Making the Proper CPAP Mask Choice

Having a CPAP machine which is correctly programmed and meets one’s needs is vitally important.  Selecting a CPAP mask is just as crucial especially for compliance. This blog post discusses CPAP mask options for sleep apnea sufferers.

Mask Size

Because there are no industry standards, sizing can vary greatly not only among manufacturers but even within the mask lines. Typically each mask line offers multiple sizes including petite, small, medium and large. However, some masks offer extra small, small wide, large wide and extra large. Although masks try to offer as many sizes as there are faces, it does tend to inject confusion into the mask choice. Once a specific CPAP mask manufacturer is decided upon, begin to understand the sizing choice amongst various masks. Every manufacturer does provide sizing templates to aid in properly sizing the face to the mask. It is critical to enlist a knowledgeable professional to assist with mask choice and sizing. The more choices available to you, the greater likelihood a properly fitted mask will be found.

Mask Types
While going through the mask choice process, make yourself knowledgeable about the different styles of masks. Manufacturers continue to add new features and offer better fits to their mask lines. It useful to come prepared for the fitting with your preferred style and mask type in mind. Of course, the choice might already be narrowed by such things as mouth breathing, facial hair, deviated septum or other specific requirements. To assist, the list of CPAP masks categories is below:

  • CPAP Nasal Masks – Nasal masks are the most common interface. They cover just the nose and are triangular in shape. Nasal masks typically have a forehead piece which aides in stabilizing the mask during sleep. These masks have a variety of cushions including gel filled, silicone, air filled and even dual walled. The cushion lies against the face and the mask is synched with a headgear which typically connects at the base of the mask and the forehead assembly. Nasal CPAP masks work best for those who sleep with their mouths closed and are able to breathe through their nose without issue. However, a chinstrap can be used to alleviate mouth breathing.
  • Nasal Pillow CPAP Mask – Nasal pillow masks have gained great popularity recently primarily due to minimal facial contact and comfort. Although nasal pillow masks can work well with nearly all CPAP users, they work exceptionally well for people who have a thin or narrow nose bridge or short face and have difficulty with nasal mask fit. Since there is no forehead assembly, these masks work well for reading or watching television prior to sleep. It also helps to alleviate any mask induced sore spots and issues with claustrophobia.
  • Full Face CPAP Masks – Full face masks cover both the nose and mouth and are prescribed for CPAP users who have difficulty breathing out of their nose. This could be caused by a simple allergy or cold or as severe as a deviated septum. They are larger and more cumbersome than other masks but are effective with mouth breathers. Although, some full face masks are designed without a forehead assembly, the majority have a forehead piece to stability the mask for active sleepers. A few full face masks are also designed to rest under the chin for added stability. Some users find full face masks somewhat claustrophobic. Once that sensation is overcome, a full face mask is an excellent solution for mouth breathers.

No single mask is appropriate for everyone. Mask choice is a highly personal decision and based purely on fit and comfort. It also is worthwhile to have multiple masks in order to alleviate specific pressure points. Switching from one mask to another every other week could be a simple solution to soreness.

Final Adjustment
Once a mask is decided upon, it is best to give it a trial run prior to actually using it during sleep. Make sure it’s understood how the mask sits on the face, how it clips and unclips for easy removal and how the headgear is tightened. In fact, it is ideal to put the mask on and lay in bed as you would normally sleep. Roll from side to side and feel how the mask moves while active. Turn the machine on and experience how the mask feels with air pressure coming through the CPAP tube. For dual cushion masks, pull the mask away from the face slightly to allow for the cushion to inflate. It is important to understand that a mask is made to seal properly without much tightening. Be aware that the mask should fit snuggly but not overly tight. If the mask is pulled tightly to seal, it will begin to ache and cause soreness. At that point, it’s time for a new mask cushion or an entire mask

No CPAP Mask is Perfect but…
Guiding your mask decision on fit and comfort as opposed to price is a good rule of thumb. It is also recommended to try on as many masks as possible. Certainly, you will see reviews and get suggestions from equipment suppliers, family and friends. But unless they are an identical twin, that mask suggestion might not be right for your face. In the end, there is no perfect mask as all leak periodically especially for active sleepers. Do not worry about periodic, small leaks as many CPAP machines have leak compensation sensors which adequately increase pressure in case of a leak. But enlist the help of your CPAP equipment provider and do not settle until the best option is found. Keep in mind that a comfortable and properly fitted CPAP mask can turn a poor CPAP experience into a one you can’t sleep without.