CPAP Mask Selection

The ever-growing number of CPAP models and styles can make CPAP mask selection confusing. The key is to find the best style and features for your facial shape and sleeping patterns.

There are many styles of CPAP masks available.

A variety of mask designs and headgear styles are available from all CPAP mask manufacturers. The basic mechanics of the mask are similar. Some masks provide different options to improve fit and comfort. A lighter weight mask can be more comfortable. Clips on headgear can make the mask easier to remove and replace if necessary during the night.

Selecting your first mask can be a daunting experience. You can be easily overwhelmed or uncertain about the concept of sleeping with a CPAP machine and mask. This feeling of uncertainty, coupled with wearing the mask for the first time in the doctor's of respiratory therapist's office, often makes it difficult to evaluate which mask will work the best for you.

Many people start out with a basic mask recommended by their doctor or therapist. Then, as they gain some experience sleeping with the CPAP machine and adjusting the mask, they may find that a different style might be more effective. The "starter" mask may not be adjustable enough or the headgear might be too cumbersome to remove.

You don't need a doctor's prescription to purchase a CPAP mask, so you are free to purchase any style that works for you. You can feel confident that the mask will function correctly since all masks are approved by the federal Food and Drug Administration (FDA) before they are sold in the United States.

There are basically five types of CPAP masks:

• Nasal mask – This is the commonly-used mask. It is triangular in shape and covers the nasal area.
• Full face mask – This mask is usually triangular in shape and covers the nose and mouth area. People who breathe through their mouth while sleeping will need to wear a full face mask. This is also an excellent style to have on hand to use on a temporary basis when you have nasal congestion.
• Nasal pillow mask – This mask fits under the nose (instead of over the entire nose area) and uses small rubber cones that fit into the nostrils to deliver the pressurized air into the nasal cavity. The cones seal against the outside edge of each nostril.
• Nasal prong mask - With this mask, nasal prongs are inserted into each nostril and form a seal on the inside edge of each nostril.
• Oral masks – These are mouthpieces that fit over the teeth and tongue to keep the back of the throat open for uninterrupted breathing. The mouthpiece extends the lower jaw forward and holds down the tongue.

Most masks can be used with any CPAP machine. Selecting the best mask for your needs really centers on how well the mask fits (so there is no air leakage) and how comfortable it is to wear while sleeping.

The individual characteristics of the face affect the way a mask fits. For example:

• Head and facial contours – A nasal or full face mask is rigid in construction and relies on soft silicon nasal cushions to fit tight against your face to form a tight seal.
• Length, size and shape of nose – The depth and width of a nasal or full face mask must be sufficient to avoid chafing.
• Facial hair – It is often very difficult for a mask to fit tightly over beards and moustaches. Nasal pillow masks are often the mask of choice for these individuals.
• Facial muscle reflexes – Facial muscle movement during sleep can create pressure leakage points.

Most masks are designed to fit most people. Individual customization usually comes from adjusting the mask. For example:

• Nasal and full face masks use forehead and nasal cushions to mold to the facial contours. Some mask designs also include "spacers" that can be attached to the top of the mask to adjust the tilt of the mask away from your forehead which provides a little more room for your nose.
• Nasal pillow masks with nasal pillows offer a variety of sizes, shapes and softness of nasal pillows. The pillows can be adjusted to point at the correct angle in your nose to achieve the most airflow.

Try a variety of mask styles and sizes. Adjust the headgear to determine which mask is the most comfortable to wear. Lay down with the mask on, turning left and right to simulate your sleep patterns. A respiratory therapist can quickly measure your face and determine the correct size mask. A sizing guide is also available online from cpap.com.

Some mask designs only work with lower air pressures and they may leak when used with pressure settings of 15 or more. Be sure to check the pressure capability of the mask if your pressure prescription is for 15 or more.

The most frequent mask problems are:

• Feeling claustrophobic – This is a very common complaint of new CPAP mask users. These feelings may go away after they get used to wearing the mask. If not, they may need to use a nasal pillow mask.
• Uncomfortable fit – The mask may be too small or too large for the facial contours.
• Pressure on the nose and forehead - Some users like to switch back and forth between a nasal or full face mask and nasal pillows. This helps them prevent the irritation that they may experience if they wear the same mask every night.
• Slippage or soreness from the headgear – The headgear may not be adjusted correctly. Avoid over tightening since this can cause facial chafing.
• Annoyance of air from the mask's vents – Not all mask styles vent the air in the same direction. Look for a mask that directs the air flow in the direction that works best for you and your sleep partner.
• Mask moves while sleeping – Side sleepers often find that their masks get shoved to the side while sleeping. Tightening the headgear or using a CPAP pillow will usually alleviate this problem.

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