CPAP mask problems: Is it just a bad fit or time for a replacement?


Critical to using continuous positive airway pressure (CPAP) to treat obstructive sleep apnea (OSA) is the way your mask fits.

A leaking CPAP mask compromises the quality of your treatment; optimal therapy depends on a secure seal between the mask and the face.

Leaks out of the tops, the sides, or the bottoms of masks can make the pressurized air treatment provided by CPAP machines (commonly called sleep apnea machines) less effective or even ineffective.

(Remember, a leak around the vent where the hose attaches to the mask is actually supposed to occur; this is where your exhaled carbon dioxide is released from the mask). 

If your CPAP mask leaks, it could be for a number of reasons. In some cases, adjustments can improve fit. In other cases, you may need to replace your current mask with a new one. 

Check out the following CPAP tips to uncover causes and solutions for poor-fitting CPAP masks.



When a CPAP mask leak can be fixed

Usually a mask leak signals poor fit.

The best way to achieve a good fit is to try it on before you connect the hose or turn on the machine. It's far more comfortable to fit it by this approach, as the incoming pressure may "tweak" the way your mask fits in a way that encourages leaking.

Even better, try the mask on by fitting it comfortably using the adjustable headgear, then recline as if you are going to bed. Only then should you add the hose and turn on the air flow. This most closely mirrors the posture and architecture of the face during sleep and will help you achieve the most accurate fit.

Don't worry if you don't get it right at first. Everyone experiences "mask burps," funny sounds that tell you your mask is not fitting well. Take your time and be patient. Use a mirror if you have to. Getting your mask to fit correctly is worth the extra effort. 

Sometimes it's just a matter of making adjustments to your mask fit in order to solve CPAP problems related to leaks.

When a CPAP mask leak can't be fixed

Sometimes your CPAP problems are a matter of using the wrong mask for your needs or because it has become damaged in some way, or even because of normal wear and tear.

How to improve leak issues

Consider the following suggestions if you are attempting to troubleshoot your CPAP leak problem. 

  1. If you can't resolve your problems with positioning of the mask, you may wish to try lying down in sleeping position when you put the mask on; your facial muscles move and relax in this position, and your mask may better seal while reclined. If this doesn't help, contact your DME for further support.
  2. If you can't resolve your problems with headgear adjustments for best mask fit, contact your DME for advice about fixing leak issues. If the mask simply does not fit your facial landscape appropriately, this might mean you need to get a different style, shape, or size.  
  3. If you do not want to shave the facial hair that may be causing a break in the mask seal, you may wish to contact your DME about finding a different mask that will work even with facial hair.
  4. If you cannot help your oily or sweaty complexion, contact your DME. They might be able to help you with some solutions that can help improve mask seal for those with skin concerns that result in more than usual sweatiness or oiliness.
  5. Those who wear nasal pillows or a nasal mask who are "oral breathers" should consider either adding a chin support to gently coax the mouth closed so that your breathing takes place only in and out through the nose, or consider swapping your mask out for a full-face mask, which allows for mouth breathing. 
  6. If you wear a nasal or full-face mask and it leaks out the bridge of the nose (at the top), this might signal a poor fit. You will need to contact your DME to discuss whether you need to move to a smaller size or to a different style of mask altogether to eliminate this leaking problem.
  7. If you can see obvious damage to the mask components leading to air leaks, contact your DME so they can either find replacement parts or issue you a brand-new mask. 
  8. If you've had your current mask with cushion for at least 3 months and are only now having troubles with leak, this may just be simply a normal wear-and-tear concern. Contact your DME to see what they recommend for CPAP mask replacement and what your insurance carrier will reimburse for.


If you really can't identify why you have a problem, that's okay. Simply call your DME provider (the specialist who provided you with your mask and machine kit) to get some advice and support. 

We are prepared to help all of our patients with any CPAP problems they have. Call our direct line at Sound Sleep Health (425.279.7151) to talk to a DME provider about any challenges you're encountering.

You can also sign up for our free patient portal at to make interaction with Sound Sleep Health even more convenient. 

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