Choosing the Best CPAP Mask: Pros, Cons, & Other Considerations

Finding the right CPAP Machine mask is crucial to continuous positive airway pressure (CPAP) therapy. With so many different mask styles, shapes, and sizes, choosing the mask that works best for you can be a little daunting at first as there’s no “miracle mask” that is best for all patients. What it all really boils down to is finding a mask that suits your own individual breathing needs, sleep habits, and comfort levels. At The Alaska Sleep Clinic we want to give you some initial key pointers and things to consider when you meet with your durable medical equipment (DME) technician as you find the perfect mask for every night use.

Three Main Categories of CPAP Mask Types

Nasal Pillow

Nasal pillow masks are among the most popular mask choices for CPAP users because of their minimal design. Nasal pillows are the smallest of the CPAP masks and rest on the user’s upper lip as it blows pressurized air through two soft nasal tubes that insert into the nostrils, and is secured by straps that go around the head.

Benefits of Nasal Pillows:

The lightweight and minimal design is ideal for patients suffering from claustrophobia or those that simply feel uncomfortable with too much material touching their face.
Optimal for wearers who like to read or watch TV before bedtime, as it offers a better field of vision than many of the other mask types.
Allows user to wear their glasses as there’s no material covering the bridge of the nose.
The direct airflow into the nasal passages reduce air leakage.
Good for active sleepers who toss and turn a lot.
Works best for users who have a lot of facial hair that may cause leakage in other mask types.

Drawbacks of Nasal Pillows:

Often not ideal for patients with higher-pressure needs, as the airflow is very direct and may cause discomfort at higher pressure settings.
Some users find the direct air pressure leads to higher incidences of nasal dryness, and in some cases, even nose bleeds.
Not ideal for mouth-breathers. If you’re not accustomed to breathing through your nose, using a nasal pillow may feel unnatural or uncomfortable. Although, if you’re a mouth-breather and really want to wear a nasal pillow, try using it in conjunction with a chin-strap.

Nasal Mask

Nasal masks are triangular in shape and fit over the nose, covering the areas from the bridge of the nose down to the upper lip. They are popular among CPAP wearers because of the wide range of sizes and fits, making finding a perfect mask for any user very likely.

Benefits of Nasal Masks:

More natural airflow than nasal pillows as the delivered pressure isn’t as direct.
Better for higher-pressure settings than nasal pillows.
Many different styles cater to a wide range of facial structures and features.
If you move around a lot in your sleep or sleep on your side, the suction of the nasal mask helps keep it securely in place.

Drawbacks of Nasal Masks:

Much like nasal pillows, nasal masks are not ideal for mouth-breathers unless accompanied by a chin-strap to keep the jaw closed.
Some CPAP wearers complain about irritation caused by the pressure of the mask resting on the bridge of the nose or the forehead supports of some models.
Not ideal for patients who frequently experience allergies or colds that cause blockage of the sinuses.
Not recommended for patients who have difficulty breathing through the nose from medical conditions such a deviated septum, enlarged turbinates, or a collapsed or narrowed nasal valve.

Full Face Mask

Buy CPAP Machine full face masks cover the nose and mouth and all, or part, of the face with side straps that keep the mask in place. Some hybrid face masks cover the mouth but also have nasal prongs that fit into the nostrils like a nasal pillow.

Benefits of CPAP Face Masks:

Face masks are ideal for mouth-breathers and those that haven’t worked well with the nasal mask/chinstrap combination.
Ideal for patients who that have nasal obstructions or frequent congestion due to allergies or cold symptoms.
Oddly enough, some claustrophobic patients have preferred the full face mask that covers the entire facial area, as the mask only touches the outsides of the face. Whereas the nasal pillows and nasal masks touch the upper lip and/or the bridge of the nose.
Works well for very high CPAP pressure settings because the wide surface area of the mask makes it feel as if the pressure is more tolerable and less direct than with other masks.
Works well for those that sleep on their back as the supine position is best for an optimal air seal. However, the added straps and support help keep the mask in place for restless sleepers.

Drawbacks of CPAP Face Masks:

Because of the larger surface area, there is a higher chance of air leakage.
Some users complain of air leakage near the top of the mask, causing dry, irritated eyes.
Most claustrophobic patients can’t tolerate the extra material and weight of the full face mask, although there are some exceptions.
Full face masks make it difficult to read or watch TV in bed or wear glasses.
If you’re a stomach sleeper, the bulk of the mask will make it difficult to sleep comfortably on your abdomen.

Things to Consider When Choosing a CPAP Mask

Size, fit, and comfort are the most import considerations when choosing a CPAP mask. If the mask doesn’t fit, isn’t comfortable, or doesn’t meet your breathing needs, it’s not likely that you will be compliant with CPAP therapy. Take the time to go over the best mask for you with your DME tech, and don’t be afraid if you change your mind later and want to try a different mask.
Make sure to tell your DME tech if you are an active sleeper so that you get the most secure mask possible.
Tell your DME tech if you are claustrophobic or if there are areas of your face that are easily irritated.
If you have facial hair, it’s important to find a mask type that won’t leak due to the uneven surface area.
If you read, watch TV, or wear glasses in bed, find a mask that allows you the best field of vision so as not to disrupt your nightly routine.
If you breathe through your mouth, you may need a full face mask or a nasal pillow/mask in conjunction with chinstraps.
As there are many different cushion types (gel, silicone, foam, cloth etc), find which is most comfortable for you.
Check to see if the mask you choose has replaceable cushion parts.