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The Best CPAP Mask: Pros and Cons of 3 Different Styles

Your success with using CPAP relies on how well your new CPAP mask fits.Before you choose your first one, here’s an overview of the types available and the pros and cons foreach type.

They include nasal pillows, nasal mask, and or a nasal(or full-face) mask.

Nasal pillows

This is the smallest form of CPAP mask. The soft cushions of nasal pillows rest right at the opening to the nostrils; they are held in place by small, soft headgear. The air pressure generated by the CPAP machine enters your airway through these cushions.

Advantages of nasal pillows include:

  • the minimalist, ultralight design. There is considerably less headgear to strap on with nasal pillows

  • If you don’t like materials touching your face, you may prefer this mask design, which appeals to those with claustrophobia

  • ease of use for those who wear glasses or like to read or watch TV at bedtime, due to a nearly unobstructed field of vision

  • less problems with leakage because airflow to the upper airway is direct

  • secure fit for users who toss and turn

  • best fit for those with heavy facial hair, which can interfere with mask seal

Disadvantages of nasal pillows include:

  • discomfort for users who use therapy with higher prescribed settings, due to the direct nature of the pressurized air delivery

  • nasal dryness and nosebleeds caused by CPAP use

  • issues with loss of seal caused by oral breathing (breathing through the mouth). The seal must remain snug so that you receive adequate therapy

For this last concern, a chin support may be added to the headgear to help address oral breathing.

Nasal mask

This is the most common form of CPAP mask. While not as small as nasal pillows, the nasal mask is still fairly small. The mask rests over the nose and against the cheeks and upper lip. It is held in place with headgear that attaches to the mask at the forehead and sides of the face. The CPAP machine sends pressurized air into the mask, which surrounds your nose before you inhale it.

Advantages of using a nasal mask include:

  • comfortable delivery of pressure due to its less direct nature

  • better tolerance by users with higher pressure settings

  • more choices for shapes that can fit your specific facial profile

  • secure “seating” on the face, meaning it remains sealed even if you are an active sleeper

Disadvantages of using a nasal mask include:

  • the chance of a broken seal caused by oral breathing

  • irritation to the bridge of the nose or the forehead due to contact pressure from the mask frame or cushion

  • discomfort for those who have frequent allergies, hay fever, sinus infections, or head colds

  • difficulty breathing for those who have enlarged turbinates, narrow nasal passages, or deviated septum

As with nasal pillows, a chin support may be added to the headgear of a nasal mask to help address oral breathing.

Oronasal or full-face mask

The largest CPAP mask currently being used is the oronasal or full-face mask. The full-face mask resembles the nasal mask, but it is long enough to cover both your mouth and nose. It’s also held in place with the same style of headgear used for nasal masks. Instead of pressurized air circling your nose, it traps a pocket of pressurized air that both the nose and mouth can inhale.

Advantages of using a full-face mask include:

  • relief for those who breathe through their mouths

  • a more comfortable interface for users with congestion problems or nasal obstructions

  • comfort for those with claustrophobia; though the mask is larger, it covers the entire face and may be less noticeable for some users

  • excellent performance for users with high CPAP settings, as the wider surface area disperses pressurized air more comfortably

  • optimal seal for those who prefer to sleep on their backs

  • added headgear support for restless sleepers who move around at night

Disadvantages to using a full-face mask include:

  • more chance for mask leak due to increased contact with the skin

  • fit issues at the top of the mask, which may release air into the eyes, causing dryness and irritation

  • added weight and material, which may contribute to less comfort

  • problems using for those who wear glasses or read or watch TV while in bed

  • the inability to sleep comfortably on the stomach

To best prepare for your visit at the sleep center to select a CPAP mask, keep these considerations in mind, try on as many as are available to you, and remember that the success of your therapy will ride on the comfort level of the mask you choose.

But don’t worry if, after a couple of weeks, you find the mask you’ve chosen isn’t working for you. Contact your sleep specialist and let them know. After a few weeks of user experience, you will have a better idea what you need.

You may also consider visiting a sleep apnea support group to learn some tips from real-world users for how to make your current CPAP mask work for you.

Whatever you decide, a quick follow up with your sleep medicine team should result in finding a mask that best suits you.

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