Sleeping on your side


Recently, I have gotten several messages that the seal on my CPAP mask is not good enough. I haven’t changed the sit on my mask. I was wondering if sleeping on my side may be effecting the fit of the mask.


If your mask is fitting properly, sleepng on your side should not affect the seal. What type of mask do you have, and how old is the interface?


I am using a AirFit P20 full face mask with a standard cushion. Have been using it since the first week of Feb. 2018.


I had the same problem with the Airfit N20. My doctor’s office first switched me to using the smaller Airfit N20 Women’s Pink Headgear, which did fit my head better. But I was still getting very bad results in the myAir app for mask leaks. So, she next switched me to the Fisher&Pykel Zest-Q, which is of a similar design. This mask has very thin, flexible plastic arms across the cheeks instead of the thicker, non-flexible plastic arms that the Airfit N20 has & she said this seems to be the fault with the Airfit N20 mask when used by people who sleep on their sides (even if it seems to be tightened as much as possible, which can also be the problem - I had tried doing that, too, several weeks into using this mask when I consistently wasn’t getting good mask fit results in the myAir app, & though I don’t remember why she said that can also contribute to this problem, I know I continued to get very bad mask fit results in the myAir app).

The other thing she said is that since the nose mask for the Airfit N20 mask is somewhat rigid, this might also be why it’s not sealing well; the Airfit N20 nose mask just doesn’t conform to the shape of your cheeks around your nose, whereas the F&P Zest Q has a softer foam insert inside the very thin silicone outer part of the nose piece & that causes it to conform with the shape of your face contours.

Although I have to say that I really miss the Airfit N20’s magnet strap release feature & that I don’t especially like the pad that fits against my forehead that the F&P Zest-Q has (think morning forehead marks instead of cheek marks), if you like this kind of nose mask, you might give the F&P Zest-Q a try. I have been getting excellent results for mask fit in the myAir app & the headgear does fit my face & head well. It’s also very comfortable to wear (except for the forehead part initially, but you will adjust to that in no time at all).

One thing I must caution you about the F&P Zest-Q beforehand, though, is that you have to remove the foam inner nose cushion before washing the mask every day, but this is easy to do & easy to reinsert. The reason I tell you about this is that when it came time to reorder the mask (I bought the 1st one directly from my doctor’s office, so this was the 1st time I ordered it from the supplier), the supplier didn’t say a single word of caution about removing the foam insert before washing, & unless you read every single word on the cleaning instructions (which some people don’t do), you can ruin the mask before you even wear it for the very 1st time.

Also, If you have silicone irritation like I do, you’ll still have this with the F&P Zest-Q nasal mask, since it, too, is made out of silicone like all other masks are. My doctor’s office has me trying a (universal, I think) nose mask pad made by Naturs Design, Inc., which I don’t recommend. It’s too big & slightly obstructs my breathing (even after making adjustments to the fit) & if you go with this nasal mask pad, you will probably have to cut it to adjust for fit & comfort. I’m going to try the Pad-A-Cheek nasal mask pad next to see how that one fits with the F&P Zest-Q mask. But if you already have invested in mask pads for the Airfit N20 nose mask, I would assume they would fit the F&P Zest-Q nasal mask, too, but you’ll need to ask the manufacturer about it to be absolutely sure about this.


Thanks! You have given mea lot to think about.


I assume you meant Airfit F20 if you’re using a full face mask (you stated it’s a P20, which is a little nasal pillows mask). This leads me to ask what the reason is you are using a full face mask and not just a nasal mask of some type. The full face masks can have more leakage problems than just the nasal masks.

If you can breathe with your mouth shut, you should be able to use a nasal mask. If not, there are pillows designed specifically for cpap users. Also the Mirage Quattro full face mask is an oldie but a goodie. I’ve used that mask in my sleep lab with much success.


I am curious about the Mirage Quattro full face mask. Is it the one that uses a combination of nasal pillows and a mask that covers your mouth? I am yet to get comfortable with my Airfit F20 mask. One problem is the mask seems to leak air into my eyes, leaving them dry and irritated in the morning. Looks like the Mirage mask might mitigate that.


No, the Mirage Quattrolooks like this


My error! I was actually thinking about the Mirage Liberty mask-the one that combines nasal pillows and a mask over one’s mouth. Any opinions about that one?


I’ve had more experience with the Amara View, and find it to work quite well.


Hello there Jmatish.
I will agree with kentcaylor here, the Mirage Quattro maybe an older mask but it is the best you will get for side sleeping, and as kentcaylor says if the mask is fitting you correctly you should have no problems.

Yet, through my own experiences with the Mirage Quattro mask there are some problems with the way you have your body posture, if this is not correct then you will have some leaks to your eyes, but you can remedy this, I have since being on CPAP have had all the usual problems we all seem to have, especially with leaks and pressure settings, the thing is never to give up, just keep on going despite the frustrations it may cause, I did and got my machine supplier to change me over to APAP, I also dropped the use of the ramp, and lowered my pressure settings, and it worked like a dream.

Now if you find what your happy using in the way of 1 or 2 pillows, then by using a neck pillow on top of these you will get the right support for your neck and also support for your chin, thus your chin not dropping onto your chest, it will also support your mask by allowing it to stay fitting to your face without the usual and bothersome moving of the mask as you sleep.
Also for some it could be useful to use a body pillow as well to support your back, helping to keep you on your side, ( sometimes called a nursing pillow) this also helps with not disturbing you sleep partner.

The one thing kentcaylor mentioned is that the Amara View mask is fine for him, ( he my not be a mouth breather) but for me as a mouth breather who has jaw drop it did not work at all for me and my machine supplier just told me to bin it, and go back to the Mirage Quattro.

Anyway hope this helps you, if you decide to try these things, please let me know how you got on.