Having a dry mouth with positive airway pressure (PAP) to treat sleep apnea is common.. Some people even stop using their CPAPs or bilevel PAPs because dry mouth can be so significant.
Having a dry mouth with PAP is typically due to one of the two following causes:
During the night many people breath through their mouths instead of exclusively through the nose. Breathing through your mouth will allow air to blow out through the mouth. People with mouth breathing often have difficulties breathing through the nose and will compensate by breathing through the mouth.
PAP mask leaks
Below are 11 changes you can make that may help with a dry mouth when using PAP:
1. Use your PAP humidifier and try increasing the humidifier setting.
2. Resolve PAP mask leaks.
Ensure that you PAP mask is fitting well. Your mask has a “physiologic” (or purposeful) leak often on the front of the mask to allow the air you exhale to be released. However, leaks where the mask rests against you skin could be causing problems. If you are experiencing mask leaks, you first should review the instructions to ensure that you are putting it on correctly. If you are still experiencing problems you should talk to your medical equipment company that manages your PAP machine. They may want you to come in for a mask refit to ensure the mask fits well and that you are wearing it properly. You may need a different mask, different size, or may need further instruction on how to properly apply the mask. Additionally, some people tighten the mask too much, which actually causes more leaks.
3. Treat nasal congestion/obstruction if present.
If you have difficulties breathing through your nose, you are likely to breathe frequently through your mouth during sleep, increasing the risk for a dry mouth. Many different reasons exist why you may have difficulties breathing through your nose, including inflammation or swelling of the tissues in your nose due to allergies or other causes, deviated nasal septum, or chronic sinus problems. If you are having difficulties breathing through your nose, talk with your doctor for further evaluation and management.
4. Consider trying a chin strap.
A chin strap is an extra device you put around your head to help keep your mouth closed while you sleep. You can check with your medical equipment company/PAP supplier or insurance to see if your insurance will cover the cost. Most PAP suppliers can order a chin strap for you; however, if you don’t like what they offer, there are many chin straps available online.
5. Switch to a full face mask.
If you are using nasal pillows or a nasal mask, consider switching to a full face mask that covers the nose and mouth. Although you may still experience a dry mouth if you are mouth breathing during sleep, a full face mask helps some by also blowing in humidified air through the mouth if you open it. Talk to your medical equipment company/PAP supplier if you think you may benefit from a full face mask.
6. Stay well-hydrated.
The minimum recommended amount of water for most people per day is at least 64 ounces of water and some people need much more than that.
7. Make sure you are not on a medication or have a medical problem that can cause dry mouth.
If you are experiencing a dry mouth throughout the day (and not just related to your PAP use), you may be on a medication or have a medical problem that can cause dry mouth. Talk with your doctor if you think the dry mouth is not just due to the PAP machine so that you can be evaluated further.
8. Try a room humidifier.
Since the PAP machine is pulling in air from your room, sometimes using a room humidifier may help, especially during the winter months when the air is drier.
9. Quit smoking.
Smoking can worsen dry mouth.
10. Consider trying an over-the-counter remedy for dry mouth.
There are many options available including sprays, mouthwashes, lozenges, and even toothpaste. The following are a few affiliate links from Amazon.com with highly rated products for dry mouth: XyliMelts, Biotene Mouthwash, Act Dry Mouth Lozenges, Biotene Mouth Spray. As with any product, please read the label and review potential side effects before buying to determine if the product is right for you – if you are uncertain, please ask your doctor.
11. Follow up with your sleep doctor to see if a lower PAP setting can be used.
If you’ve tried the above but are still experiencing issues, talk with the doctor managing your sleep apnea to see if a lower PAP setting can be used and still effectively treat your sleep apnea. When the machine is at a lower setting, it blows in less air, which means less air going through your mouth and less dry mouth. Your sleep doctor can also talk with you about alternatives to PAP to treat sleep apnea, where you may have less dry mouth.
As you can see, there are many remedies for a dry mouth. Don’t give up on treating your sleep apnea.
Remember to never drive or engage in activities requiring a high level of attention when drowsy.