Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

139 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes dry mouth while using CPAP mask every night?

Answered by
Dr.
Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

default
Posted on Mon, 4 Aug 2014 in General Health
Question: I use the CPAP mask every night. Iwake up at least 5 times during the night with extremely dry mouth

I take the following medicine nightly Micardis 40mg and Crestor Tab 20 Mg

In addition to my age 75, I am 6 feet tall and weigh 232 lbs
doctor
Answered by Dr. Shafi Ullah Khan 4 hours later
Brief Answer:
Needs a consult and management

Detailed Answer:
Thank you for asking
The two drugs you mention are telmisartan and to rosuvastatin and none of them cause dry mouth. Sleep apnea itself is a major cause of dry mouth or xerostomia. It needs a little work up and consult to your doctor to sort out the cause of dry mouth in your case.

Your BMI is roughly 32 and lies in obesity category and needs to be addressed. Obesity itself can trigger dry mouth and sleep apnea.in nutshell your troubles of obesity, sleep apnea and dry mouth seem connected and need to be dug a little further for surety.
Here are some of the general measures for dry mouth management.

-regular sips frequently up to 2 litres of water a day minimum to keep mouth hydrated.
- Avoiding the medicines and where not possible replacement with some less xerostomic drugs, consulting with your urologist will help.
-avoid irritants such as smoking, alcohol and caffeine intake.
-keep good oral hygiene, treat oral candidiasis or caries precautions to stay safe as dry mouth predisposes to oral troubles, stay in touch with the dentist for further oral management.
-Anxiety and stress should be avoided as they themselves are causative agents.
-Try some salivary substitutes as Artificial saliva can provide relief of dry mouth. They are manufactured with a neutral pH and contain electrolytes that approximately correspond to normal saliva. They are either mucin or methycellulose based preparations. The mucin based products are better tolerated and have a longer duration of action. Preparations are available in the form of sprays, gel and lozenges.
-Mouth washes with garlic water etc.
-Try salivary stimulants , here are some
a-Chewing Gum
Sugar free chewing gum increases and promotes salivary flow by stimulating taste receptors, and its use is usually not associated with side effects. A combination of regular mouthwash and chewing gum is proved helpful.
b-Ascorbic Acid (Vitamin C)
Vitamin C tablets are used to treat xerostomia/ dry mouth  in palliative care. In a study, the effectiveness of ascorbic acid was compared against artificial saliva and other stimulants in patients with xerostomia. Vitamin C was shown to be subjectively more effective than artificial saliva, but less effective than other salivary stimulants. The main disadvantage of using ascorbic acid long term is its detrimental effect on teeth enamel.
c-Malic Acid
Malic acid is effective in the treatment of xerostomia and is naturally found in fruits such as pears and apples. Its main disadvantage is that it causes demineralisation of teeth enamel, which limits its long-term use.
d-Pilocarpine
Pilocarpine is a muscarinic receptor agonist and has been shown to improve symptoms of xerostomia.It is available as 5 mg tablets and can be administered up to a maximum dose of 30 mg/day in divided doses. The effects of Pilocarpine are usually immediate; The increase in saliva production generally lasts for 4 h. Its undesirable side effects include perspiration, flushing, lacrimation, urinary frequency and gastrointestinal disturbances. As a result of its cholinergic effect, it is contraindicated in patients with asthma, chronic obstructive airway disease, heart diseases, epilepsy, hyperthyroidism and Parkinson’s disease..
e-Other Parasympathomimetic Drugs
carbachol. pyridostigmine,Cevimeline etc are proved helpful.
f-Radiprotectants
Cytoprotective agents such as amifostine have shown to minimise tissue damage secondary to radiotherapy and decrease the incidence of radiation-induced xerostomia
g-Acupuncture
Acupuncture as a treatment for xerostomia is increasingly being recognised in the West. In a study from Sweden, subjects who received traditional acupuncture demonstrated a significant increase in salivary flow rate lasting up to a year as opposed to those in the placebo group
I hope it helps. Take good care of yourself and don't forget to close the discussion please.
May the odds be ever in your favour.
Regards
Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Drug/Medication
Treatment/Therapy

Recent questions on  Parkinson’s disease

doctor1 MD

My husband had a pre-op ECG (hasn’t had one in years) which was read as abnormal. Here’s the text of the reading: “ Sinus rhythm , normal P axis, V-rate 50-99. Left anterior fascicular block , axis (240, -40), init forces inf, no previous tracing...

doctor1 MD

Over the past 3 months I have had episodes of waking in night with total body tremors. Total of 4- the last was this past Sun. night- much more intense-next day I felt total exhaustion and had a headache-never have headaches . I have a Dr's appt....

doctor1 MD

I have fatigue, headaches , anxiety but the main thing that is new is tremors, it feels like the earth is moving under my feet, it first happened when I was sitting down in a chair, but now it happens often while I try to sleep, one night it felt...

doctor1 MD

I am a young man, just turned 31 years old. About a year and a half ago, I started to develop a slight tremor in my left forearm/hand. Over time, the tremor has gotten more exaggerated. Just recently I have noticed that my left lower leg/foot has felt heavy and stiff and I cannot move or rotate my foot as well as my right one. I have jogged a couple of times recently and although, while running I was okay, afterwards, this caused lower back ankle/foot pain. When I stand or walk for an extended period of time, I have pain in my lower back and ankle/foot. Sometimes when turning my head quickly, I get a pinching type pain in my neck on both sides of my neck. When I sleep, the tremor goes away. When I wake up with the sensation of pins-and-needles in my arm from sleeping on it, although it is numb, as it normally would be, I have complete use of my hand and fingers, normal dexterity, without the tremor, until normal feeling comes back, usually up to about 5 minutes. The more relaxed I am, it seems, the less the tremor. But the stiffness or lack of dexterity of my fingers stays the same. Also, a drink or two of alcohol suppresses the tremor. As a twelve year old, I had scoliosis surgery, placing rods in my back, from “T-4 to the end plate of T-10 and T-11 through L-3’. Also, about 10 years ago, from a target shooting gun accident, I have a .22 caliber bullet fragments remaining in my upper left arm. At first, we thought the bullet fragments were the cause since only my lower left arm was affected but since the EMG shows normal nerve conductivity and now that my left leg seems to be affected we don’t think this is a factor.. I was told, when I had the scoliosis surgery that possibly, down the road, I could experience problems from my neck. Currently, as stated earlier, I get some neck pain and stiffness and lower back pain. Earlier, in the summer, after doing some strenuous yard work, I had acute lower back pain that lasted for several weeks. I took Skelaxin, a muscle relaxer, which helped. This is the first time I have ever had that extensive pain in my back. We have been to several different neurologists, without much success. I have had a brain MRI done, a neck MRI, 2 different EMG’s, extensive blood work and an EEG done as well. All reports are included. You will see that the Brain MRI shows normal. The EMG shows that the nerves and muscles of my lower arm are normal. The blood work and EEG are normal as well. The Neck MRI is, we believe now is the area of focus, as the report says that I have “significant reversal of the cervical lordosis and a moderate to large, right sided disc herniation at C6-C7. The neck problems seems to have been overlooked to date by doctors as originally, the diagnosis was that I had an anxiety related tremor because when I concentrated on something else, the tremor went away, briefly. Also, there was some concern from just one of the doctors that it may be Parkinson’s disease. However, most of the doctors felt that the frequency of the tremor, 10 Hz doesn’t suggest it. Also, in trying Cararbidopa-levodopa, 25-100MG tablet, which should have stopped the tremor, if it was Parkinson’s, did nothing but made me nauseous. It had no affect on the tremor. Speaking of medicines, to date, I have been prescribed the following medications with literally no results. Starting from earliest date to most recent…      Trihexyphenidyl – 2MG, taken twice daily – (this made me dizzy, headachy,weak.)      Pramipexole Dihydrochloride, (Mirapex) - .5MG, taken 1 tab, 3 times daily – (this caused       diarrhea)      Lorazepam - .5MG, taken one tab, twice daily. (this lessened the tremor slightly for just a day or two but it kept me awake).      Carbidopa-Levodopa – 25-100MG, taken 1 tab, three times daily, (Made me very       Nauseous, with no affect).      Clonazepam - .5MG tab, taken 1 tab, twice daily. (no affect) Amantadine – 100MG, taken 1 tab twice daily. (Lessened tremor for just a day or tow but then made me nauseous, headachy).      Propranolol – 20MB tabs, taken 1 tab daily. Since there was no affect, this was       Increased to 3 tabs, 3 times daily. (No affect at either dosage).      Prednizone – Tried a metered dose pack to see if it would reduce inflammation hoping       to reduce the tremor some. (There was no significant affect).       I am currently not taking any medications other than occasional Advil for pain in my lower back and neck stiffness. Additionally, I tried acupuncture for 8 appointments. While on the table, relaxing, the tremor went away, then, after getting up, the tremor came back. my newest mri of my neck is:c2-c3: unremarkable c4-c5: posterior disc bulge. Mild left uncovertebral hypertrophy. No significant central or foraminal narrowing. c5-c6: Mild posterior disc bulge. Mild right neuroforaminal narrowing. central canal is patent. c6-c7: Small right foraminal disc herniation and eccentric right uncovertebral hypertrophy causing moderate right neuroforaminal narrowing. this effaces the ventral thesal sac. there is no significant central spinal stenosis

doctor1 MD

I am a young man, just turned 31 years old. About a year and a half ago, I started to develop a slight tremor in my left forearm/hand. Over time, the tremor has gotten more exaggerated. Just recently I have noticed that my left lower leg/foot has felt heavy and stiff and I cannot move or rotate my foot as well as my right one. I have jogged a couple of times recently and although, while running I was okay, afterwards, this caused lower back ankle/foot pain. When I stand or walk for an extended period of time, I have pain in my lower back and ankle/foot. Sometimes when turning my head quickly, I get a pinching type pain in my neck on both sides of my neck. When I sleep, the tremor goes away. When I wake up with the sensation of pins-and-needles in my arm from sleeping on it, although it is numb, as it normally would be, I have complete use of my hand and fingers, normal dexterity, without the tremor, until normal feeling comes back, usually up to about 5 minutes. The more relaxed I am, it seems, the less the tremor. But the stiffness or lack of dexterity of my fingers stays the same. Also, a drink or two of alcohol suppresses the tremor. As a twelve year old, I had scoliosis surgery, placing rods in my back, from “T-4 to the end plate of T-10 and T-11 through L-3’. Also, about 10 years ago, from a target shooting gun accident, I have a .22 caliber bullet fragments remaining in my upper left arm. At first, we thought the bullet fragments were the cause since only my lower left arm was affected but since the EMG shows normal nerve conductivity and now that my left leg seems to be affected we don’t think this is a factor.. I was told, when I had the scoliosis surgery that possibly, down the road, I could experience problems from my neck. Currently, as stated earlier, I get some neck pain and stiffness and lower back pain. Earlier, in the summer, after
chris ::: doing some strenuous yard work, I had acute lower back pain that lasted for several weeks. I took Skelaxin, a muscle relaxer, which helped. This is the first time I have ever had that extensive pain in my back. We have been to several different neurologists, without much success. I have had a brain MRI done, a neck MRI, 2 different EMG’s, extensive blood work and an EEG done as well. All reports are included. You will see that the Brain MRI shows normal. The EMG shows that the nerves and muscles of my lower arm are normal. The blood work and EEG are normal as well. The Neck MRI is, we believe now is the area of focus, as the report says that I have “significant reversal of the cervical lordosis and a moderate to large, right sided disc herniation at C6-C7. The neck problems seems to have been overlooked to date by doctors as originally, the diagnosis was that I had an anxiety related tremor because when I concentrated on something else, the tremor went away, briefly. Also, there was some concern from just one of the doctors that it may be Parkinson’s disease. However, most of the doctors felt that the frequency of the tremor, 10 Hz doesn’t suggest it. Also, in trying Cararbidopa-levodopa, 25-100MG tablet, which should have stopped the tremor, if it was Parkinson’s, did nothing but made me nauseous. It had no affect on the tremor. Speaking of medicines, to date, I have been prescribed the following medications with literally no results. Starting from earliest date to most recent… Trihexyphenidyl – 2MG, taken twice daily – (this made me dizzy, headachy,weak.) Pramipexole Dihydrochloride, (Mirapex) - .5MG, taken 1 tab, 3 times daily – (this caused diarrhea) Lorazepam - .5MG, taken one tab, twice daily. (this lessened the tremor slightly for just a day or two but it kept me awake). Carbidopa-Levodopa – 25-100MG, taken 1 tab,
chris ::: three times daily, (Made me very Nauseous, with no affect). Clonazepam - .5MG tab, taken 1 tab, twice daily. (no affect) Amantadine – 100MG, taken 1 tab twice daily. (Lessened tremor for just a day or tow but then made me nauseous, headachy). Propranolol – 20MB tabs, taken 1 tab daily. Since there was no affect, this was Increased to 3 tabs, 3 times daily. (No affect at either dosage). Prednizone – Tried a metered dose pack to see if it would reduce inflammation hoping to reduce the tremor some. (There was no significant affect). I am currently not taking any medications other than occasional Advil for pain in my lower back and neck stiffness. Additionally, I tried acupuncture for 8 appointments. While on the table, relaxing, the tremor went away, then, after getting up, the tremor came back. my newest mri report says: c2-c3: unremarkable c4-c5: posterior disc bulge. Mild left uncovertebral hypertrophy. No significant central or foraminal narrowing. c5-c6: Mild posterior disc bulge. Mild right neuroforaminal narrowing. central canal is patent. c6-c7: Small right foraminal disc herniation and eccentric right uncovertebral hypertrophy causing moderate right neuroforaminal narrowing. this effaces the ventral thesal sac. there is no significant central spinal stenosis

doctor1 MD

sir mi aunt is suffering with Parkinson disease since 6 years and now she is having D.B.S the main problem with her is highly edicted to medicines and she is consuming over dosage even though not required and always thinking about medicines and nothing else. now she is using syndopa plus 1/4th tablet for every 2 hrs in between 6.am-9.pm pramipex 0.5mg thrice a day,zolfresh 5mg at 9.am & 5mg at bed time,mitraz 15mg at bed time. i request you to suggest to control her over thinking about the medicines and ediction to medicines. thnak you....

doctor1 MD

I want to discuss about my grand father Age 85: Suffering from Parkinson disease for the last 20 years his joint and muscles have become rigid.he is completely on bed.pampers are applied to him. till 4-5 days before he was ale to sit and talk but now he can hardly talk and also feeling difficulty in swallowing .we are giving him liquid food but with great difficulty.we can hardly understand what he wants to say.he was also heart patient suffering from angina and took medicines for this for a long time but now he is not taking these medicines. dementia has also developed.doctor has prescribed medicines sinemet tab and requip but of no benefit.for sleep disturbance revotril is being given to him.we want your advice and suggestion so that he may take food easily and muscles rigidity is controlled and others.here the doctor has told us that it is an old age related disease,nothing can be done,carry on nursing only.kindly guide us in detail and prescribe medicines.