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Which CPAP Mask is Best for Me?

Tracy R. Nasca

With dozens of different mask choices, how can we determine which mask to choose?

Mask Types

Traditional Nasal Masks

Nasal masks are the most common interfaces used by patients and are typically triangular in shape and cover the nose. Most have additional forehead braces with pads that lay above the eyebrow area to add stability. This mask works best for patients who sleep with their mouths closed and are able to inhale and exhale well through their nostrils only.

Components include a hard plastic like frame which holds a softer inner cushion that lies against the face. Head gear consists of the straps and sometimes a forehead brace.

Nasal Pillow Masks

Nasal pillow masks have gained great popularity in past years. They work best for patients who sleep with their mouths closed and are able to inhale and exhale well through their nostrils only. They are a better choice for patients who have a narrow nose bridge or short face and have difficulty with Nasal Mask fit and leak in to the eye area. Since nothing lays above the nostrils, nasal pillow masks work well for patients who may otherwise be intimidated by the size of traditional nasal masks or have claustrophobia issues.

Components include a frame which holds the soft nasal pillow cushions which attach to strapped head gear.

Full Face Masks

Full face masks cover both the nose and the mouth. They are prescribed for patients who are mouth breathers.

Components include a hard plastic like frame which holds a softer inner cushion that lies against the face. Head gear consists of the straps and sometimes a forehead brace.

About Mask Sizing

There is no industry standard for mask sizing and so brand to brand and even within manufacturers, sizing can greatly vary. It is vital that we try on masks to know what size we need. Sizing choices can be found to include petite, extra small, small, medium, large and extra large. Many masks today come with a variety of mask cushion sizes within the packaging which takes the guess work out of the decision making process. Most masks include the strapped headgear which comes in “one size fits most” however smaller and sometimes larger sizes are available upon request or special order to accommodate those patients with a small or large head circumference.

Size Up Your Face

Most manufacturers offer sizing gauges for each of their mask products. These are useful as a starting point in determining mask size but not always completely accurate due to other variables with each of our individual facial features.

Facial features to consider when choosing a mask are: length of the nose from nose bridge to base, width of nose base, width of nose bridge; surface area of upper lip (the skin between the base of your nose and your top lip), distance between eyes and overall circumference of the head.

Consider that nasal masks and nasal pillow masks rest on the upper lip so pay particular attention to this area of the face when trying on masks. The base of the frame should not touch the top lip.

Mask Fit and Adjustment

After you have chosen the best mask size and style for your face, you must adjust it properly before sleep. Sit on your bed, turn machine on, and place mask on your face with straps loose. Lay down in your sleeping position with your head on your pillow as you would normally sleep. Slowly pull the straps JUST UNTIL you get a good seal.

Seating a Dual Cushion Mask

If your mask has a dual cushion, it will need to be “seated”. After you have fitted and adjusted your mask using the steps above, to “seat” gently pull the mask straight out and away from your face to allow the dual cushions to inflate properly. Lay the mask gently back on your face.

Don’t Expect Perfection

If you shop wisely, and try on a variety of masks, you should be able to find the best possible mask choice for your face. Know that all masks can and do leak, but usually, this occurs when we change positions during sleep and that just cannot be helped. We have little control over what we do in our sleep! Your CPAP and mask provider can help you in your search for the best mask choice, but you need to take responsibility to keep them informed as to what works and what does not. Ask your supplier about 30 day mask exchange programs that allow the patient to try a mask at home for up to 30 days with the option to exchange for another mask in the event it does not work well.

The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Contact your physician or health care provider when you have health related questions. Never disregard or delay medical advice because of information you have obtained on this site.