind of interesting to lie there and feel it happeing.

[@MrHabernet]

I have an air curve 10 ASV and I get chipmunk cheeks, aerophasia (spell check) nightly. I use coverroll to tape. I have a nasal mask. What am I doing wrong? I have no ability to change the settings on my device. Just basic stuff like ramp time and tube temp.

[@maryann5573]

You can access the clinical menu on your machine by going to home: my options…push and hold both the home button and selector knob until the clinical menu shows up. Use the selector knob and push the center of the knob to affirm selections

[@bethover4hu544]

I found a good pressure and have control of my oas and cas but the flow rate curve is still choppy. What am I missing? chipmunk cheeks is gone too. cpap 8 with epr 1

[@cebruthius]

You can increase pressure first. If that doesn't resolve flow limitation, then you probably need more EPR (and a pressure correction to prevent lowering EPAP, check in OSCAR) If EPR 3 doesn't resolve everything, then you need BiPAP. I use BiPAP with PS=5, so two cm higher than maximum EPR.

[@steamwalker]

I tried V-com but found the pressure drop to be too sufficating, even with CPAP set to 20.

[@Freecpapadvice]

Your strategy would be to move to bilevel....without seeing any data to back that up!!! 😄

[@steamwalker]

@@Freecpapadvice I think you're right. It's something I plan to look into once eligible with my insurance.

[@suave-rider]

Out and proud chipmunk here thanks to the Resmed f40 🤭

[@joelow1282]

I heard that Tik tokers are taping their mouths shut . Drs are saying it’s dangerous 😂😂

[@BLenz-114]

I get chipmunk cheeks with my full face mask but I’ve actually found that it improves mask seal, so I quit fighting it.

[@stuartcrisp2027]

It is worth remembering to set Ti Min longer than Rise Time, just to ensure that the time for the pressure to rise cannot be cut short. My experience with Easy-Breathe when using EPR on an AutoSet is that the Rise Time was about 1,5 seconds, i.e. longer than maximum Rise Time on my Bi-Level. Cannot comment about Easy-Breathe on a VAuto machine though as that is not the Bi-Level that I have.

[@cebruthius]

Ti Min doesn't do what you think it does, and EPR doesn't do what you think it does. Ti_min doesn't cut short, instead it is a lower bound on the inspiration time period. If you're looking for a setting to cut things short, then you're looking at Ti_max. EPR on AutoSet does not have Rise Time, it has the "Easybreathe Sharkfin" that takes quite some time to reach the full pressure, but due to the asymptotic shape of the sharkfin it gets real close very quickly.

[@stuartcrisp2027]

@@cebruthius Agreed about Ti Min, it does not cut ramp short, but it prevents ramp being cut short if spontaneous cycle is "detected" (possibly incorrectly) sooner after trigger than the Rise Time. Agreed that AutoSet has no Rise Time setting (accessible to a user), but that "shark fin" takes time to rise (i.e. a rise time?), determined by Easy-Breathe. On my charts, that was about 1.5 seconds long and, as you say, more of a linear ramp than the first order step that the Bi-Level had with Rise Time set to 900 ms. It took a fair bit longer to "get real close". But that is just my observation from my data. I did not, and do not, claim that to be the same for everyone.

[@cps-slc]

I've had problems with chipmunk cheeks since I started CPAP 9 months ago (fixed pressure, 8cm). I am not a mouth-breather at all, so tape does nothing to help. I don't know if EPR helps or not - I can't tolerate it. I breathe more comfortably, but it gives me too many Central Apneas. The DME guy said to use a FFM to equalize the pressure between the inside and outside of my mouth. That helped, but didn't eliminate the problem. As I start to fall asleep, my jaw relaxes just enough to break the seal I created with my tongue and a little air slips through. Using a soft cervical collar helped with that problem - so the combo of FFM and SCC pretty much eliminates the problem with my current mask (F30i). A Knightsbridge dual band chin strap also works in place of the SCC, but I find it too itchy and uncomfortable. I've tried other hybrid masks that still give me the chipmunk cheeks - the F40 and F30. Maybe it's because of the QuietAir elbow on these? Maybe there's more pressure without the extra venting of air with the F30i, and it's forcing my tongue to slip? Another issue I have that may contribute to the chipmunk cheeks: I have RCP-D ("no-burp syndrome"), which apparently causes a lot of pressure in the esophagus, and which may be why so many people with RCP-D have hiatal hernias and acid reflux. I've wondered if there's a battle going on between the air in my esophagus due to the RCP-D and the air from the CPAP. I'll be having a procedure in July that will hopefully cure it, and can't wait to see if it helps with my CPAP treatment. I've considered trying a V-Com, but thought I'd wait until after that's done.

[@catallergiccat]

I just couldn’t find a balance between mouth seal and aerophagia, meaning either suffer from compromised therapy or abdominal pain, both result in arousals, especially during REM. Tried BiLevel, no luck, VCom helps a little, but still can’t tolerate optimal pressure. FFM is a total failure for me. I asked my GI if there is an operation tightens my LES, but they didn’t recommend it as my acid reflux is not that bad, and suggested me not to use CPAP .. Good luck with your up coming option and let us know.

[@cps-slc]

@@catallergiccat Thanks! I'll try to remember to update.

[@belindavanowen1990]

Did you have the procedure? What was it and how did it go?

[@cps-slc]

​ @belindavanowen1990 I did have it, but it has only been partially successful. (Botox is injected into the upper esophageal sphincter to relax it temporarily, which hopefully teaches it how to allow you to burp even when the Botox has worn off.) I've had some burping, but not as much as I should be, so it has helped somewhat with the aerophagia/bloating/pressure, but not entirely. I don't see the doctor for the followup visit for another couple of weeks, but I'm guessing I'll probably have to have a 2nd procedure. In the meantime, I only tried using CPAP once, and because the sphincter is still partially paralyzed from the Botox, it was like pumping air into a balloon - there's nothing to stop the excess air from traveling into the stomach. I'll have to wait until the Botox wears off (about another 2 months) to see if it has made a difference. But if I have the procedure again, then I'll have to wait another 3 months after that. On the positive side, I actually feel a lot better since I stopped using the CPAP (I am not sure my sleep study was very accurate).

[@belindavanowen1990]

@@cps-slc I had no idea this was a thing. Thank you for sharing

[@beltycat5490]

No problem with 🐿 cheeks

[@benrollans4144]

Stop using Resmed and get a Löwenstein machine

[@cebruthius]

Why?

[@benrollans4144]

@@cebruthius the Resmed machines are notorious for over treating and will give you typically over 2cm of water pressure than what you need. I have seen this many times. A persons anatomy can only hold so much air pressure hence the chipmunk cheeks or aerophagia. Capping the MAX pressure or utilising a fixed pressure will help this. In my experience having tried the Philips Dreamstation, F&P Sleepstyle and Resmed airsense 10 the Löwenstein Prisma device is the only device I have had that is a true automatic therapeutic algorithm that seems to treat my OSA. Over my several years of being a Respiratory Therapist and CPAP consultant I have personally not had better results out of any device but also have I never seen better results with patients. I always tell my patients to focus on how they feel versus what the machine is telling them and I have had better outcomes with the Löwenstein than any of the other manufacturers devices.

[@snospmoht3252]

It's always the tongue, isn't it? 🫤