How to Find and Choose the Best CPAP Masks to Treat Sleep Apnea

1
Choose a mask style that suits your needs.

Select a CPAP mask style that appeals to you to optimize your experience with CPAP therapy for sleep apnea
Select a CPAP mask style that appeals to you to optimize your experience with CPAP therapy for sleep apnea. Brandon Peters, MD

If you have been diagnosed with sleep apnea, the next step will be to start treatment, and if this includes continuous positive airway pressure (CPAP) you may wonder how to find and choose the best CPAP masks. The options available to you are numerous, but before becoming overwhelmed you can follow a few simple guidelines.

In general, CPAP is meant to provide a constant stream of air that supports your upper airway and keeps it open, thus preventing apnea and snoring. This air may be delivered through your nose, mouth, or both, and the preference may depend on your individual needs.

Most people use a mask that delivers air through their nose. Most nasal masks consist of a triangular-shaped gel or plastic cushion that covers the nose and rests from the bridge of the nose to just below the nostrils. Attached to this will be a headgear, often consisting of fabric, Velcro, or plastic clips that secures the mask to your face. Finally, there will be a plastic hose attaching the mask to the CPAP machine itself.

There are many variations of masks, usually consisting of some combination of ingenuity and marketing. Many masks also have a brace that relieves pressure by adding a few contact points on the forehead. There may be added cushions or seals to prevent marks on your face or leaks. Some masks are even designed to float on a cushion of air.

Still other distinct options are available. One consists of nasal pillows, which typically are plastic inserts that look like headphone earbuds that are inserted in the nostrils. These are an excellent option if you struggle with claustrophobia or don’t like the mask leaving marks on your face. They may not be everyone’s comfort choice, however.

Some other masks are large enough to cover both the nose and mouth, which can compensate for those who mouth-breathe. This can prevent dry mouth. There are even masks that cover the entire face, including the eyes. Other mask interfaces act like a mouthpiece, and can correct jaw positioning while delivering CPAP treatment.

2
Get fitted with the appropriate size.

Make certain that your CPAP mask is properly fitted to reduce air leak and compromised CPAP therapy
Make certain that your CPAP mask is properly fitted to reduce air leak and compromised CPAP therapy. Brandon Peters, MD

Most people are fitted with a mask in the context of a sleep study, sometimes called a titration study. The purpose of this study is to introduce you to CPAP, present you with a few of the mask interface options, find the proper size, and allow you to try it out while the pressure setting is determined.

The staff who run sleep studies often have a favorite handful of masks that work well for most people. Chances are they will try these out on you first. Don’t be afraid to ask for other options, and—more importantly—don’t be afraid to ask for a different size. Whether at a sleep study, sleep clinic, or at the durable medical equipment provider that is supplying your equipment, they should be willing to help you out.

Most mask interfaces come in a spectrum of sizes, and these depend on the manufacturer. There may be plastic sizing templates available. Some masks may have intermediate sizes such as “medium-small” and helpful accommodations like “wide.” Try to select a mask that is large enough to allow adequate air delivery. Avoid over-sized masks that may be prone to shifting on your face or excessive leaking.

Make certain to try it on while its attached to a machine delivering your level of air pressure. Put on the headgear and get the full experience. Try to replicate real-world use the best you can before you take it home and realize that when you lie on your side the thing leaks like a sieve, or when you strap it in place the pressure across the bridge of your nose is intolerable.

3
Use the accessories that can make compliance easier.

Chinstraps, mask liners, and other accessories can improve the use of CPAP masks and optimize therapy
Chinstraps, mask liners, and other accessories can improve the use of CPAP masks and optimize therapy. Brandon Peters, MD

Aside from getting the proper style and fit, you may also want to explore some of the other CPAP accessories that make treatment easier to tolerate.

The headgear that is used to secure the CPAP mask to your head can have as varied features as the mask interfaces. Many are made of fabric that is machine-washable. Some may have Velcro to customize the fit. Others may have plastic quick-release clips that allow you to fit it properly once, and then take it on and off easily. This way you don’t have to constantly adjust and readjust to find the perfect fit every time you use it.

If you are finding yourself breathing through your mouth, you may need to try a chinstrap.

Most people benefit from using a heated humidifier attached or built into the CPAP machine to moisten the air. There is also heated tubing that prevents moisture or condensation in the tubing.

If you have trouble tolerating the pressure as you fall asleep, you may want a machine that has a ramp function that starts at a low pressure and then builds up to your treatment pressure over a set period of time.

If the plastic bothers your skin, or if you are having trouble getting a good seal with excessive air leak, you may want to look into using a mask liner. There are also pads and cushions that can improve the fit of the mask.

There are many convenient options available to you, and these can make your life better and the chance of you complying with the treatment more likely.

4
If things are not working, address the problems early.

Get help if your CPAP mask is not working to optimize your compliance to CPAP therapy
Get help if your CPAP mask is not working to optimize your compliance to CPAP therapy. Brandon Peters, MD

If you run into problems early or aren’t seeing a benefit, you are less likely to want to keep it up. Therefore, it’s important to address problems early or you may feel like giving up.

If your mask is the wrong size, if it leaks too much, if it leaves sores or marks on your face, or you have any of the numerous other problems associated with CPAP use, get help. You may need to talk to your equipment provider or your sleep doctor to get things fixed. Remember that you are a valued customer and they are running a business, so if they aren’t willing to help you out, find someone else who will.

Finally, keep your equipment clean by following the cleaning guidelines and replace things as they wear out. Most insurance policies will cover regular replacement of CPAP equipment, including masks, so look into how often you can update yours.

CPAP can make a profound difference in your life and health, and getting off on the right foot by selecting the right CPAP mask can make all the difference.

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